Britain's obesity problem is in the news at the moment, again. Not only are we the heaviest drinkers and among the hardest drug users in Europe; we are now, apparently, also the fattest. But today, for the first time, a campaign has been announced which looks to address the latter of these problems in the same context as the other two; overeating is a problem with its roots in social, cultural and economic causes, and its corollary in habit and addiction.
Unlike the previous, scattershot attempts by the health sector to approach the issue of obesity, this time we have a manifesto, an ultimatum and a series of terrifying statistics to help kick us into action. Already a quarter of British women and a third of under nine's are clinically obese and by 2050 this figure is predicted to have risen to accommodate over half of all British citizens, a reality our NHS could not support. This must be the time when this epidemic starts to be tackled pragmatically; when policy replaces the empty rhetoric and class based condescension that has characterized the debate up until now.
The report released by the Academy of Medical Royal Collages (AMRC) calls for a series of measures to be put into place, "starting right now", that will break the cycle of "generation after generation falling victim to obesity related illnesses and death". These include mandatory food-based standards to be introduced in all UK hospitals, a limit on the number of fast food outlets situated near schools, colleges and other places children gather, and traffic light food labeling to show calorie counts.
It also proposes a series of measures that are familiar from past policies designed to quell our appetite for other harmful substances, notably alcohol and tobacco. A nine o'clock watershed for advertising of foods high in saturated fat, sugar and salt, a tax hike on sugary soft drinks that will increase their price by at least 20%, and increased intervention and advice from GPs to educate people on the dangers of over-eating.
Professor Simon Capewell worked on the report and talks of a need to reverse the obesegenic environment created over the last three decades by the junk food industry. "Unhealthy food has always been associated with healthy living. Advertising tells us that it makes us strong, fit and happy. The reality, that it makes you fat, sick and miserable, is only heard on the periphery."
He talks also of comparisons to the tobacco industry, a similarity referred to throughout the report. "They both shift the blame onto the consumer, in the full knowledge that the product they are selling is seductive, and ultimately addictive."
Dr. Damien Downing, the president of the British Society for Ecological medicine and an addiction treatment specialist, says that overeating must be approached, at least in part, as an addiction. "Often overeating is linked to an addiction to sugar", he says. "This is a physical illness, functioning in a similar way to other addictions. If we are to address the problem, this fact must play a significant part of the approach".
The science supports his theory. A high intake of sugar results in all the defining symptoms of addiction; physical and psychological dependence, increased tolerance, withdrawal symptoms, and changing behavioral patterns.
Dr. Downing explains. "When sugar is consumed your body reacts to it as it would drugs or alcohol, producing an increased amount of certain neurotransmitters, such as dopamine, serotonin and adrenaline. These are the chemicals that make us feel good, whether that is the feeling of relaxation, energy or focus. But this artificial stimulation over time reduces our body's ability to produce the chemicals on its own, meaning we become reliant on the stimulant just to get us feeling normal."
The result of this is not only dependence on sugar, but the mental and behavioral symptoms so often associated with obesity. Capewell talks of studies made on children which show that increased consumption of sugar leads to worse behavior in school, while the AMRC report talks of the "depression, anxiety and severe mental illness" that can come from overeating.
Daniel Gerrard is the founder of Addiction Helper, an addiction helpline. He reports that 10% of the 27,000 calls they receive a year are from people looking for help with food addiction. "We treat it in exactly the same way as people with other addictions" he says. "Many patients are referred to residential rehabs, while others receive work through a 12 step program."
While this approach goes further than that mentioned in the AMRC report, they do recognize that "change requires that the emotional and psychological factors (of overeating) be understood and tackled, rather than neglected or minimised". They call upon GPs and local health services to treat obesity as the multifaceted problem it is; to open both their minds and their services.
If the report is acted upon, it will herald a fundamental shift in the way we approach obesity. It is very possible; the economic incentives are there and the public mood for such a change is strong. If the comparison to the social shift against smoking is anything to go by though, it could be a long haul. It took almost fifty years for the tobacco lobby to be overturned after the first government report documented the harm caused by cigarettes in the 1950s. The junk food lobby is equally strong, and their product nearly as addictive. Whether the policies are implemented or not depends on what comes first, our appetite for junk food, or our appetite for change.