Obesity is affected by a number of environmental, socio-cultural and economic factors. These include access to an affordable and healthy diet and the availability of cheap, high energy foods that are accessible, convenient and heavily marketed. People we talked with were well aware that individuals gain weight when they consume more calories than they use. Some also talked about how changes in the environment and culture had contributed to the increase in overweight and obesity, which has been evident since the 1980s. People reflected on their own childhoods and the numerous ways in which they had seen the environment and diet change since the 1960s.
When Meeka was a child it was rare to see anyone who was overweight.
When Meeka was a child it was rare to see anyone who was overweight.
Age at interview: 66
Sex: Female
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The obesity. Didn’t surprise me. I’ve seen it. I’ve seen it from being little. When I was little, most people had difficulty getting enough food. Certainly, when I was growing up there wasn’t any wastage in food. There weren’t the supermarkets when I was growing up. Your food, you went with a basket and you bought it. My grandfather used to go to the market to buy the meat on Saturday and bring vegetables home and it was, it was cooked food. The only thing we had in tins were peaches for Sunday and carnation milk that went over the tinned peaches, so everything was fresh. And we were outdoors a lot more and moving a lot more, so I didn’t, I don’t think I even knew or heard the word obese when I was little. I don’t, you know, and, and if there was a fat person, you were shocked. You were taken back by somebody that was really overweight. It just, wow, we wouldn’t think that they’d got that way with eating. We thought they must have a medical condition, okay. So it never occurred to us because there was very, there wasn’t that much food around that we thought anyone could get fat off it to be truthful, so it wasn’t an issue.
When Alan was growing up they didn’t have a car and so tended to walk more; he sees processed food and constant use of cars as contributing to people being overweight.
When Alan was growing up they didn’t have a car and so tended to walk more; he sees processed food and constant use of cars as contributing to people being overweight.
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Too much convenience food really, and if you look at convenience foods, then they're full of fat, they're full of salt; that’s not going to help you. And they're easy to have lots of because you don’t have to prepare them; just put them in the oven or the microwave, which is a bit different than spending half an hour peeling and chopping and doing what else. So, I recognise that it's going to be a problem. I suspect they're talking about younger generations coming through, it being the problem so much, I don’t know. I'm aware of the conversation about it.
Well, when I grew up we used to... we didn’t have cars, so you tended to walk more. Now we have cars, we walk less. We don’t walk to the pub, to the bus-stop even so much now because you get in your car outside your house or something, so I should think that’s probably a big reason. And I suspect, apart from the people who do a lot of exercise, and that’s probably a fairly small amount really, I suspect most people don’t, apart from the people who do a lot of exercise, I suspect the rest do less exercise than we used to, therefore you're going to put more weight on because you're not burning it off, and your portion sizes are bigger than they used to be. And the sort of food we get now is less healthy than we got when I was youngster, purely and simply because it's much more processed. So, I suspect that’s... those are the only thoughts I've got on why it's going to be a problem.
Lesley is worried about the popularity of high sugar energy drinks and the amount of time everyone spends sitting down or driving rather than being active.
Lesley is worried about the popularity of high sugar energy drinks and the amount of time everyone spends sitting down or driving rather than being active.
Age at interview: 60
Sex: Female
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So, I think that age, the age we’re in of the readymade meal or the instant food is probably the thing and the other thing I think for young people, luckily my two, are these energy drinks that I’ve seen young kids drink. I can’t believe that, they are just sugar basically in a, in a tin and that’s, I know, friends of mine have got teenagers who could drink six or eight of those in a day, every day and it’s those things weren’t available when I were young, when I was younger, so there are other bad things. We ate potatoes and no vegetables, but our sugar levels were quite low. But I do believe, I think that’s probably, and the fact for youngsters they’re much more sed-, we’re all more sedentary, I think. Fifty years ago, a lot of work was manual, and you’d come home, you’d done manual work, or you’d walked to work, you’d walked to school. You’ve done all this, so you could eat a larger dinner.
Nowadays, you drive to work, you drive to school. Everyone sits down all day and you still have your large dinner. But we’re not doing the same amount unless you actually go to the gym or do something to make it, but I think from fifty or forty years ago, we’d travel about on foot a lot more and say a lot more jobs. We’d go out playing or go out walking or something like that. Whereas, now it’s the computer, the Internet. I think the combination of the both is making it, that’s how I see it.
Before his heart attack Alan Y used to regularly eat cereal bars as healthy snacks. Afterwards, he found those particular ones to be ‘full of sugars and salt’.
Before his heart attack Alan Y used to regularly eat cereal bars as healthy snacks. Afterwards, he found those particular ones to be ‘full of sugars and salt’.
Age at interview: 48
Sex: Male
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Better, yeah because with my job I wasn’t, I was starting at 7 so I wasn’t eating anything before I went out and I used to have the breakfast cereal bars that you get in the packets, and I was having that at ten o’clock. Eating a lot of the Special K things, you know, having lots, not really looking at the time beforehand and then following heart attack and being in hospital, put on lansoprazole you must eat within half an hour anyway. So, I was then, I was having them when I woke up and then having cereal before I went out. So I totally cut out the cereal bars, which then when they say to you, “Yeah, because they’re full of sugars and salt.” So with just doing that and some small changes has made, and then going to the gym and everything else.
Okay, okay. So a small change that made a difference.
Yeah, things that you, you think you’re doing healthy by having say, like you say, having cereal bars but then when you look at them what’s actually in them, you’re not doing as good, even when you’re, who did I ask, about like the brand name yoghurts. You think, ‘Yeah, you’re doing well because you’re having yoghurt and you’re having fruit.’ And then you get told, “No, they’re not that healthy. You’re better off having just a no fat yoghurt and getting fresh fruit and doing them, making your own yoghurts that way.”
The role of supermarkets in shaping food choices was a big concern for the people we spoke to. Offers, like Buy One Get One Free, food positioning, and marketing shaped people’s choices. Some also singled out food and drinks manufacturers and big business for seeking to maximise profit at the expense of people’s health. Ria said, “there is so much vested interest in terms of the big companies that are churning this stuff out, isn’t there?” A greater role for government policy, local planning permissions and regulation was suggested, alongside appropriate public health messages.
Meeka notes that fast food outlets are often sited in low income areas
Meeka notes that fast food outlets are often sited in low income areas
Age at interview: 66
Sex: Female
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Politically, look where McDonald’s are placed. In the middle of housing, often social housing, there’s a lot of social housing round here. Where you have the supermarkets, there will be McDonalds and these places are open 24/7 and when they start cooking and you’re out in the garden in the summer, you can smell the burgers cooking, and of course, the kids can smell that too, and smell will entice them to go down.
If they go down shopping or whatever, or they go down to see about their iPods, or whatever they’re going down to the shopping centre for, it’s right there in front of them and they will go in and they will buy the McDonalds.
Shirley thinks the numerous cheap fast food outlets in her village have contributed to poorer diets and people being overweight.
Shirley thinks the numerous cheap fast food outlets in her village have contributed to poorer diets and people being overweight.
Age at interview: 56
Sex: Female
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Do you have any more general ideas about why more people are overweight these days?
I think it’s fast food. I think fast foods got a lot to do with it. I think even though people say they haven’t got money it’s ridiculous, because I’m not a McDonalds fan or whatever, but I have been in recently and thought, ‘How cheap?’ Like, 99p for a burger and fries and if people can buy food that cheap they’re more likely to go to get them and the variety, it’s, I can remember going back to the supermarket and probably years ago with Mum and having, I don’t know, about four types of crisps and now you go in and it’s like, rows of them, and, you know, and again, special offers on stuff. It’s ridiculously cheap and I think it’s too easy for people to keep doing that rather than finding healthy, healthier things. I think perhaps now you’ve got the Aldi and Lidl, they’re probably helping people that haven’t got as much. But I, I don’t know people that seem to not have money and are overweight tend to go for the rubbish food rather than I know you can get stuff quite cheaply now in supermarkets, so I find that quite odd. But yeah, I think fast outlets are quite a, because if you look in our village you’ve got three pizza places, a chip shop, and a Kebab place, all in that village and three coffee shops and that’s just in small, small village like ours so I think it’s all too readily available these days.
Cheap food in general was seen as one of the causes of the obesity epidemic, with some people singling out particular types of food, such as cheap carbohydrates. Ellie suggested that “the things that make you fat don’t cost as much as the good stuff”. Myra felt that “fruit and veg isn’t a cheap option” and “it’s a bit more expensive… to eat really healthily”.
Maxine Mary notes that being overweight and poverty are closely related.
Maxine Mary notes that being overweight and poverty are closely related.
Age at interview: 63
Sex: Female
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People like to label and yeah they make assumptions about people by their appearance. So if you are overweight they think you’re a, lazy and even I think there is a socio-economic because thin people are very rich usually and poor people tend to eat a lot of carbohydrates and they get very fat. And they are very depressed. It’s not fun being fat is it. It’s not being fun being poor either. So I, I don’t know. I don’t know whether you think that’s reasonable but I find the two go together, a poor diet and, and, you know, not having much money and obesity.
Sue X doesn’t agree with the perception that good food inevitably costs more, although people also need to have time, cooking facilities and know-how to prepare food. Some supermarkets sell fresh products cheaply but the issue was “knowing how to use the ingredients and the best way to make a meal that all the family is going to eat”. Sometimes the cheaper, high calorie food may be more likely to appeal to the whole family and avoiding waste becomes the priority. John Y highlighted that it is no good to simply tell people to eat better diets and blame them if they do not: attempts to improve people’s diets need to be backed up with opportunity and access in disadvantaged communities.
John Y advocates community allotment schemes to help people on low incomes to grow and exchange fresh food.
John Y advocates community allotment schemes to help people on low incomes to grow and exchange fresh food.
Age at interview: 80
Sex: Male
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What I am saying is you don’t have to eat badly because you are financially poor if you are given the opportunities. And I think there are quite a few set up in East London haven’t they recently where the council give a certain amount of thing for…
Land?
Of land for allotments and then it’s a community allotment so the people who are good at growing strawberries, grow strawberries and the people who are good at growing potatoes, grow potatoes and they do exchanges. There is no money involved in it. So, so the cost is not there.
It’s pushing people, it’s…
Providing?
It’s involving people involving people in it and showing them what can be done without pushing them and saying, “You must be doing this. You must do that.” You know, you’re wasting your money.” And what have you. It’s actually involving them in it. So which is where these allotment type things, you know, do come in because everybody is involved. It’s a community thing. You learn from experience and you learn from people who already have the experience.
Even for those with fewer money worries the wide availability of cheap, high calorie, convenient foods was tempting, particularly for those with busy lives and little time to cook. Added to this were social pressures to achieve and to combine family and work in a fast-paced world.
Portion size was also an issue, as June had noticed it was easy to slip into having the ‘supersize’ portions “sometimes when you do get a bit more money, nobody alerts you to the fact that… it’s fine meeting your friends for a coffee but don’t have the super-duper coffee or don’t be tempted by the piece of cake”.
Sue X says that it is hard to avoid temptation when ‘rubbish’ food is so readily available.
Sue X says that it is hard to avoid temptation when ‘rubbish’ food is so readily available.
Age at interview: 61
Sex: Female
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Do you have any more general ideas about why more people are overweight these days?
I think it’s just simply because of the availability of food and in fact I think it’s worse now than when I was younger because I think with the coffee shop culture, you know, you walk through any city now and there’s loads of coffee shops and so many people sitting there with you know, lattes and with, you know, with caramel flavourings in and cakes and things and food is cheaper than it was and more readily available and there’s just more rubbish food about if you know what I mean.
I mean, you know, I, I love rubbish food but it’s so readily available, you know, you look there’s Cornish pasty shops, there’s pie shops, cake shops, sweet shops, fudge shops, you know they’re everywhere. It’s very hard to avoid temptation, very hard and it’s like, if I meet friends, you meet, you meet for a cup of coffee and nine times out of ten people will say, “Oh shall we have cake as well?” You know and that, you don’t just go for a cup of coffee, you go and have cake as well. So, it’s hard, it’s hard for people I think.
June reflects on how the pace of life contributes to people being overweight.
June reflects on how the pace of life contributes to people being overweight.
Age at interview: 60
Sex: Female
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I think just, just one thing I would like to mention really is the busyness of today’s world is a big factor that I haven’t mentioned. I do think society is changed and speeded up an awful lot and people have jobs that have, you know, perhaps not as physically demanding obviously but mentally very demanding and a lot more stress in life and I think all of that is another major contributor to overweight. People not having the time to cook, to think about the shopping before they do it. To be supervising the children, to be sat down at a family meal table. I think time is a massive other factor that needs to be thought about in any initiatives. It’s no good thinking we, we live in this ideal world of the fifties because no, nobody does anymore.
June has overweight and diabetes in her family; cheap multi-buy offers for bars of chocolate and too many everyday temptations make it hard to make the best choices about food.
June has overweight and diabetes in her family; cheap multi-buy offers for bars of chocolate and too many everyday temptations make it hard to make the best choices about food.
Age at interview: 60
Sex: Female
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I can only say for myself I don’t think it’s one thing at all. I think that would be most people’s experience that yes my father was overweight, but he got diabetes and his mother was overweight and the same thing so, there is like a possible genetic thing there. But I do think everyday life comes now with so many sort of, you know, ways that encourage you to be overweight and I think a lot of people, it’s like having a selection of a hundred things and people chose some of them. So, for example, my local mini-supermarket a bar of chocolate is 80p, but you can have three bars of chocolate for £1.20 and as a chocoholic that’s terrible temptation because you think, ‘Well that’s ridiculous. I’ll buy three and I’ll put two in the glove compartment. One can be for tomorrow. One can be for the day after,’ but no you see I’ve been eating. I’d creep out to the car at midnight and get one out of the glove compartment. I, I just think there are so many every day temptations and if you’re already over weight and you think to yourself that you think a slimmer person has either got more self-control or doesn’t need to exercise for some reason their brain is wired differently, you know, that you’re presented with say thirty choices in a day to do with calories or exercise and you just pick some of them wrongly every single day.
See also: ‘What has worked when trying to lose weight? Finding what works for you’ and ‘Messages to others interested in controlling their weight’
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