Obesity, smoking, class and everything else

We do keep going on about the slippery slope on this blog, don't we? Still, it's called Velvet Glove, Iron Fist for a reason and I intend to go on about the slippery slope until someone learns the lessons of history.

I've written various pieces about how anti-tobacconists used to swear on a stack of Bibles that the crusade against their bête noir wouldn't lead to an attack on others (eg. this). While nonsmokers cherished their status as first class citizens, I've been giving countless examples of zealots setting their sights on those who, like Jaws in the Moonraker shuttle, are less-than-perfect themselves (eg. this, this and this).

Let's take the case of food. In relative terms, we're not even at the "let's have nonsmoking sections on planes" stage yet, but things are moving rapidly. This quote from the Journal of Public Health Policy doesn't require any comment but I'll add some black ink for any young children reading who might not have got the point yet.

The food industry's ultimately anti-social behavior—whether conscious or inadvertent—is spreading globally.... Signs of marketing efforts by multi-national food corporations are appearing everywhere in developing countries....

The tobacco analogy: this industry, which deliberately encouraged children to become addicted to cigarettes as early as possible, then continued to market cigarettes even once well aware of the health dangers. We now know the health dangers of obesity, but the epidemic continues. To protect the public, perhaps we can learn from anti-smoking efforts about means to constrain the food industry.

This editorial turned up in the same week that the Canadian Medical Association Journal published an article called 'Legislative approaches to tackling the obesity epidemic' that recommended anti-obesity policies which come straight out of the anti-smoking textbook. You know, the textbook that was designed to tackle the "unique danger" of smoking...

Government-level interventions

Taxing junk food

A proposed intervention for reducing the consumption of energy-dense and high-fat drinks and foods is to implement a “sin” or “junk food” tax. It has been highly debated in the Canadian media, notably in Ontario and Quebec. The rationale stems from the success of cigarette taxes, a proven and effective intervention to combat smoking.

School- and youth-level interventions

Banning advertisements for unhealthy foods

An early antitobacco strategy used by the government was to outlaw cigarette advertisements in the media, on billboards and at sporting events. Based on the success of these interventions, the 2006 obesity guidelines recommend limiting the “screen time” of children (i.e., television, video and computer games) to reduce their exposure to food advertisements.

Do you see what they did there?

Let's get down to brass tacks. The obesity situation isn't a real public health problem, it isn't very complicated and it has nothing to do with smoking. Most of what is said about obesity is bullshit anyway because it depends on a BMI measure that has been downgraded to create a crisis in the first place. The idea that obese people place a cost on the economy is debatable (unlike with smokers, where the idea is simply absurd). In any case, I've always found it strange that left-wingers are the first to complain about having to pay for other people's problems. Isn't that what socialists are supposed to do?

What is undeniable is that there has been a rise in the number of fat people. That's due to people (a) being able to afford to be fat, (b) the decline of manual labour, and (c) people being too lazy to cook themselves decent meals. It has absolutely nothing to do with cycle lanes or television commercials.

On the subject of (c), don't even think of saying that we're all too busy to cook these days. Working hours have fallen sharply in the last fifty years and no country which sees dross like Eastenders regularly get ten million viewers can claim to be pressed for time. We're either lazy, incapable or choosing to do something we find more rewarding. No taxes or advertising bans are going to do anything about the indolence and stupidity of the British public. What will change things is that most people don't want to be fat and are prepared to do something about it.

There is a simple epidemiological transition going on which doesn't get anywhere near enough attention. Fifty years ago it was the middle classes who were fat and suffering heart attacks. Today, obesity is seen as a working class problem and it is certainly more prevalent amongst lower socio-economic groups. Why? The simple answer is that the middle class got richer and took office jobs first and the working class followed them a few decades later.

That simple answer is half-right, but it doesn't explain why the middle-classes haven't got even fatter as they got even richer. The answer to that, I think, is that they got accustomed to being able to afford whatever food they wanted and stopped eating the high calorie foods their fathers and grandfathers did—the food they grew up with—and changed their diets over time. Their children, now fully grown, have a completely different diet to their grandfathers and are less fat than their fathers. Their grandchildren—may God curse them into eternal damnation—have grown up, joined a gym and want to force everybody else to be like them. That is a natural, if regrettable, transition made by observation, self-improvement and insufferable self-satisfaction. The government played no part in it.

It is short-sighted, patronising and plain prejudiced to believe that the same transition won't take place through the rest of society in the fullness of time. The crucial difference between being fat and being a smoker is that smokers feel great right up until the moment they get the cancer diagnosis. Fat people—with the exception of the fat acceptance movement and my uncle Malcolm—generally don't want to be fat; not because they might get diabetes in 30 years time but because it's not a good look.

If you'll excuse me for going all Karl Marx here for a second, there is a class issue at work. Fat people didn't get any grief when fat was a predominantly middle class problem, just as smokers were treated with education rather than coercion when smoking was a classless habit. I'll even up the ante here and say that flying abroad and driving cars wasn't considered a problem until us proles had the money to do it.

Coincidence? Maybe. But what do these overwhelmingly middle-class reformers propose as the cure-all solution to these supposed problems? Make them more expensive. Apply the most regressive policies imaginable. Tax the lower orders out of the market.

But let's get back to the slippery slope. It is, I think, indisputable that the same tactics that were once used only against smokers are being deployed against the general population. It is likely that the targeted groups will end up being denormalised in the same way as smokers are today. And it is highly probable that if the general population had been aware circa 1980, or even circa 2000, that anti-smoking policies would be directed at nonsmokers there would have been a general revulsion against the whole concept of top-down public health.

If you had told the average person in 1980 that meals should be taxed to deter purchase or that food advertising should be restricted to prevent obesity, he would have laughed in your face. That would be true even if the average person was a member of the British Medical Association.

How did things change? They changed, in no small part, because the campaign against tobacco crowbarred open a door that allowed the regulation of any human behaviour that might have the slightest impact on their or anybody else's health. Once opened, it is a door that is very difficult to close. I don't expect it to close in my lifetime.

And I'm only 34.