Could the panic about obesity be making things worse?

Panic: Scare stories about obesity have been coming thick and fast over the last few days. On Friday 25 August, we were told that England would have 13million obese people by 2010 - one million of them children. The government appointed health minister Caroline Flint to co-ordinate action on increasing our activity levels as a result. This week, the British Fertility Society recommended that women with a body mass index (BMI) above 36 should be denied free fertility treatment on the grounds that they were less likely to conceive - although they were only suggesting a national strategy to replace the current hotch-potch of local restrictions that are often even more severe. Thursday saw the release of an `obesity map' of England, with the slimmest areas all being London boroughs, while the areas with the greatest risk of obesity are mostly in the north.

Don't panic: While the grim reports of early death and chronic disease associated with obesity are used to scare us into staying thin, the truth is that while we're getting fatter, we're also living longer. In fact, the government seems to be promoting two contradictory panics at the same time: that life expectancies may fall due to obesity, while the country will be bankrupted by pensioners living too long.

The relationship between obesity and ill-health is much more complicated than the simplistic fat=unhealthy story we are typically given. In fact, being `overweight' is associated with lower mortality than `ideal' weight - and being `overweight' is certainly healthier than being underweight. BMIs above 30 are not necessarily unhealthy either. The key seems to be activity - fat but active people have similar or better health prospects than thin but sedentary people. In any event, obesity is only relatively important as a health risk in younger people. Since young adults don't get sick very often, this relative increase in risk still represents a low absolute risk. As people get older, the effect of age far outweighs the effect of weight.

Not only is the concern about obesity overstated, the anxiety about our weight has all sorts of negative consequences: it screws up our relationship with food; it creates a nation of hyperchondriacs fretting every time they step on a scale; it promotes misery about our appearance. Worse, by encouraging dieting, which in turn leads to most people yo-yoing in weight, it may actually increase the risk of ill-health: people who lose weight and regain it have a greater risk of mortality than those who never tried to lose weight.

Incredibly, because two-thirds of us are categorised as overweight or obese, the panic about obesity manages to demonise the majority of the population. We have created a carnival of self-loathing that surely outweighs any possible benefit from being thinner. As the American commentator Paul Campos shrewdly notes about the `war on fat': `In the end nothing could be easier than to win this war: all we need to do is stop fighting it.'

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