Being fat is a class issue, and Scotland needs a radical obesity strategy

In January 2006, in one of his first major speeches as the newly elected leader of the Conservative Party, David Cameron asked why when the UK faced an obesity crisis, WH Smith was selling half-price chocolate oranges instead of real ones.

His remarks, in a speech on health policy, caused panic among industry and those in his party of a libertarian bent who saw this hinting as the worst kind of Nanny State-ism. The retailer itself was quick to point out that chocolate oranges were not the only fruit.

Cameron had tackling childhood obesity as one of his priorities for government and despite his later moves as Prime Minister to deal with it, he got an early taste for what happens when politicians have the temerity to confront commercial interests in attempts to tackle public health issues.

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A decade on, his successor – who was keen to express a clear divide between his premiership, which was perceived as one rooted in privilege, and her own, in which she vowed to make Britain a country that works for everyone – has been, ironically, the one to water down Cameron’s efforts to get to grips with Britain’s ever expanding girth and as a result, she will further damage the poor.

In her first speech as Prime Minister, Theresa May pledged to “fight against the burning injustices” of poverty, race, class and health and give people back “control” of their lives. Moments later, she sacked George Osborne, the Chancellor, who had surprised the food and drinks industry by proposing a so-called sugar tax, and a month later her government published a long awaited but much watered down child obesity strategy.

Gone was a ban on restricting junk-food marketing and advertising and in was a heavy reliance on voluntary action by the food and drink industry. The 13-page strategy was branded a disgrace and campaigners claim it will condemn too many poor children to a lifetime of health problems and a premature death.

And make no mistake, being fat is a class issue. The poorest children in society are also the fattest children – they are almost three times as likely to be as obese as the richest – and inevitably, more likely to become the fat and sick adults of the future.

This stark inequality is often tiptoed around, with even GPs worried about raising weight issues with their patients. But those whose children with a body-mass index in the red zone, who are in danger of high blood pressure, stroke, diabetes and getting cancers as they grow up, are also the poorest. The very rich might be called the fat cats, but in the main, they are also the thinnest because, ironically, they can afford to be.

Shouldn’t any government that claims to care deeply about social justice be doing more to change this?

Last week a seminal report published by the Royal College of Paediatrics and Child Health (RCPCH) revealed that Scotland, despite all its preventative health initiatives, has one of the worst children’s health records in Western Europe. It was unforgiving in its findings – the quarter of a million Scottish children who live in poverty are more likely to be obese, not breastfed and have parents who smoke.

The contents make for uncomfortable reading for a country that prides itself on its egalitarian principles. And for an SNP government that has put prevention and tackling inequality at its core, it is a damning indictment.

Aileen Campbell, Scotland’s public health minister, has been charged with pulling together Scotland’s latest obesity strategy which should be published in the next few months.

We need a game-changing strategy. One that stands up for our children rather than bends over to industry, that pays no heed to the libertarians that squeal about a Nanny State and that is brave enough to tell parents that they too have a responsibility to protect their children from harm by their actions.

Obesity is a more complex problem to tackle than smoking or drinking and an effective strategy needs to be multifaceted. But it’s not rocket science. People are fat because they eat too much and exercise too little. Of course, it is complicated by inequalities but that should not be an excuse for impotence and the minister should take some succour from the fact that among politicians and stakeholders, there already exists a strong consensus on the range of measures necessary. She could also piggy-back on the outrage that followed a diluted approach from England and declare ‘we can do better’.

As it stands, our children will suffer from a rising tide of ill-health due to obesity well into the future. And if politics is about anything, it is surely about insurance-proofing Scotland for the next generation.

Scotland led the way on a ban on smoking and on attempts to introduce minimum pricing on alcohol. It is true that in terms of parliamentary powers to deal with a sugar-tax or on advertising, there are limitations. And some of the messaging will be hard. But we have found ways to be innovative and brave before. The question for the Scottish Government over the next few months is whether it truly stands up for Scotland. If not, it will be judged, ultimately, on how it let its children down.