Why is no one addressing the true cause of obesity?

The last week has seen yet another bout of worry about the state of the nation's waistline with the launch of a campaign by surgeons, psychiatrists, paediatricians and GPs at the Academy of Medical Royal Colleges to battle our ‘single greatest public health threat’ (1) - obesity. Cue lots of advice, finger wagging and commentary which can generally be summarised as "just eat less calories and exercise". The argument is that it is all about personal lifestyle choices and if only we'd eat fewer calories and exercise more then we'd all be thin and happy.

But something is missing.

Sure, there are a lot of people out there who are obese due to lifestyle choices, but there are also a lot of people who are trying to eat well and still struggling to lose weight. Is it always a case of a lack of discipline?

No, it isn't. In fact a big part of the reason we find it difficult to control our calorie intake is that the totality of how we eat and how that relates to our health and weight seems to have been reduced to a simple equation: food = calories. Now, I know that on one, simple, level this is true and that if you eat too many calories you will put on weight. But it doesn't account for everything that food is and how it affects us. Allow me to illustrate this with a rather cruel, but illuminating experiment carried out in 1960:

In 1960, researchers at Ann Arbor University performed an interesting experiment on laboratory rats. Eighteen rats were divided into three groups. One group received cornflakes and water; a second group was given the cardboard box that the cornflakes came in and water; and the control group received rat chow and water. The rats in the control group remained in good health throughout the experiment. The rats receiving the box became lethargic and eventually died of malnutrition. But the rats receiving cornflakes and water died before the rats who were given the box....(2)

What this shows us, other than the fact that researchers at Ann Arbor in the 1960s had empathy issues, is that there is clearly more to food than how many calories it has. Which is why we often still feel hungry an hour or two after eating an average breakfast cereal; we are getting calories, but not the nutrition we need. This is the real reason so many put on weight even while carefully calorie counting: if you measure out your food intake to ensure you only consume 2,000 calories a day, but 500 of those are from a chocolate bar and a coke (which I can assure you, have a worse nutritional profile than even the cornflakes fed to those unfortunate rats) then we shouldn't be surprised when we still fancy a midnight snack. At first you might lose weight, but as research has shown time and again, eventually most are likely to put the weight back on, plus a couple of extra pounds for good measure. In essence when you lose weight by calorie counting without accounting for the nutritional profile of the food you are consuming, you are starving the body of nutrition, and it will make you crave more food until you change what you eat or simply give in.

What is truly interesting about this is that everyone more or less already knows this. We know that coke and most chocolate bars are bad and that greens are good. In fact, most people have an idea that they should be eating whole grains over heavily refined foods. But despite this, I continue to see calories from very different types of food equated with each other more or less every time I read about food in the media. If you are in any doubt have a look at this quote from a recent article about the hidden risk presented by the high quantity of sugar found in many fruit juices:

Half of people who admitted to drinking three or more sugary drinks in a day said they did not compensate by reducing the calorie intake of their food while nearly a quarter of those surveyed did not take into consideration their liquid sugar or calorie intake when they were last on a diet. (see 3, my emphasis)

Note that the problem isn't that you are having sugary drinks, but that you aren't reducing your calorie intake from elsewhere in your diet to compensate for those sugary drinks; after all, what matters is the number of calories, not where they come from, right? Wrong. Very wrong in fact. In the 17th century there are tales of sailors who were shipwrecked on islands for months and lived on nothing but water. Alarmingly, there are also stories of sailors who were marooned with water and a shipment of sugar - they all died within two weeks (4). It would seem it is better to eat nothing than sugar, and yet we are being told not only that we can incorporate this into our diet, but that we should actually replace other calories to accommodate it!

It is interesting how eager we seem to be to replace everything we understand about food with a simplistic and abstract model, which at best distorts the true impact of our eating decisions, and which potentially does considerable damage to the health of our society. I believe that until we understand that what we eat is far more important than how much we eat, we will not see an end to this obesity problem.


1. Academy of Medical Royal Collages: http://www.aomrc.org.uk/item/medical-profession-united-in-fight-to-defuse-obesity-time-bomb.html
2. Fallon S. and Enig, M. G. 1999 Nourishing Traditions
3. http://www.independent.co.uk/life-style/health-and-families/health-news/sugar-warning-for-healthy-drinks-7654017.html
4. Dufty W 1975 Sugar Blues