Michael Buerk has a point

He may be an anti-fat snob, but he’s right that unhealthy lifestyles won’t bankrupt the NHS.

Rob Lyons
Columnist

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Topics Politics UK

Writing in this week’s Radio Times, veteran journalist and presenter Michael Buerk offers a fairly uncompromising view of obesity and autonomy. ‘The obese will die a decade earlier than the rest of us… See it as a selfless sacrifice in the fight against demographic imbalance, overpopulation and climate change.’ He says obesity should not be treated as a disease, but as a lifestyle choice made by the weak: ‘You’re fat because you eat too much.’

Putting aside Buerk’s personal views on overpopulation and climate change – and his clear distaste for overweight people – he is actually right to question the frequently made claim that obesity will bankrupt the NHS. ‘Who can calculate how much an obese person would have cost if they were slim? How much would he or she cost if, instead of keeling over with a heart attack at 52, they live to a ripe, dementia-ridden old age, requiring decades of expensive care? In any case, VAT on takeaways, confectionery and fizzy drinks more than covers it.’ Indeed, Dutch researchers concluded in 2008 that ‘if you live longer, then you cost the health system more’.

While there may be considerable outrage at this bean-counting approach to health, it is nonetheless factually correct. Providing health- and social care to older people is relatively expensive because they may have multiple chronic health problems while being increasingly frail. The obese, smokers, heavy drinkers and more will have health problems earlier, on average, than those who stay trim, eat their five-a-day and take plenty of exercise. But in terms of NHS costs, it is those who live the ‘correct’ lifestyle who end up costing more in the long run, simply because they need healthcare for longer.

That is before we take into account other costs to the state. Once we reach retirement age, we are entitled to a state pension, free public transport and many other benefits – and rightly so. The elderly have worked all their lives and paid taxes on the basis that the state would take care of them in their later years. The real shame is that it is not more – the state pension offers a meagre existence, if better than in the past, and social-care provision is too often patchy and underfunded. We may perhaps reach a stage where healthcare is good enough to keep those of us with ‘bad habits’ alive as long as the skinny snack-dodgers, but that’s not the case right now. So the fewer years we receive these later-in-life benefits, the cheaper it is for the state.

Moreover, those who indulge in the ‘wrong’ foods are already paying more tax than those who live healthily. Buerk is right to note that crisps, chocolate, biscuits and takeaway food all attract VAT (sales tax) even before we get on to the newish tax on sugary drinks. Those extra billions are a welcome addition to government coffers. On the other hand, fresh fruit, vegetables, meat, fish and dairy products are not taxed at all.

Where Buerk is wrong is when he says, simplistically, that obesity can be explained by the fact that people simply eat too much. Obese people clearly have a greater propensity than slimmer people to gain weight. Moreover, to say it is a matter of will is to underestimate just how much sacrifice is required to get thin. Yes, you could work out for two hours a day and eat rabbit food, but that is hardly sustainable for most people. While ‘fat acceptance’ is all the rage, the fact is that the vast majority of fat people would much rather be thinner, and many of them make endless attempts to be thinner. In the majority of cases, the success of such efforts is relatively short-lived and the weight goes back on again. Understanding why this happens – rather than trotting out the mantra of ‘eat less, move more’ – could improve the lives of millions.

In the meantime, blaming fat people for their body shapes or accusing them of destroying the NHS is just plain mean. It turns biological tendencies into moral categories with which to look down on those who fail to meet society’s idea of what your proper body mass index should be. Trying to nudge, harangue, tax or ban fat people into becoming thin doesn’t work – it simply makes them miserable and poorer. Let’s stop it.

Rob Lyons is science and technology director at the Academy of Ideas and a spiked columnist.

Picture by: Getty Images.

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Comments

Ven Oods

15th August 2019 at 4:45 pm

People obsess about losing weight when what they need to lose is body fat.
A colleague (then in his fifties) was very proud that he weighed exactly what he had when on active army service. The fact that he was by then pear-shaped and couldn’t run for a bus seemed to have escaped him.

Nessimmersiom Ness

9th August 2019 at 3:54 pm

Connelly summed it up best – Eat less & Move more.
Where the contention about health costs fails is that 80% of health care costs occur in the last 2 years of life, whether that is in your 50’s or 90’s.
It is equally valid to argue that health care costs are less for healthy molesters who drop down dead at 90 rather than incurring costs in their late middle age.
The best way to stay healthy may be to minimise any contact with our wonderful health service.

Andrew Tait

8th August 2019 at 1:38 pm

Rob Grant’s satirical novel “Fat” notes standards in epidemiology to have lowered to a point where it’s possible to prove anything causes just about anything else; that cholesterol can’t actually enter the bloodstream, and that being overweight can actually improve life expectancy. Some brains, it’s thought, don’t process pleasurable sensation as closely as those of others, so may feel a need to eat more.

David Margison

7th August 2019 at 6:06 pm

OK. I ‘m able to eat a lot of food without really affecting my weight, I’m 10 stone and 5’7″ my weight has varied by only half a stone over 30 years. I am very fit and have allways excercised. I’ve eaten ready meals and home cooked, nothing seems to increse my weight. I did give up ready meals many years ago though. I know I’ve inherited thinness Now a friend of mine, same age and heigh but 14 stones, could only be described as fat and unfit; he can put a stone on while on holiday his diet was not great and he drinks a good bit. Recently for health reasons he had to change his diet, fatty foods were out! (Gaul Bladder) Within 3 months he had lost 3 stone, he and I have been Walking 8 to 10 miles once a week for about a year, he also walks his neighbours dog. He still needs to lose a bit more, but I know he can do it. He allways said his weight was how he is! Obviously it does not have to be! He definitely does have a genetic propensity to put on weight.though. He used to struggle on walkes, not now, he looks healthier and is healthier. I suspect many obese people could do the same as him.

Ven Oods

15th August 2019 at 2:31 pm

(Gaul Bladder)…
Those bloody Frenchies again! Coming over here and swapping out bladders…

Neil McCaughan

7th August 2019 at 3:04 pm

Louis Jordan said everything that needed to be said.

https://www.youtube.com/watch?v=cfdzeNMcTGI

Pru C

7th August 2019 at 1:52 pm

This is such a complex area.

I’m always saddened how we see these things as though they are separate, when nothing is that simple. Obesity is only part of a person’s life – there’s a list of things they’re grappling with. A list of crap to deal with and some have longer lists than others. Some of the things on the list they create themselves, some of them are wrongly identified, some are intractable or wicked problems and some are genuine.

Resisting buying the 3-for-2 packets of biscuits sitting on the supermarket shelves is often last on the list.

There’s a whole area of what people perceive to be a highlight of their day (ie: biscuits), why they have nothing better and why things that should don’t bring them joy.

There’s also an odd phenomenon to me, which is that often their is a great deal of genuine self denial of reality. Think of all the stories of those who saw a particular photograph of themselves and until then had not grasped the obvious – how does that happen?

Willpower is easy when life is good or OK, willpower for the mentally/emotionally exhausted who’ve used theirs up on other things is too much to expect. I’m coming out of a long period (years) of battling a nasty disease. Getting back to my athletic physique (which I had enjoyed all my life up to the day I started treatment) is the last ‘job to do’. Surviving was item 1 to 10 on my list. It included surviving the treatment too. I’m luckier than many: I’m still on the planet, I’m relatively free of ‘issues’, so things that have dropped off my list of crap to deal with have not been replaced – this all means loosing weight is now in a top position on my list.

Someone has commented “There, but for…” – a wise way of looking at your fellow human being. You cannot ‘know’, unless you’ve walked a mile.

Pru C

7th August 2019 at 1:56 pm

Agh, ‘there’ is a great deal of… not ‘their’… that’s what comes of redrafting a sentence after pasting it.

gershwin gentile

7th August 2019 at 12:48 pm

I shall remind you all of the Carrott bit. This hole is bigger than this hole.

Bri Fullerton

7th August 2019 at 12:12 pm

@SIMON GIORA
Sorry but you do not have possession of all the facts.
1. To lay down adipose tissue (body fat) you need your body to produce insulin so as to transfer excess glucose (sugar) from your blood stream and into you fat cells.
2. Dietary fat will not produce an insulin response.
3. Protein causes a weaker insulin response than Carbs.

YOU SAID “Presumably the author believes there is no relationship between calories in and calories out.”

The only relationship between calories in and calories out is to do with Carbs and to a lesser extent Protein. The much vaunted fact that dietary fat has a greater calorific density is irrelevant to obesity as our body is not a Calorific bomb furnace but is a biological organism the reacts to and treats different macro nutrients very differently (unlike a Calorific bomb furnace that burns it).
In relationship to diet and obesity a Calorie is of little use as a marker of weight management unlike in chemical engineering.
Why are more people obese……just look at the vast amounts of high glycemic Index /load and highly refined Carbs the are now consumed compared to years ago. Fizzy drinks and snaking (that we did not and do not need) are by far the most to blame.

Ed Turnbull

7th August 2019 at 1:20 pm

I must disagree with your conclusion on the causes of the contemporary obsetity ‘epdemic’. It’s not refined carbs and snacking. I grew up in the 60s and 70s (if there are any millenials presents it was my good self who stole your future; you’re welcome 😉 ) and the food of those days was chock full of sugar, and carbs, in the form of potatoes, formed a very large part of the everyday diet. The fizzy drinks were incredibly sugary – and delicious!

And yet, when I look at my class photo from my final year at primary school (1975) I can’t see a single fat kid. Not one. Sure, some of the kids are a little plump, but nothing more. No one’s within a mile of what you’d call ‘obese’. It was largely the same when I moved to secondary school later that year. It was a large school, with nigh on 2000 pupils, and there were maybe half a dozen kids you’d actually describe as ‘fat’. Compare that to today.

So, no I don’t think refined carbs in the diet are the cause. I think the obesity problem stems from changes in the general behaviour of kids, some of which Captain Scott mentions below. When I was a kid there was no Playstation (other ridiculously over-priced games consoles are available), no internet / social media / streaming / smartphones or similar electronic distractions. Heck, I didn’t even have a TV in my bedroom (there was one TV in the house, which would probably qualify me for being ‘in poverty’ these days), no video / DVDs. The opportunities for becoming a juvenile couch potato were nigh on nil. And so I was out for long periods doing ‘kid stuff’, which was usually pretty active. Even when I was in my later teens, and the electronic toys were starting to appear, I’d be out of a summer’s eve playing volleyball on the beach with my mates (and this was in Australia, this was in the north east of England).

But today, how much activity do kids *really* do, when they have myriad electronic distractions, and over-protective parents, to keep them in doors and largely immobile?

The obesity issue is really simple: if you’re fat it’s down to your lifestyle (the number who’ve a genuine medical reason for being fat is tiny) – you eat too much and you don’t exercise enough. And I can speak with experience here: around 20 years ago I was very very fit and active – martial arts 4 or 5 times a week, and mountain biking for good measure. But then I let the martial srts and mountain biking fall by the wayside…yet I continued to consume the same mount of calories. The result was inevitable – I became a fat bastard. Not hugely fat, but still heavier than I wanted to be.

Well, following marital breakdown I took a long hard look at myself and didn’t like what I saw. Cosequently action was taken: I cut out the crisps an choc completely (snacking had becoming an increasingly frequent activity), and made a determined effort to get back on my bike, even after work when all I wanted to do was open a beer and veg in front of the telly. It took much self discipline, but in just two months I dropped two stone. There was no magic involved it just took will power.

And there’s the rub: will power, self discipline, call it what you will, seems to be in short supply. I’m tired of people who bleat about being overweight, seeking sympathy and pats on the back because they had a lettuce leaf with their supersize burger, or because they walked up one flight of stairs rather than taking the lift. If you want to lose weight just bloody do it! It really is that simple. No one’s asking you to sprout wings and fly to Land’s End, simply get off your lardy arse, eat less and move more. And keep at it.

I loved that reality show Katie Hopkins did a few years ago, where she deliberately gained, and then lost, four stone to prove the argument I just made above. Of course the ‘fat acceptance’ snowflakes were frothing at the mouth; one in a studio discussion even threatened to call the rozzers on Ms Hokins for ‘hate crime’ KH simply invited her to have at it. Priceless.

Finally, the whole fat / obesity thing is about responsibilty and accountability. Accepting the resonsibilty to make your own decisions, and accepting accountability for the outcomes of those decisions.

Hana Jinks

7th August 2019 at 6:34 pm

It’s a hate-crime, Ed. It’s personally offensive, and l intend to report it.

The only good thing you can say about them, is they’re hilarious.

https://youtu.be/_YZ2FEGSeGc

Bri Fullerton

8th August 2019 at 1:23 pm

“eat less and move more” WRONG

(1). Eat much much less fattening foods (Carbs) then you will not feel hungry due to blood sugar crashes after your body stores the excess sugar from the carbs as body fat because of your insulin spiking.

(2). As for exercise (other than high intensity interval training [HIIT]) if you over do it (i.e. Cardio) then you will deplete your Glycogen stores and become hungry then you go back to (1).

I grew up in the 70s and we had treats (not daily snacking) once or twice a week, including 1 big bottle of pop (dandelion and burdock) not a big bottle of coke per day.

Eric Praline

8th August 2019 at 1:43 pm

This argument that because I can do something then so can anybody else doesn’t really stack up.

Hana Jinks

8th August 2019 at 4:25 pm

Agree 100%, Bri.

Ed, in a sane world, her hairdo would be considered a hate-crime.

Captain Scott

7th August 2019 at 10:08 am

We wrap our children in cotton wool, drive them to school and don’t let them out on their bikes for fear of mythical peados. We take them to McDonald’s for a treat and promise them chocolate if they are good.

Then we wonder why they turn out fat.

The obesity problem starts in childhood. My generation ate crisps, chocolate and all sorts of rubbish but we spent all our waking hours out on our bikes. Eat more, move much more.

christopher barnard

7th August 2019 at 9:18 am

Buerk’s views, like those of other commentators, are not really relevant.

The population is becoming fatter and fatter, and fat people have votes.

No politician is going to do too much to punish fat people financially, just as no politician is going to do too much to restrict car use or to catch more speeding motorists.

In a democracy it is only practical to punish unpopular minorities, not substantial numbers of ordinary voters

Jerry Owen

7th August 2019 at 9:11 am

Buerk is of course not a Doctor just as Attenborough is not a climate scientist.
When I go into my town centre and see all the disgustingly fat ( women in the main ) waddling into Pizza Hut Burger King and MacDonald’s it is hard to disagree with Buerk. There aren’t many fat people in the food bereft places in the world.
If people want to eat cake let them, if they cost the NHS money I’m glad ( touch wood ) that I’m not costing the NHS money as it means I relatively healthy… there but for the grace of God … etc.
I have the same attitude for smokers, We need to leave people alone.

Dave Wyatt

7th August 2019 at 9:02 am

Obesity is a massively complex area that is just not understood by most people – including Buerk and it appears the NHS. Ask yourselves why obesity has risen, when it started and who gained most from its rise. Considering the huge number of Slimming clubs, health clubs, so called low-fat diet foods and iffy government advise on the subject (which we’ve had for decades) why is it still on the increase? Shouldn’t you be asking ‘why’ rather than a simplistic ‘these millions of overweight people are just weak’. Take a look at the processed food industry and it’s highly addictive products. Take a look at what happens to the millions of people who diet only to put all the weight back on and more. As for quoting the NHS website (Giora comment above) – these are the people offering free slimming world at our expense when quite evidently it is only a short term fix (a knee jerk response)and has very little success and almost no long-term success. These are the people who can’t decide if eggs, fat and natural foods are good for us – the advise changes constantly. I used to respect Buerk but here he is being a complete berk.

Pru C

7th August 2019 at 1:18 pm

Yes, it is unfortunately complex and the simplistic interpretations have no or little due diligence behind them.

I’m curious why it’s women who are the fat canaries. I’m not prone to make knee jerk assumptions here though it’s all too easy to do. There’s a male species who would cry ‘women are lazy, here’s the proof’, sadly. No, there feels to me to be a response to something – something expressing itself which has an ‘unforeseen consequence’. The root of it… I’m not equipped unfortunately to dissect my own hypothesis. My guesses would be a combination of biology, business and pressure.

Simon Giora

7th August 2019 at 8:40 am

“Where Buerk is wrong is when he says, simplistically, that obesity can be explained by the fact that people simply eat too much.”

From the NHS web site: “Obesity is generally caused by eating too much and moving too little.”, Presumably the author believes there is no relationship between calories and and calories out.

“Obese people clearly have a greater propensity than slimmer people to gain weight.”. Not sure how to take this statement. If it means obese people are obese because of their metabolism then it is false. Only a very small percentage of fat people are fat because of a metabolic problem.

The author can do a simple experiment: eat lots of high calorie food everyday for the next 6 months, aim for around 5000 calories a day, and see if his weight changes.

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