Our obesity strategy is stuck in the 1970s

Telling people to count calories does a fat lot of good – we need a modern approach to a big problem

Put down your double mocha latte for a minute and take a look at your stomach. How do you see yourself? Plump, perhaps, or bigboned, proud owner of a beer belly or sexy in a size 16? Maybe you admit to being midlife fat, curvaceous or carrying a little extra timber. Alright, overweight, dammit, but not obese. Not that.

Yet hold fast. For by 2050 more than half of us will have achieved that status in strict clinical terms – some morbidly so – with all the health problems that excess poundage brings.

With the best will in the world, the NHS, already spending about £16 billion a year on the direct medical costs of diabetes and conditions related to being overweight, will collapse like an unreinforced hospital bed under our weight. And our national productivity will wither as obese workers each take an extra four days off sick a year. It is a problem of gargantuan size; one that needs an innovative, bold, 2010s, multi-factorial approach. Yet here’s the latest scheme to combat Britain’s obesity problem from the Government’s health watchdog Public Health England with its “One You” nutrition campaign: count calories.

So while obesity may have increased by 92 per cent since the 1990s, it seems official advice about how to lose weight is firmly stuck in the 1970s. While overall recommended daily consumption levels will be unchanged – 2000 calories for women and 2500 for men – the new guidance of 400 calories at breakfast and 600 at the other two meals, is to be a “rule of thumb” to help people cut back.

Certainly, since new research from the Office for National Statistics shows that the average Briton consumes 50 per cent more calories than they realise, cutting back is not a bad idea.

But where is the nuance in the advice? Where is the acknowledgment that “moving more and eating less” has been on the dieter’s menu for decades and all that’s happened is that our collective weight has risen more and more quickly?

For in the past few years, numerous and diverse studies have shown it’s not just how much energy we take in that matters, because the human digestive system does not dispose of all calories equally. When we eat matters, what type of calorie we consume matters, even how much sleep we get matters. We are complicated biological entities, not blast furnaces.

Nor are all calories of the same benefit. Reduce nutrition to numbers and what’s to stop us eating chocolate all day until we reach the approved limit? A 2,000-calorie limit will see you through eight 58g Mars bars; try to stay slim on that.

Faced with an oncoming tsunami of obesity and associated health problems, it’s impossible to find this new advice anything more than optimistic, perhaps whimsical, at best.

Instead, we need a new holistic approach. That means listening to experts such as cardiologist Dr Aseem Malhotra, who actively advocate against counting calories and say it’s more crucial to choose your foods wisely – avoiding sugars and refined carbohydrates and opting instead for healthy fats such as olive oil and nuts.

We could also fund more study of the gut microbiome. Research is already showing how this could play a key role in explaining why we all metabolise the same foods differently. There is surely a role for the various methods of fasting, too.

We also need to utilise urban planners to tackle obesogenic environments; those areas where there an abundance of takeaway shops selling energy-dense food with no safe cycle paths or walking routes, leading to sedentary lifestyles.

Epigeneticists also have insights. Those born in the Dutch Hunger Winter of 1944-45, when the Nazis punished the Netherlands for strike action by blocking food supplies, were found to weigh more than average in later life. It’s postulated that the genes that regulate metabolism could have been silenced when in utero. In effect, their bodies might have found it harder to burn calories, however many they counted.

The first ever diet book is believed to be Diet & Health With Key to the Calories, which became a bestseller in 1922. Its author Lulu Hunt Peters demystified the idea of calories. Nearly one hundred years later – on so important an issue – it’s time to try something more ambitious.