Dismiss it at your peril: obesity is a serious problem, especially for women

Tackling the subject is difficult enough without the media’s absurd claims that belittle the seriousness of the health risk

Independent on Sunday, 13 December 2015

Obesity is as dangerous as terrorism: it’s an extraordinary claim, as a number of news reports rushed to point out. Did the country’s chief medical officer, Dame Sally Davies, really say it? The answer is that she didn’t, not in so many words, but anyone who skimmed last week’s headlines would be left with the impression that the Government’s leading health adviser had said something really quite preposterous.

Despite the use of quotation marks, the comparison was actually an inference, drawn from a 162-page analysis of risks to women’s health. In her introduction, Davies suggested that obesity should be added to a register of national risks that includes severe weather, coastal flooding, flu pandemics and various kinds of terrorist attacks. So the headlines could have said that obesity poses as much risk to human health as floods or animal diseases, which are also on the list. But that would be nowhere as attention-grabbing – or as easy to ridicule.

This is how the anti-science lobby works. It dismisses any attempt to help people understand their bodies and reduce damage to their health – by giving up smoking, say – as interference by the “nanny state”. It’s tragically effective, as evidenced by the very long time it took to persuade people to give up a habit that was killing half of them (too late for my parents, who started smoking as teenagers and both died of lung cancer).

Any day now I expect to read a blog arguing that being obese is the “new normal” and we shouldn’t worry about it. And I wasn’t surprised to see Davies’s “extraordinary claim” about obesity and terrorism, which she didn’t actually make as far as I can see, denounced as hyperbole. One hostile writer even went off into a fantasy in which Davies’s defenders “might argue that obesity has killed more people than Islamic State”, adding helpfully that “beheadings and bombings exist in a different moral universe to high blood pressure and diabetes”.

I was reminded of a headline that appeared in Newsweek a few years ago, predicting that a 40-year-old single woman was more likely to be killed by a terrorist than to get married. Twenty years later (yes, it took that long), the magazine published a retraction, acknowledging that the terrorist line didn’t appear in the academic study that prompted the headline. I’m not sure what lies behind this impulse to drag belittling references to terrorism into stories about women’s lives but it certainly doesn’t encourage serious discussion. Perhaps there’s now an unwritten rule that every story has to mention the Paris attacks in some way, but the inaccurate Newsweek headline went on being repeated in the media for years. I fear that the obesity-terrorism link will do something similar.

Anyway, while much of the reaction to Davies’s report was predictable, that doesn’t excuse it. The same people who complain about political correctness and its even more evil cousin, “political correctness gone mad”, react with outrage whenever someone points out the obvious fact that obesity is destroying individual health, shortening lives and putting a huge strain on the NHS. In particular, it is having specific effects on women of child-bearing age and future generations.

These are not marginal concerns at a time when just over half of women in the 25 to 34 age group are overweight or obese. The statistics for men are even worse but two factors, pregnancy and longevity (women live longer and thus spend more time suffering from the debilitating effects of being overweight), explain why this latest reports focuses on the impact on the female half of the population.

Women’s weight is a western obsession and a huge industry is based on it, offering any number of slimming products and wonder diets. It’s remarkable ineffective, judging by the statistics, producing a great deal more in the way of anxiety than weight loss. One of the reasons, I suspect, is that women are encouraged to obsess about looking slim rather than the health benefits of losing weight. That’s the shift Davies is trying to make and she knows perfectly well that her report is going into territory that’s troublesome for many women. “This is a difficult message to convey,” she says, “as it risks burdening women with guilt and onerous responsibility.”

What women need to know is that obesity makes it harder to get pregnant and raises the risk of miscarriage, while early embryos of obese mothers show an increased incidence of developmental abnormalities. Obesity even affects the eggs of the foetus, so that a woman’s health during pregnancy has an impact on her children and grandchildren. How many young women are aware of that?

One day last week I got on to a Tube train at the same time as a group of women in their twenties. One of them was wearing a security pass, which is how I know she is a care assistant. She talked about her job enthusiastically to her friends but the most striking thing about her was her weight; this young woman, who had chosen a difficult and poorly paid occupation looking after vulnerable people, was massively obese. I couldn’t imagine how she managed to cope with the physical demands of her job without getting out of breath and putting a strain on her heart.

It’s little short of tragic to see even quite young women struggling to live with the effects of obesity. The United Nations has called the UK the “fat man of Europe” but it’s high time the Government looked closely at the health of the other 51 per cent of the population.


When ageism meets sexism: a toxic combination

You don’t have to live on the Moon for ageing to be miserable, but women are treated with a lack of respect verging on cruelty 

Independent on Sunday, 6 December 2015

I’ve never actually seen this headline but I can easily imagine it on a magazine cover: “Getting old: is it a poor lifestyle choice?”. The fact that ageing is inevitable– the alternative being even less appealing, of course – is barely acknowledged in our youth-obsessed culture. People are living a lot longer, getting to ages beyond the reach of all but the most favoured individuals for most of recorded history. But it hasn’t been accompanied by a revolution in how we think about the elderly.

This year’s John Lewis Christmas advert, made in association with Age UK, features a lonely old man living on the Moon. A German supermarket chain has come up with something a great deal starker; it’s the story of an elderly man, sick of being on his own at Christmas, who fakes his own death to trick his adult children into visiting. Too many elderly people are on their own at Christmas but I’m not sure whether such adverts have useful practical effects or confirm fears about getting older.

I was reminded of all this last week when I read about a court case involving a middle-aged woman who insisted on the right to refuse life-saving treatment. The woman, referred to only as C, died last weekend at the age of 50 after refusing to undergo kidney dialysis because she didn’t want to become “poor, ugly or old”. C was absolutely clear that she didn’t want treatment, prompting the NHS trust which was looking after her to seek a court ruling last month.

Her doctors argued that she had a “dysfunction of the mind” which rendered her unable to make decisions about treatment, but a judge ruled in her favour. He acknowledged that many people would be horrified by C’s decision but said she was “sovereign” in respect of her own body and mind. More controversially, he offered a character sketch of C as someone who had “led a life characterised by impulsive and self-centred decision-making without guilt or regret”.

The judge said she had had four husbands and a number of affairs, had spent money recklessly and been “an entirely reluctant and at times completely indifferent mother” to her three daughters. Then came the most eye-catching part of this unflattering portrait: “It is clear that during her life C has placed a significant premium on youth and beauty and on living a life that, in C’s words, ‘sparkles’.” Naturally this phrase made headlines while one of the most significant facts – that C had damaged her kidneys in a failed suicide attempt after being diagnosed with breast cancer – was relegated almost to an aside.

I’m still not sure whether this distressing case is about someone who didn’t want to get old or an extreme reaction to the prospect of having to undergo treatment for cancer. And it took me a while to work out why the judge’s remarks, which came down on the side of C’s right to make her own decision, are so troubling. It’s partly because they characterise C as a narcissist without any reference to the culture that encourages such behaviour, but it isn’t just that. Some of the things we fear about living into our 70s and 80s – being short of money and on the receiving end of poor medical care – have some basis in reality. Two of my elderly female relatives have been misdiagnosed after falls; in one case doctors missed a broken wrist and in the other, astonishingly, a broken neck.

The best-selling feminist author Erica Jong has just published a rather messy novel, Fear of Dying, which is as much about fear of getting older as it is about death. Her heroine, who has dying parents and a sick husband, is frank about her yearning for youth: “I hate, hate, hate getting older.” The novel unintentionally exposes the fantasies of a generation of wealthy, successful women who have no means of dealing with something they never expected to happen to them: “We thought we would get better and better forever.”

You might object, at his point, that fear of getting older isn’t specific to women. Men have anxieties about loneliness and ill health as well, but I think there are two circumstances which bear particularly heavily on the female half of the human race. While men are living longer, homes for the elderly are overwhelmingly populated by women who are now in their 80s and 90s; they grew up at a time when men were still valued more than women, a fact that has a powerful if unconscious impact on how we view older people. The other is that ageing women – a phrase often used as an insult – are treated with a lack of respect that verges on cruelty, as the following comparison illustrates.

Hillary Clinton is 68. She’s a hugely experienced political operator, a former Secretary of State in Barack Obama’s government, and is making her second bid to be the Democrats’ presidential candidate. It’s prompted a slew of articles asking whether she’s too old for the job; someone has even posted a montage of photographs online, inviting viewers to “watch Hillary Clinton age 50 years in just over a minute”.

Jeremy Corbyn is only two years younger than Clinton. He will be 71 at the time of the next general election, but his age isn’t an issue. Here’s The Daily Telegraph, no fan of the Labour leader, making the point: “It is Jeremy Corbyn’s age that makes him seem fresh.” When will I ever read a sentence like that about an older woman?