In this day and age, you are more likely to be obese than underweight. Obesity is expected to overtake tobacco as the biggest cause of preventable death, leading to more than 30,000 deaths a year in the UK alone. The costs of obesity and diabetes on the NHS are greater than the costs of the police, fire service, and judicial system combined.
But why, in the 21st century, is obesity such an issue? There are no shortages of weight-loss pills, fads, and diets, and yet more and more people are struggling with their weight. How has science not cracked the code to human nutrition? Why are children becoming obese at earlier ages and staying obese for longer? Perhaps our mainstream weight-loss “solutions” are not solving anything.
In many ways, individuals cannot be blamed for their poor health. According to the government guidance on obesity and the food environment, we live in an ‘obesogenic environment where less than healthier choices are the default’, suggesting that it is easier to eat unhealthily than healthily. Moreover, eating healthily is straight up more expensive: The King’s Fund suggest that only half of UK households can afford to pay for food that meets the government’s Eatwell Guide, as it costs almost three times the average spend one pays for food per week. The environment you live in can also have a major factor on your waistline: areas with higher deprivation are correlated with higher number of fast-food restaurants, lower levels of physical activity, and higher levels of obesity and obesity-related illnesses.
Even when someone decides to lose weight and look for advice, the information is arguably outdated and oversimplified. The basic guidelines for losing weight is the rudimentary equation that burning more calories than one consumes will result in weight loss. This overlooks the fact that calories are not the same, and they have different effects on your body. A calorie from a chocolate bar will do completely different things to your body than a calorie from steak, for example. Weight loss and health cannot be reduced down to mere calories: nutrition plays a huge role.
While nutritional health is often highly contested, much of what we consider to be “healthy” is being pulled into question. It is becoming general consensus that saturated fats have been demonised, and cholesterol does not tell the full story when it comes to heart health. More and more nutritionists are discussing the detrimental effects seed oils – such as vegetable oil, canola oil, and soybean oil – have on our health. Seed oils were originally used industrially, and have only recently been put in our diets as a so-called “healthy” alternative to animal fats. However, seed oils are ‘proven to be some of the leading causes of heart disease, cancer, and other life-degrading conditions’. Seed oil contains high levels of linoleic acid, omega-6, and chemicals, which all can have negative impacts on health.
Despite this, seed oils are present in many food items and are often used and reheated in restaurants. Moreover, NHS guidance recommends to ‘get most of your fat from unsaturated oils and spreads’ and to use vegetable oils to lower LDL cholesterol. It seems to me that NHS health guidance does not adhere to the latest science or nutritional guidance. And even if we were to give the NHS the benefit of the doubt, it still does not follow its own guidance in practice. From my experience, hospital food is poor in nutrition and only vaguely gestures towards a healthy diet.
Unfortunately, it is hardly a surprise that the UK population is getting more obese and sicker. The NHS, like other public funded services, uses a business-like management that seeks to treat as many people as possible in the name of efficiency. This has the risk of the NHS strategically prioritising issues that are easy to treat. Consequently, preventing illnesses is not incentivised. Arguably, therefore, the NHS’s management leads to poor advice on keeping healthy and following a nutritional diet, as it simply is not prioritised by the NHS’s business-like and efficiency goals.
It seems to me that the solution to weight-loss are anything but learning about real nutrition and exercise. “Low fat” foods that are filled with sugar and are a good example of a misunderstanding of what actually leads to weight gain (it’s sugar, not fat). Meal-replacement shakes may help individuals lose weight, but they are full of artificial ingredients and miss out on vital nutrients and fibre.
Other solutions are more serious. Operations such as gastric band, gastric bypass, and sleeve gastrectomy all achieve a similar goal, of making the stomach smaller and therefore making the individual feel fuller sooner. The side effects of weight-loss surgery are numerous, and the decision to have such procedure cannot be taken lightly.
Liraglutide (or Saxenda) has recently been approved to be available at pharmacies without a prescription. Liraglutide is taken through injection and mimics the hormone GLP1 which our bodies naturally produce to give the signal “I’m full” to the brain. The drug therefore suppresses appetite, and has been found to result in users losing 5% of their body weight within the first 3 months when combined with a healthy diet and moderate exercise. But, again, the side effects of nausea and price tag of £150 for four and a half weeks is enough to put anyone off.
Nutrition and health are complex topics, and there is no one-size-fits-all when it comes to diet. However, as many procedures and drugs focus on reducing one’s appetite in order to foster weight loss, it is evident to me that we, as 21st century humans, have forgotten how to eat. Our bodies are anatomically akin to our hunter-gatherer ancestors, who ate whole foods, fresh meat, no processed foods, and were not surrounded by the huge temptation of foods high in sugar and fat. In many ways, the Westernised way of living encourages unhealthy habits. Perhaps, as a start, we should look at our diets.
Dr. Chris Knobbe: Diseases of Civilization: Are Seed Oil Excesses the Unifying Mechanism?
Paul Mason: Vegetable and seed oils are inflammatory
Obesity Science & Practice: Liraglutide for weight management
The New England Journal of Medicine: Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined
NHS Better Health: Lose Weight
UK Government: Eat Well Guide