Obesity - a growing problem

Health promotion lecturer David Wilkins weighs up the growing concern over overweight boys and asks what should be done

If you're in your mid-thirties or above, think back to your childhood. How often did you see boys or young men who were overweight?

It was unusual enough probably, that the names of your more heavyweight contemporaries have stuck in your memory for that reason alone. Yet in the last year for which national figures are available (1994), almost one boy in ten was overweight; a proportion that had, amazingly, virtually doubled over the preceding ten years. Although no more recent figures are available, it seems clear that the numbers have continued to rise. These chubby juvenile trailblazers will soon be grown, and the evidence is that they are likely to remain overweight for much of their adult lives, with all the attendant risks to their health and well-being. Already 17% of adult men are obese and no less than two thirds are more than the recommended weight for their height.

Of course, this is not a simple issue. There are medical arguments to be had about whether to be overweight is necessarily to be unfit - and it would be an arrogant over-simplification to assume that to be overweight is to be unhappy. Similarly, we ignore at our peril the nettled reaction of those who observe that the 'weight police' have now come knocking for men too (and it is certainly true that the tyrannous equation, 'slim = desirable' is increasingly becoming as familiar to men as it has long been to women). Nevertheless there is no denying the evidence; that with greater weight comes greater risk of illness, disability and premature death. Those lines on the graph run inexorably parallel, like railway tracks onto a rickety bridge.

Whose fault is this? The unreasoning observer might be tempted to shrug his or her shoulders and reply to this straightforward question with an accusatory enquiry - one beloved of football crowds everywhere: 'Who ate all the pies'? But is it just that individual men are eating too much and exercising not enough? At its most basic level, of course it is - and we need desperately need significant investment in good, practical interventions that address these issues in a way that takes account of male sensibilities. At the same time, we need to look a little more searchingly at ourselves and our society. We also need to ask some pertinent questions of our politicians.

Ultimately, we can address the problem of increasing numbers of overweight men - a problem, as we have seen, of unprecedented scale - only by considering it within prevailing social, cultural and political circumstances. One does not need to be a social scientist to see that changes of the magnitude we have seen in the past couple of decades must reflect changes in context at least as much as changes in individuals. There are questions here for health professionals and academics: we need to ask, for example, just why so many men apparently do care so little about their health and appearance; to try to understand why so many men drink so much (over a million men drink more than 50 units of alcohol each week according to figures published this month by Alcohol Concern); and to consider the decline in participation in sports and other physical activities amongst our youngsters. There are questions for our elected leaders too about the priority - or rather, lack of priority - given to health when policy decisions are made in other fields: we need to find ways of influencing food policy, transport policy, education policy, planning policy, and policies that have an impact on work/life balance.

Roget's Thesaurus lists 'fat', 'obese' and 'overweight' as synonyms for 'fleshy'. Amongst the alternatives, it offers 'jolly'. At a population level however, this really is no laughing matter.

David Wilkins; Lecturer/Practitioner in Health Promotion

Bournemouth University and HealthWorks, Dorset