Colored image of an obese individual

Anthropology: Exploration of Obesity and its Impact on British Society

Obesity is one of the leading risk factors for premature death, causing 4.7 million (8%) deaths in the world in 2017. It is considered an individual problem in many societies. However, some view obesity as a social problem, not an individual one.  Britain has one of the highest rates of obesity in Europe (Littleford, 2022). In fact, the UK government considers obesity as “one of the biggest health crises the country faces” (gov.uk).   The government’s new ‘Better Health’ campaign is led by Public Health England (PHE). The aim of the campaign is to call on people to embrace a healthier lifestyle and lose weight if they need to. This article will explore the issue of obesity and its impact on British society.

What is obesity?

According to the National Health Service (NHS), the term ‘obese’ describes a person who’s very overweight, with a lot of body fat. According to the NHS, the easiest and most common way to check whether someone has a healthy weight for their height is by calculating their body mass index (BMI). The formula for BMI = kg/m2, where kg is a person’s weight in kilograms and m2 is their height in meters squared. A result between 30 to 39.9 means a person is obese, and 40 or above means that the person is severely obese.

However, the NHS highlights that BMI is not used to diagnose obesity because people who are very muscular can have a high BMI without much fat. The NHS website also suggests that for most people, BMI is a useful indication of whether someone’s weight is healthy.

Another, more reliable way to measure excess fat is waist size, which can be used as an additional measure for people who are overweight. For men, a waist size of 94cm or more, and for women, a waist size of 80cm or more.

colored infographic showing body mass index and weight classifications
lipedema.net

Causes of obesity

Besides the most obvious causes, such as genetics, medical reasons, calories, poor diet, and lack of physical activity, there are several other factors that can have a significant impact on whether someone becomes obese or not. According to the report “Tackling Obesity: The Role of the NHS in a Whole-System Approach” (2021), there are four factors that interact to shape health. These are the socio-economic factors, unhealthy behaviors, the physical environment along with social relationships, and finally, the treatment and support provided by the health and care system (Holmes, 2021).

The environment

The environment in which people live can pose a great challenge to healthy eating. This is because people who are surrounded by foods that are high in sugar, salt, or fat will choose those types of food as a default. Unfortunately, fast food outlets are more prevalent in deprived areas, meaning that those who come from a deprived environment are more likely to have an unhealthy diet, and in turn are more likely to become obese than people from less deprived areas (Holmes, 2021).

The economic aspect

In addition to the environmental factors influencing people’s diet, there is an economic factor that is related to food prices. For many people, healthy choices are simply more expensive. Actually, only half of UK households can meet the costs suggested by the guidelines of the government’s Eatwell Guide (Holmes, 2021).

Psychosocial factor

However, environmental and economic factors are not only related to income and choice. As the report points out, there are various psychosocial factors that are caused by poverty. For example, people who live in deprivation experience high levels of stress, causing them to lack the mental energy to dedicate time to cooking, preparing food, or being able to make healthy choices (Holmes, 2021).

Why is obesity a problem?

Obesity is considered a common problem in the United Kingdom. It is estimated to affect around 1 in every 4 adults and 1 in every 5 children aged 10 to 11. This means that 25% of UK adults are obese. In addition to this, a further 62% of UK adults are classified as overweight (Littleford, 2022). Globally, adult obesity is more common than under-nutrition. At least one-third of the world’s adult population is either overweight or obese (Seidell and Halberstadt, 2015). The increase in obesity around the world leads to significant health problems and reduced quality of life.  There are 7 million cases of diabetes, 6.5 million cases of heart disease and stroke, and 500,000 cancer cases linked to obesity in the United Kingdom (Littleford, 2022). According to studies on obesity, there is evidence that obesity can be linked to a range of physical and psychosocial health issues.

A graph showing statistics on weight and obesity in the UK
Weight statistics in the UK (2022) (healthexpress.co.uk)

Obesity and the increased risk of developing conditions

Tackling obesity is important because it can lead to a range of serious medical conditions. The main conditions linked to being overweight include:

  • High blood pressure and high cholesterol
  • Coronary heart disease
  • Stroke
  • Type 2 diabetes
  • Some cancers (for example, breast cancer, colon, kidney, and bowel cancer)
  • Gallbladder disease and gallstones
  • Osteoarthritis (joint condition affecting knees, hips, or back)
  • Gout (a disease that affects joints caused by too much uric acid in the blood)
  • Asthma and sleep apnea (a breathing condition that causes a person to snore heavily and briefly stop breathing during sleep)
  • Pregnancy complications

Although not everyone who is obese has these problems, being overweight or obese increases the risk of having those conditions (Ratini, 2020).

Impact of obesity on mental and emotional health

In addition to all the physical problems linked to obesity, researchers have found a relationship between obesity and psychosocial health issues. Excess weight affects the quality of life. Many people who are obese are physically unable to do the things they love, such as, for example, travel. This can lead to various negative outcomes such as isolation, loneliness, and even depression (Vafiadis, 2021).

Discrimination

Another significant challenge for those who struggle with weight issues is discrimination. Despite the fact that as obesity increases, our tolerance towards it also increases. Meaning that being overweight or obese has become more acceptable. There is still significant discrimination against obese people in many societies. Society often creates negative stereotypes and attitudes that associate obesity with unattractiveness, laziness, and lack of discipline. Those views and attitudes can be present at work, school, among peers, within families, and even in medical settings. Discrimination has a significant impact on people’s mental health and can lead to low self-esteem, depression, and anxiety (Vafiadis, 2021).

colored image of many pointing fingers at an obese woman behind her back
Obesity among young people is one of the key reasons for teasing and bullying (today.uconn.edu)

Anxiety

Finally, obesity can cause chronic pain as well as heightened inflammation. This can lower people’s immunity and can be one of the factors that cause depression and anxiety (Vafiadis, 2021).  Therefore, obesity is a public health crisis that has a negative impact on the individuals affected. It reduces life expectancy by an average of 3 to 10 years (NHS). But this problem has a negative impact on not just the individual, but the society as a whole. This is because it adds considerably to national healthcare budgets (Seidell and Halberstadt, 2015).

The economic costs of obesity

Obesity rates among adults in the United Kingdom are rising. In the last 25 years, the number of obese people in the UK has almost quadrupled. With rising numbers of overweight, obese, or morbidly obese people, the costs of treating medical conditions caused by obesity are also rising. It has been estimated that the total cost of obesity to health services around the world is US$990 billion per year (this is 13% of healthcare expenditures). The highest costs are in the Eastern Mediterranean and American regions. According to estimates, by 2025, global obesity prevalence is predicted to reach 18% in men and more than 21% in women (World Obesity, 2020).

In the United Kingdom, between 2014 and 2015, the NHS spent £6.1 billion on treating obesity-related illnesses. According to a report by The King’s Fund, titled “Tackling Obesity: The Role of the NHS in a Whole-System Approach”, it is forecasted to rise to £9.7 billion per year by 2050 (Holmes, 2021). Obesity is considered the biggest strain on the UK National Health Service. In the UK, bariatric (weight loss) surgery exceeds the annual cost of  £4.5 billion. In the year 2019/20, there were over 8 thousand hospital admissions for women, and over 3.5 thousand hospital admissions for men in England alone, where obesity was the primary or secondary diagnosis. This was an increase of 17% from 2018/19 (NHS Digital, 2021).

Colored graph showing number of hospital admissions for obesity in England
Number of hospital admissions for obesity in England from 2002 to 2020, by gender (statista.com)

Obesity and children

In the United Kingdom, 1 in 5 children in the reception year (that is 4-5-year-olds) is obese. Over a third of children in year 6 (10-11-year-olds) are classed as overweight or obese. Just like adults, children who live in more deprived areas are twice as likely to be obese.

According to data, 26% of children aged 10-11 years old living in deprived areas are obese, meanwhile, only 12% of 10-11-year-olds living in the least deprived areas are obese. Similarly, 13% of children 4-5-year-olds from deprived areas are obese, while only 5% of 4-5-year-olds from least deprived areas are obese (Littleford, 2022).

Obesity affects children’s body image and has negative physical and psychological consequences, similar to those experienced by obese adults. Many children in the UK have issues related to confidence and body image; 46% of 15-year-old girls report being “too fat”, compared with 23% of boys. Those children are also more likely to report being bullied because of their weight (Littleford, 2022). Discrimination and the stigma that leads to bullying have a significant negative impact on children’s mental health and can cause low self-esteem, anxiety, and depression.

Government strategies aiming to tackle and prevent obesity in the UK

In the last seven years, there have been six policy changes aiming to reduce and prevent obesity. In 2016, “Childhood Obesity: a Plan for Action” aimed to ‘significantly reduce rates of child obesity in the next ten years. This policy also introduced proposals to reduce the sugar content of soft drinks, which came into force two years later, in 2018 (Holmes, 2021).

In 2018, “Childhood Obesity: a Plan for Action Chapter 2” committed to halving childhood obesity rates and reducing the obvious gap in obesity prevalence between children from the most and least deprived areas by 2030 (Holmes, 2021).

Next year, in 2019, “Childhood Obesity: a Plan for Action Chapter 3 part of Advancing our Health: prevention in the 2020s” aimed to halve the prevalence of obesity among children and consult on food labeling options as well as reduce the sugar content of milky drinks (Holmes, 2021).

Government strategies aiming at preventing obesity in the 2020s

More recently, in 2020, a new government plan titled “Tackling obesity: Empowering Adults and Children to Live Healthier Lives” was established. This policy calls for individuals to lose weight and commits to improving the quality of food labeling by requiring restaurants to introduce calorie labeling on menus. In addition to this, the policy aims to change how food is marketed. This would be based on a ban on television advertising unhealthy food (foods high in fat, sugar, or salt) after 9 pm when children are most likely to see them (Gov.uk).

In 2021, there was another government measure introduced focusing on “Integration and Innovation: Working Together to Improve Health and Social Care for All”. This policy highlights the proposals including putting calorie labeling and advertising bans into law. In addition to this, it explains how the National Health Service should focus more on prevention and sets out a guide on how this should be done in the future (Holmes, 2021).

On Wednesday 6 April 2022, new rules requiring calorie information to be displayed on menus and food labels came into force after Parliament approved changes in 2021. As a result, large businesses with more than 250 employees are now legally required to display calorie information of non-packaged food and soft drinks. The businesses include cafes, restaurants, and takeaways. According to Public Health Minister, Maggie Throup: “It is crucial that we all have access to the information we need to maintain a healthier weight, and this starts with knowing how calorific our food is. We are used to knowing this when we are shopping in the supermarket, but this isn’t the case when we eat out or get a takeaway.” (Gov.uk)

The Better Health campaign to tackle obesity

In 2020, the Better Health campaign was launched, supporting people in the UK to take action and improve their health. The aim of the campaign is to make people feel better through simple steps towards a positive, healthier lifestyle. According to Talbot and Branley-Bell (2021), the public reactions to the Better Health campaign were mixed. Many individuals embrace the ideas behind the campaign, while others are critical of the lack of consideration of mental health and ‘surface-level’ solutions to the issue of obesity, which can cause more harm than good to those suffering from eating disorders.

The government’s approaches to tackling obesity are important in improving access to information. However, according to The King’s Fund report, addressing the various, complex factors affecting obesity, such as the environmental risk factors, requires a much broader approach. For example, the use of taxation and making healthy choices easier for those living in the most deprived areas in the UK (Holmes, 2021).

Cultural significance of obesity in anthropology

Obesity is an issue studied by various disciplines. An anthropological approach to obesity focuses on a complex evolutionary background and variations of obesity prevalence across cultures. Similarly, attitudes towards obesity and perceptions of body image vary across cultures. There are cultural norms, values, and beliefs specific to certain cultures and societies that surround physical appearance. Thus, there are some cultures that see obesity as a sign of affluence because of other social issues being prevalent, such as poverty and food shortages. Therefore, obesity is culturally significant because it affects the culture, and vice versa.

 

References:

Gov.uk (2020) “New Obesity Strategy Unveiled as Country Urged to Lose Weight to Beat Coronavirus (COVID-19) and Protect the NHS”. Available: gov.uk

Gov.uk (2022) “New Calorie Labelling Rules Come Into Force to Improve Nation’s Health”. Available: gov.uk

Holmes, J. (2021) “Tackling Obesity: The Role of the NHS in a Whole-System Approach”. Available: kingsfund.org.uk

Littleford, R. (2022) “Obesity Statistics: Facts and Figures in the UK”. Available: healthexpress.co.uk

NHS Digital (2021) “Statistics on Obesity, Physical Activity, Diet, England 2021”. Available: digital.nhs.uk

Ratini, M. (2020) “Health Risks Linked to Obesity”. Available: webmd.com

Sedell, J., C., and Halberstadt, J. (2015) “The Global Burden of Obesity and Challenges of Prevention”. Annals of Nutrition and Metabolism 2015; 16 (suppl 2). Available: karger.com

Talbot, C., V., and Branley-Bell, D. (2021) “#BetterHealth: A qualitative Analysis of Reactions to the UK Government’s Better Health Campaign”. Journal of Health Psychology. Vol. 27. No. 5. Available: journals.sagepub.com

Vafiadis, D. (2021) “How Excess Weight Impacts Our Mental and Emotional Health. Available: ncoa.org

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