Quotulatiousness

January 2, 2013

Don’t let your BMI scare you (too much)

Filed under: Health, Media — Tags: , , , , — Nicholas @ 10:47

A quick reminder that the Body Mass Index (BMI) is more a convenient mathematical trick than an actual healthy weight guideline:

In a finding that could undermine many New Year’s resolutions, a new government study shows that people who are overweight are less likely to die in any given period than people of normal weight. Even those who are moderately obese don’t have a higher-than-normal risk of dying.

Being substantially obese, based on measure called body mass index, or BMI, of 35 and higher, does raise the risk of death by 29%, researchers found.

But people with a BMI of 25 to 30 — who are considered overweight and make up more than 30% of the U.S. population — have a 6% lower risk of death than people whose BMI is in the normal range of 18.5 to 25, according to the study, being published Wednesday in the Journal of the American Medical Association.

People who had a BMI of 30 to 35 — considered the first stage of obesity — had a 5% lower risk of dying, but those figures weren’t considered statistically significant.

In other words, a few extra pounds are not going to threaten your life (a lot of extra pounds might). In the western world, few of us have the kind of jobs that require much in the way of physical exertion and we also have both relatively low food prices and much greater access to calorie-dense food. Our parents tended to have jobs that required more physical effort and their access to food was not as great as ours (they were less wealthy overall, and didn’t eat at restaurants or fast food joints as often as we do). Two otherwise positive trends that combine to produce a less-positive result on the scales.

Earlier discussion of the limitations of BMI as a guideline here, here, here, and here.

December 15, 2012

We solve a worldwide problem … and replace it with a new worldwide problem

Filed under: Africa, Economics, Food, Health — Tags: , , — Nicholas @ 00:02

Malnutrition used to be one of the biggest problems facing the planet: except in the west, starvation was rarely more than a bad harvest away. Today, except in sub-Saharan Africa, that’s been replaced by obesity as a worldwide problem:

Here’s a good news story that warmed the cockles of my heart as I wolfed down my breakfast of chocolate croissant with extra-large latte — obesity is now more of a problem than starvation. As we report:

    With the exception of sub-Saharan Africa, eating too much is now a more serious risk to the health of populations than eating poorly, found the Global Burden of Disease study, published in a special edition of The Lancet.

    Across the world, there has been significant success in tackling malnutrition, with deaths down two-thirds since 1990 to less than a million by 2010.

    But increasing prosperity has led to expanding waistlines in countries from Colombia to Kazakhstan, as people eat more and get less everyday exercise.

[. . .]

Likewise the fact that humanity can not only feed billions of people, but feed them well enough to give many of them Type-2 diabetes, shouldn’t be considered a worry but, after the Moon landings, perhaps humanity’s greatest achievement yet. Yes, we’re all stuffing ourselves silly, but we evolved in an environment where food was scarce and fats were vital to our survival. The very fact that, despite numerous doomsayers, we continue to overcome our problems, is something we should be celebrating.

December 12, 2012

“Big Food” is killing us!

Filed under: Cancon, Food, Health, Media, Science — Tags: , , , , — Nicholas @ 09:59

At sp!ked, Rob Lyons debunks a recent video by Canadian anti-corporate activist Dr. Yoni Freedhoff:

This is a handy menu of food-related government intervention that is trotted out all the time by food crusaders everywhere. But before we get to those interventions, maybe we should ask how we got here in the first place.

First, food got cheaper while, on average, we’ve been generally getting richer. In particular, if America is anything to go by, we spent less as a proportion of income on meat and dairy products — surprisingly, spending on fruit and veg has been pretty constant — and more on processed foods and sweets. In other words, we bought convenience with the money we were saving.

Second, suppliers and retailers realised that as food got cheaper, the way to make money was to ‘add value’ — in other words, take basic ingredients and make them more convenient, more ‘fun’, more ‘premium’ or to appeal to some other psychological need. Yes, food manufacturers are as capable of bullshitting as anybody else with something to sell.

One of the other ways that suppliers add value is to make ‘healthy’ products. But who set up those health claims in the first place? It was the media, the medical profession and, most of all, governments. Who said we should be stuffing our faces with fruit to get our ‘five a day’? Who suggested that we get more omega-3s? Who said we should aim to eat low-fat diets? All of these ideas got the big official stamp of approval. And in the spirit of convenience, the food industry has made it easy, for better or for worse, to meet these official goals.

[. . .]

Moreover, what about the wild claims made for organic food? It has a completely spurious image as natural and wholesome, but study after study finds no consistent difference between organic foods and conventional foods — apart from the price. Yet it is often the most vociferously anti-Big Food campaigners, bloggers and ‘experts’ who push organic as the healthy alternative.

[. . .]

Rather than endless calls for regulations, bans and taxes — whose efficacy is doubtful but whose effect on personal autonomy would be substantial — it would be far better to recognise that any diet with some modicum of balance will be fine for most people, who will live to a greater age than their parents or grandparents, on average, no matter how much disapproved food they consume. Claims that any particular food is some dietary panacea should be treated with a large, metaphorical pinch of salt, whoever makes them, whether they are an evil mega corporation or the bloke behind the counter at the health-food shop.

Above all, a similarly healthy scepticism should be applied to crusading medics who want to scare us with the idea that Big Food is out to kill us and who encourage politicians to regulate what we eat.

September 29, 2012

Regulating the size of soft drinks won’t solve the obesity problem, but will infringe on individual rights

Filed under: Food, Health, Law, Liberty, USA — Tags: , , , , , — Nicholas @ 10:41

At Reason, Baylen Linnekin explains that even if all the claims about the nutritional evils of sweetened soft drinks are completely true, regulations will not actually make much difference:

As an opponent of increased regulations, I find these latter scientific points noteworthy. But I also believe that even if sugar-sweetened drinks turn out to be virtually everything their opponents claim, people still have a right to buy and drink these beverages — just as much, as I argued in a recent Bloggingheads debate, as they have a right to buy a Big Mac. After all, we don’t have a right to free speech or to travel from one state to another because speech or travel has been proven by the scientific community to promote good health.

But suppose, for the sake of argument, I was to take at face value the assertions of those who claim the NEJM studies justify some combination of sugary drink taxes and bans.

There is still this problem: The solutions these advocates propose won’t likely solve the problem of obesity. For example, studies have suggested taxes will have little or no impact on obesity. And not one person has (to the best of my knowledge) even attempted to argue that soda bans would have any specific impact, either — unless one counts “sending a message” or “creating a debate” as conditions precedent to weight loss.

There is also the issue of a genetic predisposition, which again is one finding of the studies. Many people are genetically predisposed to certain food allergies — including soy, dairy, gluten, nuts, and seafood — and food intolerances. I have never seen a researcher or AP journalist like Marchione argue seriously that the widespread impact of food allergies “adds weight to the push for taxes” on wheat, tofu, and shrimp. Yet if one were to buy the argument of those calling for taxes and bans to combat consumption of sugary drinks in light of the NEJM studies, one would have to accept the idea of taxing society writ large based largely on the outcomes of what these researchers argue is a genetic condition.

September 3, 2012

A bit of common sense in food news

Filed under: Environment, Food, Health, Media — Tags: , , , — Nicholas @ 10:39

Rob Lyons reviews a new book by Mike Gibney that attempts to bring some common sense back to counteract the epidemic of fear-mongering about food:

Given much of the popular discussion about food, it would be easy to despair that we face a future where half the world’s people starve to death while the other half drown in their own fat. The words ‘new food research’ in a news report are often just the lead into another sorry tale about how some aspect of what we eat is going to kill us or how some specific food will provide ‘miracle’ protection against the chronic illnesses of our age.

Professor Mike Gibney’s new book, Something to Chew On, is a welcome step back from all this noise, offering an expert take on many of these claims. Gibney is director of the Institute of Food and Health at University College Dublin and has served on many national and international advisory committees.

[. . .]

Take pesticides, for example. Many people are prepared to pay through the nose to buy organic food which is free of artificial pesticides. But as Gibney points out, those people are actually consuming a far greater weight in natural, plant-produced pesticides that are potentially every bit as cancer-inducing as modern chemicals. ‘Nature abounds with chemicals which, while beautifully natural, are nevertheless risk-laden’, he says, from the deadly poison ricin, found in castor beans, to substances in fava beans that induce a lethal form of anaemia in some susceptible people. The key is in the dose: for both natural compounds and their highly regulated artificial counterparts, the amounts that we actually eat are too small to represent any threat to health.

Indeed, Gibney goes on to make mincemeat of all of the claims made for organic foods: they don’t taste better than conventional crops, they offer no nutritional advantage, and, by being less productive, they are actually wasteful of land. That’s hardly environmentally friendly.

Part of the reason we get such overblown nutritional and health “advice” from the media is the difficulty of conducting nutrition research:

While trying to figure out the effect of eating, or not eating, a particular kind of food on cancer or heart disease, for example, there are numerous confounding factors that get in the way of drawing robust conclusions. People lie about what they eat or simply don’t record it accurately; factors that look like cause and effect can turn out to be mere associations. Even finding enough subjects to look at the effect of diet on a relatively unusual disease, like ovarian cancer, can be very difficult.

[. . .]

The truth is that every study’s results need to be treated with caution and there needs to be open-mindedness about other possible explanations. While it is relatively easy to see the effects of vitamin deficiency, for example, for the most part nutrition research moves forward on the basis of a lot of evidence that is unsatisfactory in one way or another. The endless stream of claims that red meat, sugar, eggs and myriad other foodstuffs cause harm should be treated with an almighty pinch of salt (as do claims about salt, for that matter).

Along the way, Gibney offers his thoughts on personalised nutrition — the possibility of creating diets specifically suited to our own DNA — and epigenetics — the idea that different elements of our DNA can be switched on or off by environmental factors in the womb or the first years of life. He also offers a Jacques Cousteau-like tour of the human gut. Did you know there are 10 times more bacteria living in our guts — 100 trillion — than there are cells in the human body? Did you know those bacteria can sometimes switch on or off changes in our bodies to suit their own needs? Gibney describes our relationship to this mass of bugs as a permanent state of ‘armed peace’, with mutual benefits to both parties: body and bacteria.

August 25, 2012

Yet another factor in obesity

Filed under: Food, Health, Science — Tags: , — Nicholas @ 00:09

“I want to say one word to you. Just one word.” Antibiotics.

We aren’t single individuals, but colonies of trillions. Our bodies, and our guts in particular, are home to vast swarms of bacteria and other microbes. This “microbiota” helps us to harvest energy from our food by breaking down the complex molecules that our own cells cannot cope with. They build vitamins that we cannot manufacture. They ‘talk to’ our immune system to ensure that it develops correctly, and they prevent invasions from other more harmful microbes. They’re our partners in life.

What happens when we kill them?

Farmers have been doing that experiment in animals for more than 50 years. By feeding low doses of antibiotics to healthy farm animals, they’ve found that they could fatten up their livestock by as much as 15 percent. You can put the antibiotics in their feed or in their water. You can give the drugs to cows, sheep, pigs or chickens. You can try penicillins, or tetracyclines, or many other classes of antibiotics. The effect is the same: more weight.

It seems reasonable to assume that this effect is also true for humans. And we dose ourselves with antibiotics far more than we should (often for things that do not respond to antibiotics at all … a twist on the placebo effect). In addition, many of the animals we raise for meat are regularly dosed with antibiotics.

For now, two things are clear. First, antibiotics have done a huge amount of good in treating bacterial infections and if we’re even talking about reducing their use, it’s because we have the luxury of health that they have provided. Second, they are clearly overused: prescribed for illnesses that they have no power over, and used to fatten livestock that aren’t sick. Currently, on average, every American child gets a course of antibiotics ever year.

The overuse of antibiotics has fuelled the rise of antibiotic-resistant bacteria, but their impact on our beneficial bacteria could be equally detrimental. Blaser has been vociferously banging on this drum for years. As he wrote in a comment piece for Nature, “Antibiotics kill the bacteria we do want, as well as those we don’t… Overuse of antibiotics could be fuelling the dramatic increase in conditions such as obesity, type 1 diabetes, inflammatory bowel disease, allergies and asthma… We must make use of the available technology to protect and study our bacterial benefactors before it is too late.”

August 7, 2012

Chick-fil-A and the same-sex marriage debate

Filed under: Business, Media, Politics, USA — Tags: , , , , , — Nicholas @ 09:31

Sean Collins at sp!ked:

As welcome as it was to see many stand up for free speech, the focus on First Amendment rights missed the bigger picture. While making principled references to Voltaire, these critical liberals were still using the Chick-fil-A issue to expand the definition of what it means to be ‘homophobic’, so that it now includes the mere utterance of support for traditional marriage. It is noteworthy that Chick-fil-A does not discriminate on the basis of sexual orientation — it has gay employees and it serves gay customers. A franchisee in Chicago has held fundraisers for gay and lesbian groups.

Advocates for same-sex marriage want expressions of support for traditional marriage to be considered beyond the pale and unworthy of debate. It is amazing how fast this issue is moving. Three months ago, Obama was against same-sex marriage — is anyone who espouses that view today now anti-gay and ‘repugnant’? Obama launched his political career in Chicago — was he out of line with ‘Chicago’s values’ until his conversion to the gay-marriage cause 90 days ago? Same-sex marriage has been voted down in all 31 states where it was on the ballot, including in California — are these states filled with ‘bigoted and homophobic’ people?

Millions of Americans, including many CEOs, do not agree with same-sex marriage. But it is clear that Chick-fil-A’s CEO has been singled out because his restaurant chain fits a Culture War stereotype held by many coastal liberals: a Southern-based establishment led by Christians and frequented by ‘backward’ people. It is revealing how pro-gay marriage protesters took the opportunity to condemn Chick-fil-A customers for committing another of today’s sins — being obese. As the New York Times reported, some protesters held signs with ‘warnings that those chicken sandwiches contain a lot of fat and cholesterol’. Dan Turner of the Los Angeles Times helpfully pointed out that ‘a fairly typical meal — a deluxe chicken sandwich with medium waffle fries, a medium Coke and a fudge brownie — contains about enough calories and fat to support a Tunisian village for a week’. The ease with which commentators went from attacking a certain group of people for their beliefs on marriage to attacking them for their eating habits told us a great deal about the elitism that is fuelling the gay-marriage issue.

August 2, 2012

US military faces recruiting nightmare

Filed under: Health, Military, USA — Tags: , , , , — Nicholas @ 09:17

Strategy Page outlines the most recent major problem the US military is facing: the bloat of potential recruits (not in numbers, but in individual mass). While the number of new recruits needed is declining, the pool of potential recruits to draw from has been declining even faster:

The problem is that Americans have, in the last two decades, become very fat and out-of-shape. There are 32 million male Americans of prime military age (17-24). But because of bad lifestyle choices, only 13 percent of them (4.2 million) are physically eligible for service. Each year, the armed forces have to recruit 150,000 new troops. The military is allowed to waive some physical or mental standards, and this means that only about 20 percent of those 32 million potential recruits qualify. Each year, recruiters have to convince about two percent of those eligible that they should join up. It’s a tough job, made worse by a generation that eats too much, exercises too little and doesn’t pay enough attention in school. You not only have to be physically fit enough to join, you also have to be smart enough and have no criminal record.

The enormous growth in computer entertainment, and subsequent massive reduction in exercise teenage boys get is the major reason for the body fat percentage crisis. As a result, one of the biggest problems American military recruiters have is unfit young Americans trying to enlist. Some 57 percent of potential recruits are not eligible because they do not score high enough on the aptitude test the military uses to see if people have enough education and mental skills to handle military life. Many of those who score too low do so because they did not do well at school. A lot of these folks have high IQs, but low motivation. Most of the remainder are not eligible for physical reasons. But get this; the most common physical disqualifier is being overweight. Nearly a third of the people of military age are considered obese. Many of these big folks are eager to join, and are told how much weight they have to lose before they can enlist. Few return light enough to sign up.

Computer gaming and other forms of indoor entertainment certainly bear some of the blame for the obesity problem, but other issues should also be included: helicopter parents who don’t dare let their kids go outside to play without full-time parental supervision, schools that have reduced or eliminated physical education for budget or liability reasons, and the huge increase in availability of low-priced, high-calorie fast foods.

July 20, 2012

Reason.tv: How the Government Makes You Fat: Gary Taubes on Obesity, Carbs, and Bad Science

Filed under: Food, Health, Science, USA — Tags: , , — Nicholas @ 00:09

“The government can come along and, with all the best intentions, cause enormous problems” says Gary Taubes, a science writer and author most recently of Why We Get Fat And What To Do About It.

Reason.tv’s Zach Weissmueller talked with Taubes about his controversial work in the world of nutrition and epidemiology, including Taubes’ hypothesis that carbohydrates, not dietary fat, overeating, or lack of physcial activity, are the primary factor causing obesity. Other topics include the inability of governments and large informational institutions such as the American Heart Association to adapt to new information, the mess of bad legislation and bad science that Taubes believes led to America’s obesity problem, and why many libertarians seem to love the Paleo Diet.

Taubes’ work has unsurprisingly invited criticism from scientists, government officials and journalists, even in the pages of Reason Magazine, where he went back and forth with Reason contributor Michael Fumento.

July 10, 2012

BMI: Badly Misleading Indicator

Filed under: Health, Media — Tags: , , , — Nicholas @ 09:04

Lewis Page explains why being too thin is a bad idea health-wise:

Yet another study has shown that the so-called “obesity” epidemic sweeping the wealthy nations of the world has been massively over-hyped, as new results show that is is far more dangerous to be assessed as “underweight” than it is to be assessed even as “severely obese” — let alone merely “obese” or “overweight”.

“There is currently a widespread belief that any degree of overweight or obesity increases the risk of death, however our findings suggest this may not be the case,” says health prof Anthony Jerant, lead author of the study. “In the six-year timeframe of our evaluation, we found that only severe obesity was associated with an increased risk of death.”

Most statistics in this field are still based on the now widely discredited Body Mass Index (BMI) system, under which people are assessed as “underweight”, “normal”, “overweight”, “obese” or “severely obese”. BMI, devised in the early 19th century by an obscure Belgian sociologist without medical qualifications, copes poorly with increases in height as it assumes the human body will scale up in mass in proportion to the square of height — which doesn’t allow for the fact that bodies are three dimensional — and further fails to allow for the greater cross-sectional area needed in supporting structures to carry increasing weights.

June 19, 2012

British “researchers” call for starvation diets to meet carbon targets

Filed under: Britain, Environment, Health — Tags: , , — Nicholas @ 11:04

There’s only so much “mad” you can tolerate in the ranks of your “scientists”, and these guys are more than a bit over-the-top:

A famous mad professor who has previously called for Britons to starve their children into dwarfism so as to ease strains on the planetary ecosystem has reiterated his arguments, this time insisting that the amount of surplus flab carried by the human race will soon be equivalent to having another half-a-billion people on Earth.

Regular readers will be familiar with Professor Ian Roberts of the London School of Hygiene and Tropical Medicine already: he and his colleague Dr Phil Edwards wrote a paper in 2009 in which they suggested that it would be a good idea for Britons and Americans to model their diet and physique on that of the “lean” Vietnamese, as this would assist in such things as meeting British government carbon pledges. Lightweight Vietnamese people, according to the two scientists, not only need less food but use less energy to move themselves around.

Unfortunately, as we pointed out at the time, this would not merely have been a matter of Britons shedding some flab. In order to match the Vietnamese on weight, Brits would also have to lose four inches or so of height. Extrapolating from Roberts’ and Edwards’ figures, in fact, the people of the UK would need to shrink to a Hobbit-like stature barely over three feet to meet the more ambitious governmental carbon goals.

Oh, and in case you still think BMI has any scientific validity, here’s your disillusionment of the day:

Unfortunately the entire edifice of their argument is based on the long-discredited Body Mass Index (BMI), a frankly bizarre method of assessing how fat people are which was developed by an obscure Belgian social scientist without any medical qualifications in the early 19th century. The BMI assumes that healthy human mass goes up in proportion to the square of height, a patently absurd suggestion given that human bodies are three-dimensional rather than flat 2D shapes. All other things being equal a human’s weight should go up related to the cube of height — and indeed they aren’t equal. Any engineer will point out that cross-sectional area in support structures (feet, leg bones etc) needs to go up in direct proportion to weight carried, adding still more heft than a cube law would as height goes up. This is why elephants are not simply scaled-up dogs, and dogs are not simply scaled-up insects — they have proportionally thicker legs and other supporting structures and come out much heavier.

As one would expect, then, it has been confirmed by several recent studies among the taller populations of the modern-day developed nations that a BMI assessment of “overweight” should really be assessed as normal or healthy, while the previous “normal” range ought in fact to be dubbed “underweight”, as it has negative health consequences similar to being “obese”.

By suggesting that the human race — including the taller peoples — needs to shift into the outmoded BMI “normal” range, Roberts and his fellow public-health experts are advocating a course which would cause more health problems: scarcely what they are paid to do.

June 7, 2012

Reason.tv: Obesity in America

Filed under: Food, Government, Health, USA — Tags: , , , — Nicholas @ 00:07

May 16, 2012

Nanny knows best, part MCMLXII

Filed under: Books, Britain, Food, Health, Politics — Tags: , , — Nicholas @ 08:46

Chris Snowdon at the Adam Smith Institute blog:

When we scheduled the release of The Wages of Sin Taxes for 15th May, we did not guess that it would be sandwiched between the announcement of a 50p minimum price for alcohol in Scotland (Monday) and a new campaign for sin taxes on food and soft drinks (today). Writing in the British Medical Journal, two academics have just called for price hikes on sugar-sweetened beverages and ‘junk food’ as a way of dealing with Britain’s alleged obesity epidemic.

Obesity rates, like drinking rates, have not actually risen for ten years, but the same decade saw the medical profession gain an uncanny grip on the nation’s political process and they are in no mood to relinquish it. Taking a break from hassling smokers and drinkers, the mandarins of public health have taken the ‘next logical step’ and moved on to the general population.

“Economists generally agree,” they write, “that government intervention, including taxation, is justified when the market fails to provide the optimum amount of a good for society’s wellbeing.” Even if this dubious statement were true, there has never been a time when the market offered more choice in what we eat than drink than today. And, contrary to popular belief, it is much cheaper for a family to subsist on fresh fruit and vegetables than it is to eat out at McDonalds three times a day. For the spokespeople of public health, the problem is not that there is a lack of options, but that we plebs are not choosing the right ones.

Defining junk food is notoriously difficult. As Rob Lyons explains in his excellent book Panic on a Plate, a portion of McDonalds fries contains a quarter of an adult’s recommended intake of Vitamin C, while middle class favourites like olive oil, parmesan and pasta are rather fattening. A tax on “sugar sweetened beverages” will presumably leave apple juice and smoothies untouched, despite the fact that fruit juices are often sweeter and more calorific than Coca-Cola.

January 10, 2012

Parents (absolving themselves from any responsibility) want Ottawa to solve child obesity problem

Filed under: Cancon, Government, Health, Media — Tags: , , — Nicholas @ 10:27

Parents who fear to let their children go outside want the federal government to magically fix the problem the parents have created:

The majority of parents believe they play a major role in whether their children are overweight, but many also want the government to build more recreation centres.

[. . .]

The survey done by Ipsos Reid talked to 1,200 people, and most feel obesity is the leading health issue facing children today — more so than drugs, smoking and alcohol.

The survey found that 61 per cent of Canadians don’t think Ottawa is doing enough, and 70 per cent strongly support government initiatives that would educate children on healthy choices.

If you don’t let your children go outside unattended (hence the desire for “recreation centres”, where the little snowflakes will be supervised at all times), they won’t get as much exercise. Without exercise, on a typical modern diet, they’ll gain weight. Having gained weight, they’ll be even less likely to voluntarily exercise. Rinse and repeat for 18 years.

November 3, 2011

A “fat tax” would not improve anyone’s health or the healthcare sector

Filed under: Government, Health, Liberty, Media — Tags: , , , — Nicholas @ 09:10

Politicians and “food celebrities” in many western countries are calling for a tax on obesity, either on the foods that “make people fat” or on obese people themselves. Other than being incredibly regressive (poor people in the west tend to be fatter than well-off people), such a tax would do nothing to address the problem it is supposed to solve:

The regular calls for a fat tax — whether on the ‘wrong’ foods or on fat people themselves — are symptomatic of two regressive trends in society. The first is the view that experts know best, that these latter-day sages can come to an impartial view based on The Science, then guide government about the appropriate policy action. The new, evidence-based policy usually involves some kind of manipulation of our individual behaviour from gentle ‘nudges’ and increasing taxes through to criminalisation, as in the case of the smoking ban.

But this is not evidence-based policy, but policy-based evidence, with preconceived ideas being pushed through in the name of science at a time when those at the top of society have lost the ability to convince the electorate on the basis of a moral or political argument. This style of policymaking rarely solves social problems, but it does distort both politics and science.

The second worrying trend is the sheer intolerance towards obese people. Being very overweight has always attracted a certain amount of moral opprobrium. But Hatton’s outlook reflects a sea-change. Once, the NHS reflected a progressive outlook that disease was a misfortune that could strike any of us at any time and that the best thing to do was to share that burden across society. Now it’s every man and woman for themselves. In the worldview of Hatton and Coren, some morally weak individuals are costing them money and must be punished.

Ironically, this flows from a left-wing view of disease as having social causes. In the late Seventies, left-wingers correctly saw that some ill-health was the result of poverty, poor housing, polluted air, and so on rather than infection or bad luck. Unfortunately, this has morphed into the idea that disease is caused by individual behaviour — and so health professionals have taken to camping out in our private lives, demanding we stop smoking, drinking and eating the wrong things. Every naughty little pleasure must now be sacrificed to the god of longevity. If we don’t play ball, this intolerance suggests we should lose our right to treatment.

The disease of intolerance is likely to have a far more detrimental effect on society than obesity ever could.

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