Swedish Meatballs?

I write my column Swedish Meatballs? in TCS Daily on 16 February 2004.

We may be getting fat, but why?

Today 50 percent of Swedish men and 33 percent of Swedish women are overweight. Some 10 percent are obese, almost double the amount compared to the 1980s. The situation of Swedish children is regarded as particularly serious; 18 percent of all children between 6 and 17 are overweight.

These are dire figures for Sweden, a country that has long prided itself on its public health records. Despite paternalistic efforts by the Swedish government to promote healthy lifestyles and to ban or tax unhealthy ones, Sweden seems to be a quite normal European country when it comes to obesity and very much part of what the World Health Organization calls an epidemic of obesity.

There has been a long debate about the increased rates of obesity in society, both in Europe and in the US. Often this has been discussed in terms of good or bad food, rather than in terms of good or bad diets. This has led to a discussion promoting simplified solutions like suing companies that produce fat foods, levying taxes on fatty food, banning the advertising of certain types of food. But these reactions ignore the fact that people gain wait for reasons a lot more complex that just what they eat.

Our bodies have through evolution adapted to a life of under-nutrition (or even, before the 20th century, starvation) and hard physical labor, not of abundance and a sedentary lifestyle. We are very well suited to storing energy during short times of plenty, keeping it in reserve for long droughts. But today, because of human ingenuity and technological progress, the lean times don't come as often, so our bodies have a hard time consuming the energy they take in. Our brains are set to stimulate us to seek nutrition as if we are under a biological ideal weight, and that ideal weight is set much higher than what is good for us, since it never could be attained in the past.

Actually, the obesity debate foreshadows the health care of the future. Medicine is becoming more preventative rather than curative. Medical advances, biotechnology and dietetics will give us more responsibility for how we want to shape our bodies. There is something of a discrepancy in our affluent society: wealthier individuals tend to take a bigger responsibility for their health and bodies. Fortunately, such habits tend to spread throughout society over time, but not if those who need the most educating (often those of low income) are accustomed to someone else (the government, the WHO) asserting responsibility over their bodies. 

Taxes on fat food would hit the poor the hardest, since they suffer from the highest share of obesity, eat less healthy food, exercise less and have the hardest time dieting. Attacks on so-called "junk food" are similarly wrongheaded. We need nutrition but in the right proportions and quantities, and thus junk food isn't always to blame. Our physiology would make us gorge ourselves on light-products, too, and banning "bad" foods wouldn't make us exercise. Banning advertisements for unhealthy food doesn't seem to work either. Sweden has for a long time banned all commercials targeting children, but still Swedish children are as obese as those in comparable countries.

Targeting unhealthy foods is a quick fix to a complex issue. It might provide employment for public health experts, but it doesn't solve the problem. Rather it reduces our opportunities to make informed choices by promoting food scares and discouraging personal responsibility. The problem is in our biology, our sedentary lifestyle and our unprecedented abundance of nutrition. Science and medicine will provide us with new solutions, but until then we will have to reacquaint ourselves with personal responsibility and self-control to achieve the health we desire.