by James Walvin
The entire problem came into sharper focus via compulsory schooling which brought every child under the scrutiny of medical and dental experts. What they discovered was alarming. Beginning in the 1880s, the cumulative findings of social and medical investigators made it clear that the British poor (which included millions of unemployed between the wars) needed better food – they required ‘milk, fresh vegetables, meat, fish and fruit’. Such arguments generally fell on deaf political ears at a time when government finances were stretched and, more important perhaps, when the political will was lacking. It was to take the Second World War, with its far-reaching state intervention into citizens’ lives, followed by the creation of the modern welfare state in the late 1940s, before the lessons of nutritional well-being really began to make an impact among the British people.
The development of scientific analyses of food also raised troubling questions both about sugar in the British diet and, more disconcertingly, about the very nature of sugar itself. A number of studies revealed sugar to be wholly devoid of minerals and vitamins’. It had also become clear that large-scale consumption of sugar was having a damaging effect on children’s teeth. In the years when industrialised, sugary foods and drinks came to dominate the national diet, it was evident that the nation’s teeth were being corroded by sugar.26
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The return of warfare in 1939, and the draconian though vital food rationing throughout the conflict, once again reinforced the importance of sugar in the British diet. Along with a long list of other imported foods, the main problem was supply. European sugar beet was again under German control, and imported cane sugar from tropical sources faced the enormous dangers of submarine attacks on allied convoys. Sugar was immediately rationed to 120z per person per week (today, that seems an abundance), and food manufacturers were limited to an allocated percentage of their pre-war consumption. The British sugar-beet industry was encouraged to expand, and intricate financial arrangements developed between farmers, refiners and government. What evolved was a national sugar industry controlled by a complex political and financial arrangement to regulate the production and sale of sugar. It was to last long after the war was over.27
Sugar rationing began in January 1940 and lasted, with one brief interlude, until 1953. An Act of 1942 put the nationwide system in the hands of a subdivision of the Ministry of Food and, as wartime hardship began to bite, when German submarines seemed to be winning the ‘Battle of the Atlantic’, rations were cut further. Private diaries captured the mood. Kathleen Hey, a shop assistant in Dewsbury, noted in her wartime diary:
Sounds of prolonged groans because the rations are cut, particularly sugar, which seems even more than tea to be the thing people would like more of.
It was widely agreed that men took the lion’s share of sugar, having on average two to three spoonfuls for each cup of tea. Men, she thought, are the sugar devourers’.28
Government control of sugar – working hand in hand with Tate and Lyle, by then the dominant force in the British sugar industry – was part of a remarkably intrusive state system which was to prove very difficult to dismantle when peace returned in 1945. The British taste for chocolates and sweets, for example, was so voracious and entrenched that when rationing of those items was removed in 1949, demand was so immediate and widespread that rationing had to be re-introduced for another four years. The irony was that the British emerged from the war even more wedded to sugary foods than before 1939. Sugar consumption continued to rise, peaking at 1151b (52.4kg) per capita in 1958. Although the figures declined thereafter, they remained at a remarkable 40kg and more a head as late as 1990.29 The British entered the post-war era of rising material prosperity deeply attached to sweet food and drink.
The British sugar industry was now dominated by Tate and Lyle, which had been formed in 1921 from two earlier business competitors. The sugar industry was so central a feature of British life that it was placed on the list of essential industries designated for nationalisation by the post-war Labour Government. The fact that Labour should even consider nationalising sugar, alongside railways, coal, steel and health, is the clearest possible indicator of the importance of sugar in British society at large. Here was an industry that had insinuated itself into the very core of the British way of life – the British people seemed not to be able to function without their regular intake of sugar. That intake had increasingly come from a huge food and drink industry, which had developed its own dependence on sugar. Attlee’s Labour Government thought it appropriate to take sugar into national ownership, but Tate and Lyle and its shareholders naturally resisted, launching a powerful campaign of publicity and propaganda – ‘Tate Not State’ – to fend off state control. The company was radically restructured to shield the shareholders’ investment from the Government’s grasp. ‘Mr Cube’, the clever icon of Tate and Lyle’s campaign, remained a potent commercial image long after the Government’s attempts at nationalisation had been rebuffed.30
There is, however, an abiding irony to this story. The British sugar industry had been shored up and defended by state protection and subsidy; indeed, it had been utterly reliant on it. Throughout the twentieth century, sugar in Britain had been an industry which thrived, in peace and throughout two world wars, on the paternal involvement of the British state. By securing supplies of sugar from overseas, by providing financial encouragement for domestic beet growers, and creating Treasury-backed deals to safeguard the sugar-refining industry, the state had been the careful guardian and protector of the people’s appetite for sugar. Yet Mr Cube was now deployed – his face festooned the sides of buses, placards, advertisements in newspapers and bags of sugar – to resist the very state that had been its saviour. Without the attentive interest and financial support of the British state, sugar could never have maintained its role as a vital industry at the heart of British eating and drinking habits.31
Wartime support for sugar continued in peacetime using wartime experience as a guideline. Agreements were struck with Commonwealth sugar producers, refiners were allocated guaranteed volumes of cane and beet sugar, and British farmers producing beet were given guaranteed quotas and prices. A Government ‘Sugar Board’ managed the entire system, with a minimum of staff and fuss. But all this began to change from the 1970s, with beet replacing sugar cane as the main supplier of sugar. Even greater change was brought about by the profound impact of British entry to the European Economic Community, later to become the EU.
At the end of the twentieth century, the British sweet tooth was less pronounced, but still astonishingly insistent. And sugar was an inescapable feature of British social life. But the political arrangements – the global deals – between companies and governments were about to change by Britain’s belated entry to the European Common Market. The industry had entered into a process of complex international deals and negotiations that were so Byzantine, so complex and confusing, that they defied simple explanation. And all this for a product that was to become a cause of great medical concern by the end of the century.
13
Obesity Matters
OVER THE PAST generation, there has been rising concern about the level and the apparently relentless increase of obesity. The term is often used loosely to describe those who are significantly overweight with a high proportion of body fat, but the commonly accepted medical definition refers to anyone with a body mass index of 30 or more. In 2015, the World Health Organization (WHO) estimated that around 2 billion of the world’s population – nearly a third – were classified as overweight, of whom around 600 million would be clinically recognized as obese. And, even more worryingly, that is a figure that has doubled since 1980.
Obesity is not restricted to the West; there are millions of obese people the world over. And when establishing the cause of this global problem, time and again medical experts have pointed the finger of blame at, above all else, sugar. The world’s populations have long been consuming unprecedented volumes of sweeteners, with the
inevitable outcome of unmanageable weight gain that is all too visible, and sufferers’ health problems now tax medical services worldwide. The demand has therefore grown significantly for political action to turn the tide.
Because obesity has become so widespread so quickly there is a temptation to think of it as a uniquely modern problem, that obesity was something that earlier generations knew little about and rarely discussed. This is not the case. Overweight people were regularly discussed and portrayed in earlier periods and, as often as not, they were ridiculed. For centuries, overweight people have been traditional targets of abuse and scorn. If we want to think seriously about obesity, it is important to take a longer historical view, and we could do worse than listen to children. The young have their own way of capturing popular attitudes and moods – though sometimes in the harshest of fashions.
Through the years, larger children have traditionally been the target of cruel schoolyard humour and ridicule, and the list of nicknames aimed at overweight children is long, inventive – and often cruel. Many of us can perhaps remember such names from our own childhood. If not, we can turn to the remarkable research of Iona and Peter Opie into the playground language and play of British children in the mid-twentieth century. The Opies captured terms that are often crude and cruel, but sometimes imaginative and inventive. However, for the unfortunate victims of such barbs, they can be perceived as malicious and deeply upsetting. Who would enjoy being called, among many other things, balloon, barrel, bouncer, Falstaff, fat belly, glutton, jelly-wobble, lardy, piggy, porker, plum pudding, steamroller, Tubs . . . or, for girls, Bessy Bunter, Fatima or Tubbelina? Equally harsh terms are used for greedy children – greedy-guts, dustbin, piggy, hungry-guts – although often the greedy and overweight tend to be viewed as one and the same. Conversely, similarly hurtful terms are hurled at thin children, although the greedy and the thin tend not to attract the harsh cruelty reserved for the overweight. It also seems that children have made up their minds about larger people by the time they are six; research shows that, on the whole, they don’t like them. All this is part of an astonishingly complex popular culture which thrives among children at play, in the school yard and in their free time out of school.1 But this ‘jocular hostility’ towards overweight children also reflects a much deeper, almost ageless, culture of poking fun at fat people.
While it is hard to find much humour in the story of modern obesity, fat and significantly overweight people have traditionally been laughed at. British culture is littered with fat figures of fun – overweight characters who became enduring, popular figures on the cultural landscape. Most famous of all, perhaps, is Falstaff – fat, boastful, vain, gluttonous and utterly unprincipled – a figure of rotund fun around whom Shakespeare wove a humorous, but poignant, account in three of his plays. In the eighteenth and early nineteenth centuries, it was the turn of graphic satirists and caricaturists to make great play with overweight people – not least with living people who were significantly overweight and prominent at the royal court and in Parliament. We have Hogarth’s overweight judges; Rowlandson’s gluttonous diners; and the abiding images by Cruikshank and Gilray of a healthy, rotund ‘John Bull’ – that mythical figure of the indomitable Englishman, generally seen as a stout, assertive figure, challenging all-comers with his fierce patriotism – in contrast to an emaciated French revolutionary Jacobin. Such images of the obese flit in and out of graphic caricature throughout the period.
Dickens, too, included obese people in his writings, most memorably Mr Pickwick, as did Lewis Carroll and John Tenniel with Tweedledum and Tweedledee, their names quickly entering the vernacular to describe identical issues or people – but in the original they were obese. The tradition was continued in the twentieth century when new characters emerged as figures of fun in popular British culture, and who were distinctive because of their size or weight. We have the Reverend Awdry’s ‘Fat Controller’ in the Thomas the Tank Engine book series; and Frank Richards created Billy Bunter of Greyfriars School for a hugely popular boys’ comic. Bunter was a fat, greedy, obnoxious youth whose weekly appearance in The Magnet (and later on TV and in films) became an enduring cultural image.
He was shadowed at much the same time by another rotund character – the fat lady of the risqué seaside postcard. Best remembered in the work of Donald McGill, the round-bottomed, large-breasted lady on holiday, dominating her diminutive, hen-pecked husband, remains – to this day – a favourite item at seaside resorts.2 And with the arrival of silent movies, and later with sound, an early favourite was the American comic Fatty Arbuckle, whose name quickly became a standard insult among schoolchildren.
Today, however, sufferers of obesity are not seen as a joke but as a serious problem. We are currently experiencing unprecedented levels and degrees of obesity, with whole swathes of the population becoming obese in their early years. Before long, some entire societies will be obese, as overweight people begin to dominate the population. At the current rate of increase, for instance, obese people may form a majority of the population of the USA and Britain by 2050. Obesity on this scale is new, and the emergence of people who are significantly overweight as an obvious and inescapable feature of modern life has evolved within living memory. What was, not long ago, unusual, has become commonplace.
Overweight children and adults, and the costly facilities of all kinds to cater for them, all this is now so common to us that it often passes unnoticed; it seems merely part and parcel of who and what we are. At the same time, obesity is creating an array of problems for society at large, the most pressing being an almost inexhaustible list of related ailments and physical infirmities. Although obesity itself is not an illness, modern medicine finds itself deeply troubled and taxed by the different illnesses which are directly driven by obesity.
Curiously, the early signs of what would become the modern epidemic of obesity first revealed themselves in Pacific islands, where supermarkets and the associated new lifestyle utterly transformed local life. But the spread of obesity in those islands was too distant, too remote from the West’s beaten track to catch the eye. British medical researchers began to notice it in the 1950s, then in the ’60s and ’70s, when it began to take hold in South America, and then the Caribbean. Again, it tended to be overlooked, initially, because the most pressing medical efforts were directed at stamping out hunger and malnutrition. Doctors and researchers tended to ignore the local rise of obesity and its consequences because their attention was focused elsewhere. When people became fatter, this seemed at first sight a small price to pay for ending the hunger that had previously stalked those and other societies.3
Obesity became unavoidable under the all-determining shadow of globalisation, when so much of the world turned to fat. Urbanisation, car transport, TV and modern media, modern shopping habits – and the arrival of Western food outlets – all these served, very quickly, to transform societies into variants of their Western prototype.
Yet, at first glance, the rise of modern obesity seems mysterious. The initial response was to blame sugar – but that raised a curious problem. People on both sides of the Atlantic were buying much less sugar than their parents and grandparents, but at the very same time they were getting fatter. In the last twenty years of the twentieth century, domestic homes kept much smaller stocks of sugar in the kitchen or larder than in earlier periods, and people were adding much less sugar to their food and drink at home than in any previous period since the industrial revolution. Yet at the same time, they were getting fatter.
The explanation, obvious today but contentious and disputed over the past generation, lies in the nature of changing food and drink habits which have become so widespread. People no longer need to add sugar to their diet because it is being added for them by food and drinks manufacturers. Moreover, sugar is added in volumes which, at times, beggar belief. And as mass-produced food and drink have come to dominate people’s diet, the people who consume those commodities have become fatter and fatter.
/> Two students of obesity have recently remarked that ‘the whole world, rich and poor, young and old, is getting fatter’.4 The evidence is all around us, and the data is astonishing. People today are bigger and heavier than at any other time in global history. The total numbers of those deemed overweight and obese around the world are bad enough; worse still, perhaps, is that out of those shocking statistics, 170 million children under eighteen are overweight or obese.5
The evidence is also visible – inescapable, if unscientific – wherever we care to look: overweight and obese people are a standard feature of modern life. It is most striking in the West, often shockingly so in the USA, but obesity has become a global problem and it is equally noticeable in rapidly developing societies, notably in Asia.
The question of obesity and the great variety of serious health issues it brings is now a regular cause for debate in the media. Childhood obesity, illnesses caused by obesity, the health cost of dealing with obese people, the strain on health services . . . all these and more regularly make for arresting headlines. We hear more regularly now about the difficulties of squeezing the obese into airline seats, for example, and the economic, logistical and welfare considerations that surround air travel. In Britain, in a five-year period, the NHS spent £7 million adapting equipment to cater for obese patients – bigger beds, wheelchairs and mortuary slabs. And more than 800 ambulances have been designed or altered to cater for obese patients.6