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Fattest nation in the world?

The long-running media panic around obesity in Australia seemed to reach a crescendo in June when The Age ran with the front page headline 'Nine million Australians are a ticking "fat bomb"'. Normally I'd blame sub-editorial hyperbole for the disturbing image this evoked, but the headline accurately mirrored the title of the Baker Heart Research Institute's report Australia's Future Fat Bomb.

Australia has become the 'fattest nation in the world' the report claimed, with more than 9 million adults 'obese or overweight'. The 'fat bomb' was set to cause 123,000 premature deaths.

It's now a decade since the editors of the New England Journal of Medicine questioned the usefulness of epidemiological studies of obesity, yet still journalists unquestioningly bang on about the 'obesity epidemic'. Reports of this 'epidemic' are based on calculations of the body mass index (BMI): a person's weight in kgs divided by his or her height in metres squared. Yet the BMI is a totally arbitrary measure of 'fat', and 'fat' in turn a very poor proxy for fitness and mortality risk. Most studies show that mortality risk is determined by cardiovascular and aerobic fitness which in turn is a function of physical activity, not how much you weigh. The lowest mortality rate for non-smoking men occurs with a BMI that would be currently considered 'overweight', and the relationship between BMI and mortality is especially weak for non-smoking women, suggesting a woman of average height can weigh anything within a 35 kg range without any statistically meaningful change in mortality risk.

In any case, within days of the 'fat bomb' report, the Australian Institute of Health and Welfare rebutted the claims, saying 'it did not know of any reliable statistics which would support the claim that we are worse than all other countries'. What's more, the Baker Institute report was not based on a population survey, but on the BMI of those who had presented at 100 centres as part of a national blood pressure screening day. In other words, it sampled those who were worried about their blood pressure and heart disease, and so, given recent health campaigns, are more likely to have a high BMI to begin with.

But if fat won't kill us, our fear of fat might. Most dieters dangerously yo-yo in weight, regaining the weight they lose, while a significant number gain more than they lose. Then there's the genuinely deadly health problem of anorexia. One local parenting magazine a few years ago ingenuously warned parents about toddler obesity and teenage eating disorders in the space of a few pages. Even before the onset of adulthood, then, the current generation will have beaten a path from the weight loss clinic to the child psychologist and back again.

Many social commentators like to point to the 'obesity epidemic' as emblematic of a contemporary 'supersize' capitalism and its imperative of consumption. But what sets apart the current generation is not our plump body shape but that, unlike the 'fat' 18th century or 1890s, we are fundamentally dissatisfied with our shape. As Hillel Schwartz has pointed out in his book Never Satisfied, dieting, not obesity, expresses the logic of late capitalism.

Capitalism needs to manipulate desire, rather than provoke satiety. The diet, with its frustrations and ultimate disappointments, is good at this. Few other things go so effortlessly with the grain of capitalism: cigarettes maybe, because the pleasure smoking brings is simply the satisfaction of a craving that, if you didn't smoke, you wouldn't have in the first place.

Of course, it's not just fear of our own fat, but disapproval of others' fat that underpins much commentary on the obesity epidemic. This is what is not new. Social commentators in the 19th century deplored the eating habits of poor people, who were seen as slothful, too lazy to prepare proper food, too easily led by a passion for sweets. George Orwell bemoaned the physical degeneracy of the English in The Road to Wigan Pier, acknowledging the role of the Great War but more convinced the cause was an industrial lifestyle that provided the working classes with 'cheap substitutes for everything'.

'We may find in the long run', he wrote, 'that tinned food is a deadlier weapon than the machine gun'. Dead of tobacco-assisted tuberculosis at age forty-seven, perhaps Orwell should have been pointing the finger at cigarettes. And Fidel Castro, having given up cigars many years ago, survived to lead Cuba into its glorious fifth decade of revolution.

Anthony O'Donnell lectures in Law at La Trobe University and lives, cooks and gardens on Melbourne's northern waterways.
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Author:O'Donnell, Anthony
Publication:Arena Magazine
Geographic Code:8AUST
Date:Aug 1, 2008
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