The Giant of Excess

Attacking last week's Foresight report that claimed individuals could no longer be held responsible for obesity, a leading Government adviser, Professor Julian Le Grand, argues that a completely fresh approach is needed to reverse problems caused by the "excess consumption" of tobacco, of food, of alcohol, of illegal drugs, and of indoor leisure. Suggesting that the new "giant of excess" has arisen alongside the "five giants" identified by William Beveridge when he founded the welfare state — namely, those of want, disease, ignorance, squalor, and idleness — Le Grand says that instead of requiring individuals to opt in to healthy schemes, they should have to opt out to make the unhealthy choice, for instance by being required to buy a smoking permit before being able to purchase cigarettes.

Such "libertarian paternalism" is certainly not as extreme as prohibition, yet it still smacks of Labour's nanny state, so is perhaps not quite as radical as the professor would have us believe. For instance, when I go to work, I do so to work. I would not want my company to be required to designate an hour in the working day as the "exercise hour" — I would rather continue exercising with my family out of work hours. Equally, requiring supermarkets to sell alcohol separately from groceries or restricting the sale of alcohol to off licences would simply inconvenience and annoy customers, not change their drinking habits. As for the idea of the Health Secretary sending parents details of their children's weight measurements at the ages of five and ten, I can not think this is going to make any difference to any family's eating and exercise habits.

What Le Grand's analysis misses is that the state itself has become our biggest giant to be tackled. A truly "completely fresh approach" would involve the Government meddling less and trusting people more. It would require the Government rediscovering for which areas it properly exists and returning responsibility for those in which it should never have made society irresponsible. Only then might we begin having an impact on the symptoms of our broken society.

Our Obesogenic Society

The reporting on obesity does annoy me. First we're told it's an epidemic, when quite clearly nobody can catch the condition from anybody else. Then we're warned it's a threat "deadlier than smoking" and "worse than climate change" (which is not necessarily saying very much, of course). Now we're informed that it's "an inevitable consequence of a society in which energy-dense, cheap foods, labour-saving devices, motorised transport and sedentary work are rife" and that "individuals can no longer be held responsible for obesity."

Despite admitting there is absolutely no proof that any anti-obesity policy works, the Government-commissioned "Foresight" report claims that dramatic and comprehensive action is required to stop the majority of us becoming obese by 2050 — no doubt at a substantial cost to us tax-payers. What next from this interfering, predeterministic Government? That criminals are genetically predisposed to commit their crimes so should be locked up before they offend but absolved after the event? Oh yes, we have already had that line from them (here and here).

No, as we learnt earlier this year, the issue of obesity is linked to others such as race and class that have got worse over the past decade: just 9% of Indian children are overweight or obese compared with 23% of White and 33% of Black Caribbean children, while children in more advantaged areas of England and Scotland are less likely to be overweight or obese than those living in less advantaged areas. While there clearly is a wider cultural question to address in the West — namely, why we overfeed and underexercise ourselves and our children, despite knowing the obvious health risks — it is clear from the above graph that the problem has become increasingly serious as the nanny-state has grown increasingly strong. Therefore part of the remedy must surely involve returning a sense of personal and social responsibility to individuals and their communities.

Lock Up Fat Parents

In a little reported survey published at the start of this week, we learnt that almost one child in four is overweight (18%) or obese (5%) at age three.

Today the BBC informs us that obesity has been a factor in at least twenty child protection cases in the last year and many within the British Medical Association believe the government should consider childhood obesity in under-12s as neglect by the parents. Quite clearly we are looking at a public health problem, but are we really also looking at a child protection issue?

This Government clearly believes that the nanny state can do a better job of bringing up the next generation, that parents are untrustworthy and should hand over responsibility for their offspring from when they wake until they are ready for bed. However, do we really want to criminalise and put into care the children of parents who, largely as a consequence of their own upbringing or poor education, do not know how to feed their children properly? Given that the problem was virtually non-existent in the twentieth century†, what has changed in recent years suddenly to make this an issue? Is advertising and the cheap availability of unhealthy meals to blame? Has the ability of parents to raise their children properly been undermined by the way the traditional nuclear family has been put under pressure, single parenthood incentivised‡, and mothers encouraged into the workplace? Lastly, what are the roles and obligations of parents, schools, school-food providers, and the government in tackling childhood obesity?

† By the way, this is not just a British problem, as reported late last year in Medical News Today: Belly Fat Of US Children Grew By Over 65% Since 1999

‡ A fact confirmed again today in the second study by former Labour welfare reform minister Frank Field in a report for the think tank Reform, Welfare isn’t working—Child Poverty, in which he argues that Gordon Brown's tax and benefit system "brutally discriminates" against two-parent families.

Generation Blair

A child's start in life is still determined by the class, education, marital status, and ethnic background of its parents. By the age of three, children from disadvantaged families are already lagging a full year behind their middle-class contemporaries in social and educational development.

That is the damning conclusion of a study monitoring around 16,000 families of children born across the UK in 2000-2. An assessment of vocabulary revealed that children of graduates are ten months ahead of those with the least-educated parents, and a separate assessment measuring children's understanding of colours, letters, numbers, sizes, and shapes found an even wider gap of twelve months between the two groups.

Parents' education was not the only significant factor, however. For, although black African parents were more likely to have degrees than white parents, a quarter of the black Caribbean and black African children assessed were delayed in their development, compared with only 4% of white children. Here the difference appears to be caused by the children's family background: a third of black African (32%) and almost half the black Caribbean children (47%) were being brought up by lone mothers, compared with just 14% of white children and 5% of Indian children who had lone parents. This is an important factor, as the analysis also showed nearly three-quarters (72%) of children with single parents live below the poverty line.

In a worrying confirmation of the extent of another problem that has emerged in the last five years, the Centre for Longitudinal Studies, who carried out the research, also reports that almost one child in four is overweight (18%) or obese (5%) at age three. This study also revealed a similar difference attributable to race and class. Just 9% of Indian children overweight or obese compared with 23% of White and 33% of Black Caribbean children. Equally, children in more advantaged areas of England and Scotland were less likely to be overweight or obese than those living in less advantaged areas.

Late last year, Tony Blair claimed the Sure Start programme, designed to help the children in Britain's most deprived families, was "one of the Government's greatest achievements." Can anyone tell me what NuLabour has actually achieved with the £3,000,000,000 of tax-payers' money that it has poured into the scheme?

Obese Toddlers

News that some paediatricians are treating three-year-olds with up to 50% of their body weight consisting of fat not only echoes the questions this blog raised a week ago in connection with the case of the 14-stone 8-year-old but forces the debate onto another level.

Firstly, given that these children are at risk of developing complications such as heart disease and diabetes later in life, at a time when healthcare resources are already being placed under increasing strain, to what extent should their later healthcare be paid for by tax-payers? More broadly, to what extent should access to healthcare be limited for people who are responsible for causing their own health problems?

Secondly, it also demands an explanation as to why this problem has apparently only begun in the last five years.

Child Obesity: Whose Responsibility?

It seems only a week or two since Jamie Oliver's 2005 campaign against turkey twisters and chips led to new standards for school meals - and, in its wake, the scenes of parents passing orders of fried food through school fences to disgruntled pupils. Today's news has been full of the story of Connor McCreaddie, the eight-year-old weighing in at 14-stone, four times the average for his age, and his mother, who says her son refuses to eat fruit, vegetables and salads and will only eat processed foods.

The chairman of the National Obesity Forum has said "The long-term impact of this child's gross obesity are frightening. He has great risk of diabetes and coronary illness. His life expectancy is severely prejudiced. So action is required if his health is to be safeguarded."

But who should take what action? What are the roles and obligations of parents, schools, school-food providers, and the government in tackling childhood obesity?