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Wednesday, August 27, 2008 

No excuses for being Andrew Lansley.

There are, according to Andrew Lansley, no excuses for being fat. Or to be slightly more specific, being obese. Apparently, the idea that biology or environment has any bearing on whether someone is overweight is simply making excuses. Making excuses is bad. As is nannying. Our government does both. That makes the government bad.

This is an extension of Cameron's speech a few weeks back that a lot of people's problems are self-inflicted. To a certain extent this is undeniably true; saying so is not something radically new, or something that has been actively discouraged, despite how the Conservatives have tried to portray it as doing so. It's more simply that somebody noticed that most bristle at being told that everything is entirely their fault; rather that doing so more subtly, not being quite so confrontational and being more feel-good tends to work far better. This isn't political correctness, this is simply being far more sensitive, which is more likely to work.

In fact, Lansley is actually taking it a step further than Cameron by rejecting the idea that there are any excuses. Cameron added:

"Of course, circumstances - where you are born, your neighbourhood, your school, and the choices your parents make - have a huge impact. But social problems are often the consequence of the choices that people make.

Cameron then does indeed believe that both biology and environment have their effect on obesity, which is wise, because they both obviously do.

Ignoring where you were born and what you are born into for half a second, would Lansley agree that there is an excuse for someone being overweight if the medication which they take has a side-effect of weight gain (Yes, bear with me, I'm being rhetorical, I'm sure he would)? After all, that is most certainly an excuse which some could make when they were overweight to begin with, but it could also be a valid one.

Like with Cameron, Lansley again isn't aiming this at the obese members of his own party. It's the nod and the wink - it's not the Fatty Soameses of this world that are the problem, obviously, but rather all those gigantic, wobbling, welded to the pushchair, acne-riddled layabouts that stuff their faces all day and then have the audacity to walk around our towns and cities where other members of the public might see them. Likewise, Lansley must surely agree that there are no excuses for the put upon single-mother, the kind that has to allocate every single penny of her income, the one that shops not at Waitrose or M&S or even Tesco or Sainsbury's, but at Netto, Farmfoods, Iceland, Lidl, etc. The one that doesn't have the time, or energy, to as this person on CiF says, "produce healthy food from basic ingredients". She could do that, if she wanted to be on her feet for another two hours of the day, but why bother when she can buy the economy pizzas, ready meals at however many for £5 and otherwise which can either be popped straight in the oven or straight in the microwave?

Now that we've agreed that there are no excuses whatsoever for being the size of a house, what then are Lansley's suggestions for altering the situation. Let's start with some cod-psychological behavioural theory:

If we are going to defuse the time-bomb of obesity-related ill-health, we must change the behaviour of adults today, as well as our children. Tell people that biology and the environment causes obesity and they are offered an excuse not to change their behaviour. As it is, people who see more fat people around them may themselves be more likely to gain weight. Young people who think many of their friends binge-drink are likely to do so themselves. Girls who think their peers engage in early sex are more likely to do so themselves. Peer pressure and social norms are powerful influences on behaviour and they are classic excuses. We have to take away the excuses.

Quite so. But isn't there also peer pressure not to be fat? Perhaps things have deteriorated still further since I left school, but I'm pretty certain that being overweight was not exactly a barrel of laughs, unless of course you happen to be the barrel and the laughs were directed at you and you laughed along in a feeble attempt to pretend you weren't the butt of the joke. In fact, let's not beat around the bush here: I called fat people fat. You called fat people fat (probably). I was an unpleasant little pustule (and still am) and on one occasion I told a girl that she should consider the Slim Fast plan, thinking this was devastatingly witty. She descended into floods of tears and I became enemy number one with her friends, quite rightly, for a good time afterwards. I felt like a shallow little twat and still do. I'm pretty certain that it's probably much the same in some of the more immature offices across the land, and that those especially overweight have to face up to a fair amount of abuse when they venture out. Do these things therefore balance out, or not? I don't know. I'm pretty sure that they can't simply be dismissed as "excuses", however.

For teenagers, I believe we also have to think specifically how we can deploy leadership, role models and social marketing approaches, not just to warn them about the harmful consequences of risky behaviour, but inspire them with what they can achieve by choosing healthy living. We must not constantly warn people about the negative effects of obesity – instead we must be positive – positive about the fun and benefits to be had from healthy living.

Again, perhaps I'm being a little simple here, but aren't there plenty of role models out there that are anything but overweight? Indeed, I'm struggling to honestly think of someone obese or overweight that's a positive role model, unless we perhaps count a few singers that have emerged recently, such as Adele or those two reality show debutantes, Rik Waller and Michelle McManus. Inspiring is a noble and obvious aim - but it's one that's a hell of a lot harder to do in practice than it is when making a speech.

Today, I propose that our second responsibility deal should be on public health. I have invited Dave Lewis, chairman of Unilever UK, to chair a working group of business representatives, voluntary groups and experts. Together, we will invite views on these proposals and hammer out the details of the deal. Our proposals for the responsibility deal include: supporting EU plans for a mandatory GDA-based front-of-pack food labelling system; industry-led reformulation initiatives and reduction of portion sizes; proportionate regulation on advertising and positive campaigns from the industry and government to promote better diets; a responsible drinking campaign matched by community action projects to address drug abuse, sexually transmitted infections and alcohol abuse, using a proportion of drinks industry advertising budgets and supported by the government; and incentives and a local structure, through business organisations, for small and medium-sized companies to improve the health of their employees, working with business organisations, NHS Plus and the Fitness Industry Association.

Ah, details. On the GDA front, I'm pretty certain that it's either already became law for firms to have similar details on the packaging or have rolled them out voluntarily; the Diet Coke bottle sitting in front of me has the exact scheme described on Lansley's link on the label. This is opposing the so-called traffic light scheme, which while simplistic was far easier to understand and which the Food Standards Agency set-up. Firms like Coke, and supermarkets like Tesco opposed it. On the reformulation initatives and reduction of portion sizes, again, I think most manufacturers have already been responding to that, reducing salt and fat levels, etc. They've probably not done as much as they could, but I can't see how the Conservatives rather than Labour are going to be any more successful in persuading them to do so. On positive campaigns from industry and government, it's not as if the government has not already been doing so: there's a whole Choosing Health section on the Department of Health website, and there's been a White Paper on the subject. There's currently a responsible drinking campaign being run by the government, one which I think is actually rather good, but whether such things ever have any effect is open to question, and the community action project again seems to be the Tories deciding that the voluntary and private sector will pick up the slack, whilst the last proposal just seems to be in there to make up the numbers.

In other words, Lansley seems to be more or less siding with some of the less reputable sides of the food industry in blocking the traffic lights scheme, proposing pretty much all that the government is already doing, and not a lot else. All while being slightly more in your face, less open to the idea that there are reasons for being overweight not just limited to eating too much and not exercising enough, and not offering anything approaching new except a harsher line in rhetoric. Do I really need to keep repeating the bit about the new Blairites, except with a slightly less kind face?

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