Obesity, Poverty, and Health Inequality

In my new book The Truth About Fat, I argue that obesity is a complex, systemic problem, and explain why those offering up simple solutions are almost always trying to sell us something. Usually a diet.

In the passage below I discuss the complex and often misunderstood relationship between obesity and poverty, and suggest that attempts to enforce better diets on people, either through taxation, cookery classes or regulation, miss the real reasons for health inequalities.

In the same chapter I also talk about how our concept of a "better diet" is often riddled with middle class food snobbery, and rarely based in any nutritional truth.

Stress creates a fierce demand for anything that might soothe it, if only temporarily. Drugs, alcohol or comforting foods, particularly the cheapest sources. This is what shapes the environment in which people live. Writer and recording artist Darren McGarvey, who grew up in Pollok, a deprived area on the South Side of Glasgow, explains:

"The local economy is all about providing stress relief.

This develops into an addiction, leading to more stress.

The political classes are useless, because they have no insight into the experience of poverty.

You can modify the environment, but you really need to change the demand.

Demand will always be supplied.

If you stop the sale of high calorie foods, you will still be left with millions of people who are ill at ease.

And they will turn to the next thing."

Even if we rip apart the food supply, take away choice and force people to exercise, would we really be improving their lives?

They would still be poor. They would still be isolated. Stress would still be pumping cortisol through their veins. All you would be doing is telling people that the decisions that make sense in their lives are foolish, and that they are not responsible enough to choose for themselves.

So go ahead, take away the chicken nuggets they were going to have for dinner tonight. The ones that they can afford and they know that their kids will eat. Replace them with something that you deem better, more acceptable. See if that really transforms their lives.

What will happen is this. People will get on with it, because they are universally more resourceful and capable than they are given credit for. But all the stuff that makes their lives tough will still be there. The stress, the inequality, the loneliness. The shame people pile upon them because of their bodies, their clothes, their manners and their appearance.

The pervasive thought that they are a bad parent because they struggle to provide for their children. All that stuff will not have gone away. The only difference is that now they will be pissed off because they haven't got any chicken nuggets.

The fear and revulsion that we have for people who are poor and fat comes from our unwillingness to accept that our own success is anything other than luck. We want to believe that our lives are the result of good choices, strong morals, intelligence and superiority.

We assume that our food makes us who we are, rather than being a consequence of how we live. And so, on all sides of the political divide, we decide that if we can force our food values onto 'the poor', they will become like us.

Just as we cannot restructure food environments and expect demand to change, we cannot restructure food systems to alleviate health inequality. If we want to do that, we need to tackle poverty itself.

We need to restructure our society. We need to become more equal, more accepting, more caring. We need to stitch our broken communities together and try to understand what common purpose looks like in a world without conflict.

Change is possible. But it is not about changing the markers of poverty or sprinkling a few of the trappings of privilege on top of difficult lives.

It is about creating substantial change, relieving the worst effects of stress, fighting stigma and building a better society for everyone. It is about catching people when they fall and creating fairer political movements that make sense in the modern world.

Sadly, these things are harder to achieve than teaching people to make their own hummus. But maybe the hard path is the one that we need to tread.

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The Truth About Fat is available now from Oneworld Publications, and can be found online and in all good bookshops.