Public health advocates claim that the growth in childhood obesity is the consequence of eating junk food. Consequently they have launched their attack upon McDonalds, Schweppes and Four and Twenty Pies, all in the name of combating the health tsunami of obesity.

The advocates argue that sugar is an addictive substance; that multinational corporations are manipulating us to consume junk food against our will; that these corporations are morally bankrupt; and an unwitting public bearing the health costs of obesity.

The truth is different. For those with skin in the game of public health, there is a feeling of déjà vu in this. Obesity Policy has been cut and pasted from Tobacco Control. The problem of Obesity just doesn’t fit the Tobacco Control Paradigm. For example:

  1. Obesity rates are complex. The rise in rates date from the early 1970s; but they plateaued in the mid-1990s. There is no ever-growing tidal wave.
  2. The majority of health consequences of obesity are mediated through other diseases, such as diabetes and hypertension. Obesity only becomes an independent risk factor of clinical significance when the BMI hits the early mid-30s. Which begs the question, ‘Why don’t we target people with the primary conditions?’
  3. The health problems of obesity overwhelmingly affect adults. If there is a health emergency, it is in adulthood, not in children. Headlines like ‘A New Tax to Save Our Kids’ is just scaremongering.
  4. The causes of obesity are multifactorial, and poorly understood.
    a) Your genes are the biggest influence. Then, it’s how much you eat, and how often you eat it. Then it’s about how much exercise you get. And finally, what you eat comes. It’s not what you eat that’s important, it’s how much!
    b) Unlike the cause-effect link between tobacco smoking and lung cancer, the obesity paradigm is akin to a spaghetti diagram.
  5. The claim that sugar (ie sucrose) is an addictive substance, like nicotine and narcotics, is simply false. It is drawn from f-MRI similarities observed in pleasure reward centres of the limbic system in chronic over-eating and drug addiction. The eminent neuro-psychologist Susan Greenfield dismisses such claims as “21st-century phrenology”.
  6. Defining ‘junk food’ is problematic. Loff and Crammond use the phrase, “energy-dense nutrient-poor food”; which is a non-sequitur. Those who go to bed hungry at night must shake their heads in disbelief at First World Problems.
  7. Health advocates call for more money, to better fund campaigns to combat the problem.
    a) Even well funded public health campaigns are notoriously inconsistent in their result.
    b) It is circular reasoning to suggest campaigns that are unsuccessful are merely under-funded.
  8. Portraying fast food producers as the moral equivalents of tobacco companies is ridiculous. One advocate observed, “Advertising and promotion [is] clearly designed to increase sales”. Well, yes. It’s called marketing. And it is not the moral equivalent of manipulating nicotine levels in cigarette brands through time so as to induce addiction in the smokers of that brand.
  9. The proposed public-health campaign stigmatize ‘overweight’ children, who in many cases eat well, get exercise and lead a healthy lifestyle. In such cases, another advocate suggested that, “They should be offered counselling”.
  10. Such public health campaigns are by their nature illiberal and contrary to individual freedoms. In the case of tobacco control, the case for social engineering is much stronger. Tobacco, consumed as the manufacturer intends, will kill one in two users.

Obesity is a serious problem. But, the solutions proposed reveal that the public health advocates are out of ideas.