Rather noxious little piece today by Amanda Platell. To summarise briefly, we shouldn’t waste money treating fat people, because they deserve their fatness.
“Ah, say the fatties, but you can’t deny us medical treatment, any more than you can refuse to treat an alcoholic who needs liver surgery, or a smoker who develops lung cancer. I agree that these, too, are the result of individuals choosing an unhealthy lifestyle.
But the crucial difference is that you cannot cure cancer by stopping smoking, nor replace a liver by becoming teetotal. The vast majority of the chronically overweight, by contrast, could ‘cure’ themselves simply by following a healthier lifestyle.
Quite simply, with a cash-strapped NHS that can’t even afford to treat the dying, we must stop indulging the self-indulgent.”
And, to summarise again, what the column misses is the fact that the similarity between the clinically obese and the alcoholically is often precisely that they didn’t choose their unhealthy lifestyle. This is something Amanda edges round the side of in her anecdote about her doctor friend and the patients completely unable to follow a healthier lifestyle, but then totally misses:
“I have a friend who runs a weight-loss clinic at a London GP’s surgery, and she tells me that at times, it’s the most soul-destroying job. ‘I have patients who come in and swear blind that they eat a healthy diet, and can’t understand why they’ve been piling on the pounds,’ she says.”
When said doctor asked them to list what they were eating, the patients reported “fizzy drinks, fried food, snacks throughout the day”. Amanda concludes from this that they were lying when they said they were eating a healthy diet. Not they were telling the truth, but weren’t aware that the junk food was bad for them, which would seem to be the more obvious conclusion to draw from the guileless admition that they were eating unhealthy food after initially saying that they weren’t. Presumably Amanda is keen to avoid the trap she subscribes to ‘liberals’:
“I laugh outright when I hear the oh-so liberal lament that the obesity crisis is due to the gap between the rich and the poor. The poor, we’re told, eat junk food because it’s all they can afford. The rich have the ‘luxury’ of a healthier diet.
Set aside, for one moment, the monstrously patronising premise contained within this theory, which implies poor people are too stupid to take care of themselves.”
This is a straw man¹. We can happily accept that the patients above are not stupid while still seeing them as ill-informed. Which is unsurprising, when papers like the Mail actively agitate against health education schemes as redolent of nannyism. Amanda may well be able to take care of herself, watching ‘Jamie’s Ministry of Food’ and having been brought up in an Enyd Blyton novel:
“We swam, ran, climbed trees, played football. We ate healthily and lived healthily.”
but for those living on council estates, situated in the middle of food deserts, attending schools whose playing fields have long since been sold off, whose benefits do not stretch to free access to the local swimming pool and free lessons to enable them to use it, whose habit of processed food makes healthier options taste bland, things are a lot harder. It’s fine for Amanda to claim that the gap between rich and poor doesn’t cause obesity, but she’ll have to explain the very solid link between poverty and obesity (here’s the Office of National Statistic’s most recent dataset) by some other means. The idea that it’s self indulgence alone is less convincing than the more nuanced view that it’s to do with the lack of ready access to healthy food, a cost disencentive to buying healthier, less processed food, a lack of access to sporting and recreational facilities, a lack of education about healthy foods, the generational compounding of the above, co-incidence of contributary factors like alcohol consumption and smoking, a lack of employment and incentive to self-development, and a lack of social support. Especially since it conveniently ends up concluding that the best course of action is one that serves the interests not of the poor and obese, but of Amanda Platell and her middle class friends:
“In principle, I’m against any form of NHS rationing. The great joy of the health service is that it is free at the point of use, regardless of the medical condition that necessitates it. But obesity isn’t an illness. It’s a self-induced condition.”
Frankly, if you’re against any form of NHS rationing then you’re a fool – there are, and always will be, treatments whose benefits are so marginal that they are not worth the expense. Obesity treatments do not fall into this category – they give a chance to people society have failed. It’s easy to call for things to be taken away from people we don’t know, and don’t spend time with. It’s easy to say:
“The fact is, the current politically correct non-judgmental policy is not only failing to solve Britain’s obesity crisis, it is actually fuelling it. What’s needed instead is some tough love.”
when you don’t feel any love for the people in question. That’s self-indulgence; having someone else take the hit so you don’t have to. Only these people will be paying with their lives. This is repugnant.
¹ While we’re talking about straw men: “Consider, instead, a simple truth: it is no coincidence that the poorest nations on Earth do not suffer from an obesity crisis – only the rich ones.” Which must be a joke inserted by a mischevious sub-editor.