On obesity

Just a photo of a nice croc I saw

I read an article recently about how to best manage obesity as a society. It wasn't a medical journal, though, it was an economics/finance/management report published by the McKinsey Global Institute. It was written by business analysts and economists; which was interesting to me as usually I see these articles about obesity in the context of public health and medicine. And it got me thinking about just how did obesity become a problem. The report is very interesting and I certainly don’t intend to repeat it all; in fact what I’m writing here are merely my own insights and opinions that took this article as a starting point. But if you get the chance, read at least the executive summary of the McKinsey report here.

Food has always been a necessity for us humans, and obesity is not a new thing. The problem is the high prevalence of obesity and the subsequent high rate of health problems for which obesity is a major contributing factor. You then recall times from history like the great depression and wonder how did we overshoot so much that now obesity – an excess – is the problem. The thing is that perhaps the exact same things that brought us out of the great depression brought us to high rates of obesity.

Towards the end of the great depression, a lot of interesting things began to happen. Yes, there was the onset of World War II, which brought about destruction – and subsequently, at it's conclusion, a great need to re-create, produce, manufacture, and re-build the world! Industries soared. Governments and commercial enterprises became really good at economics and business. Extremely good.  And with the end of the great depression, of course, food became more than a rationed commodity, more than a human need, it became a highly lucrative commercialised industry more than it had ever been in our society. The success story of business and industry tracks that of obesity rates. Every strategy that led industry to thrive, also drove obesity rates to rise.

Think about all the strategies that make businesses successful, and then you finally may get closer to finding an answer to the question of how did we as a society let obesity rates rise to the levels they are today. Well, firstly, a great business needs a product that is desirable. What is a more desirable consumable than food? And more than being a desire, it is an actual human need! Food is one of those things that would sell even if it wasn't advertised anywhere.

But food is advertised – and very well; a great marketing strategy is one of the fundamentals of a successful business. The interesting thing is that the food that receives the most advertising is the least nutritious and yet most energy-dense. Unfortunately as a society we developed technologies and became really good at modifying our environment so as to minimize the amount of energy our own bodies expend. Our progress as a society, our advancement, is because we built efficient machines that use external energy to do the hard labour we previously took on. We walked greater distances, lifted more, did more physical work just in our everyday than we do now. And hence the large disparity between the energy content of what we consume (that energy-dense food advertised so heavily) and the energy we expend – with excess energy being stored in our bodies as fat.

Marketing isn't just about direct advertising, though. It even involves exploiting existing societal norms and evolving new ones. What do I mean by this? Actually this concept is the most wide-ranging aspect of how business, and food as an industry, has grown. But let’s take, for example, just two interesting quirks of us human beings: 1) we perceive more as better, and 2) we perceive bigger as better. Have you ever tried to buy just a Big Mac at McDonald’s? Well, let me tell you it costs nearly as much as a Big Mac meal, with the fizzy drink and the fried potato chips included. We all prefer to get more for our money, so we do end up buying a much higher energy intake for just a few cents more. But it’s not just about the big bad fast food giants, even our supermarkets do it.  They sell us even staple foods, but at a cheaper rate if we buy more of it. Why? Not because they think “poor, poor, undernourished people; let them have more food”. No, they do it because we are consumers, and only consumers to them. They sell us more so we pay more (we think we’re making a saving, but the reality is companies never underprice their items even in the “deals” they give us). The concept of portion size is similarly related. And portion size isn't just about how big our meals are, but the fact that because our foods are so energy-dense and our lifestyles for the majority of us are so sedentary, the physical-size of our meals isn't even what we’re really talking about here. And who does know what we are talking about when we say things like “portion-size”, “recommended daily intake”, “calories”, “kilojoules”, etc? Not that many of us! Education about nutrition and its relation to health and lifestyle are severely lacking in our society…

I want to conclude this topic of discussion with a direct passage of recommendation from the McKinsey report I mentioned earlier:

“Education and personal responsibility are critical elements of any program aiming to reduce obesity, but they are not sufficient on their own. Other required interventions rely less on conscious choices by individuals and more on changes to the environment and societal norms. They include reducing default portion sizes, changing marketing practices, and restructuring urban and education environments to facilitate physical activities.”

What do you notice about these recommendations? If you’re like me, then you will have noticed how most of the things suggested that we need to try to do as a society to combat obesity are the complete opposite of everything you need to do to have as great and successful a business as the food industry in industrialized countries is. We became obese not merely because we ate too much, but we ate more than we needed to because the food industry needed to grow its profits. I think in health care we particularly need to take note of this. Sometimes we think we must help individuals (or blame them, as we sometimes do), but the truth is individuals were helped in their demise by large industries and corporations who focused on our consumption/profit value rather than the effect of their products on our health.