Weight change & associated health problems

Family, work and social environment

The social environment includes relationships with family, friends, peers, co-workers and others. To some extent, all these interactions have a ‘spill over’ effect on the food habits of people from childhood to adulthood. Here, people talk about the social environment that has influenced their eating behaviour and contributed to being overweight or obese.

Childhood experiences shape eating behaviours as an adult

Experiences during childhood could have a profound effect on how people relate to food as adults. Sometimes this relates to how much food was available as a child. Some of those who grew up in the years after post-war rationing ended said they had eaten a lot of high calorie foods, such as butter, jam and puddings. For others, being poor or hungry growing up also shaped the way they approached food. Paul X told us “when you were brought up as a young boy and there’s nothing in the cupboard to eat, again – it leaves a mark”. An unhappy childhood could also start a pattern of using food to compensate for unhappiness.

Maxine Mary was unhappy and often hungry as a child.

Maxine Mary was unhappy and often hungry as a child.

Age at interview: 63
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

I was compensating I think with overeating for my, for my, how can you put it, my unhappiness. My mother made me very unhappy. She was not particularly a loving, caring mother although she had loads of kids. She had 6 children She wasn’t. She didn’t like children. She didn’t like any of us, I don’t think or she had her favourite but she, you know. She treated us all pretty, pretty badly but that’s because she was treated really badly too. And I, I realise this and, you know, every. I also believe that every mother does her best even if the best was pretty shoddy it was still her best at the time that she could do because she had a difficult life too. So, you know I’m not angry at her but it was really difficult for me to recognise that the emotion was, where it was coming from for a long time. And I needed somebody to help me see clearly that I was trying to make myself happier by eating. And in fact I wasn’t. I was making myself more unhappy because I was gaining weight and it was, I was on a slippery slope, a vicious circle as they say of overeating, becoming depressed and dealing with my elderly parents and their illnesses and which I found really difficult to do.
 
Actually staying the same weight has been virtually impossible for me in my adult life. I, I was a very malnourished child, actually very thin. I was hungry quite a lot because I was on my own and mother was away working. Father was away working and I had to look after myself. This is, this is really young child, 6 or 7. As a teacher now I realise that that was neglect abuse. So I was very, very hungry as a child. I remember being hungry a lot. And I was very thin. Then when I got older and I was able to provide food for myself. I was able to go and get it and I put on weight. As soon as I was 13 or 14 I got really fat but then I lost it.

People also talked about how they had learned eating habits from their parents. Meeka described being brought up to eat everything on her plate: “My generation, you eat everything on that plate or you sit there till it’s gone and if you’re dying to get out and play with your friends, what are you going to do, you just clear your plate. You’re not even tasting the food.” Ellie said she grew up thinking it was normal to eat roughly six meals a day, including fry-ups and elevenses, because that was what her mother did.

June’s mother used sweets and chocolates to relieve tensions – June also became a ‘secret eater’.

June’s mother used sweets and chocolates to relieve tensions – June also became a ‘secret eater’.

Age at interview: 69
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

She did a hell of a job, so, yep. But as to what, you can soak up what somebody else does to relieve their own tensions, like, litmus paper, you really can and mum used to do her day’s work. She worked hard and she would perhaps sit down about an hour before dad was coming home and she’d the evening meal prepared and all the stuff done and all the rest of it, and she would sit down for a while and she would have a pile of sweeties and she would eat her way through the pile of sweeties and chocolate and I remember, that I remember, things I remember and I suppose what we would all remember is that it was always an issue, in that mum was always trying to lose weight, always.

Okay, I mean your case, when did you started to try and lose weight? How old were you when you started?

When I decided I was fed up being so chubby when I was twelve and I decided I was going to lose weight and I did. By the usual methods, cutting down what I was eating.

Hm-mm. Were you having larger portions before?

No, I would, I would do what mum would do. I’d always been a secret eater. I can be a public eater as well, [laughs] I can, I can, yeah, more than anything I would, you know, sort of get my hands on a bag, sort of multipack bag of crisps or a big bag of crisps and eat my way through that or every day after school, I hated school, I hated it and that had a bearing certainly on, on them, how I felt about life and everything up until the time I was ten years old. I really, I really didn’t like any of that, and so when I came out of school it wouldn’t be any kind of a day unless I could go round to the sweetie shop with, you know, ten pence or something like that and buy some sweets.
 

Rosemary grew up in a single parent household and recalls big portions of a ‘typical English family meal’. She still likes to have ‘big volumes of food’ even when she is poorly.

Rosemary grew up in a single parent household and recalls big portions of a ‘typical English family meal’. She still likes to have ‘big volumes of food’ even when she is poorly.

Age at interview: 55
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

I don’t think I’ve ever lost my appetite once, even when I’ve been poorly, and I like big volumes of food. I don’t mind if it’s all, I don’t, I don’t mind if it’s not a varied diet, as long as I get that full feeling.

So you, you like big portions?

Big portions, and I think that’s my downfall. So, and so particularly when I was working, I would be working like twelve hours, come in really tired, think I’ve got to make tea and eat a packet of crisps and then have another four packets of crisps because, you know, and then I would have my tea [laughs].

Okay.

So, I’m a volume person. It isn’t that I, I get bored with diet. It, it’s just that I like big volumes. Carbohydrates, I like carbohydrates, like that full feeling.

 [Laughs] Was, that’s how it was in your family when you were growing up? I mean were you brought up with good size portions?

Yeah, we, we were quite poor. Mum was a single parent family. I was the youngest, so we never had very much money. We never went out for meals, but we always had meat and two vegetables. Typical English family, and always had a dessert, yeah.

People also recalled experiences of being bullied by classmates because of their weight, or discriminated against by teachers or family members. Angela described her parents’ comments about her body size as ‘unhelpful’. As a child she felt it was her fault she was size sixteen and at school her interest in joining the athletic club was frustrated by teachers.

Angela was discouraged from joining the athletic club. In the 1960s at school the fact that she was one of only three Asian girls attracted more attention than her size. Her father’s comments about her size hurt.

Angela was discouraged from joining the athletic club. In the 1960s at school the fact that she was one of only three Asian girls attracted more attention than her size. Her father’s comments about her size hurt.

Age at interview: 51
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

I remember being eight or nine and wearing a size sixteen, having to wear a size sixteen skirt and I remember my mum took me to Tesco and bought me a skirt and came back in and said, “Oh, show your Dad your skirt.” And he was like, “That is a woman’s skirt” which is not really helpful when you’re a child because you’re at the mercy of your parents to source you with clothes that fit, fit you.
 
But it, they, what they were saying was really unhelpful and obviously I’m saying it now as an adult but at the time I was just kind of, “Oh I’m sorry, this, I’m sorry I’m a size sixteen.” But there is no concept of weight loss or…
 
So, you thought it was your fault?
 
I thought it was my fault, yeah. I just thought, you know, this is my lot in life and, you know, at school everyone was thin apart from one girl, I remember this girl [name] who was, you know, a white girl, obese, I mean there were very few Asians in our school and there was like the two or three that were, that were there, everyone thought we were related because that’s how it rolled in the ‘60s and ‘70s [laughs].
 
Yeah [laughs].
 
So, I remember this girl [name] was obese and everyone used to take the piss out of her but because I was Asian that was the first thing they’d take the piss, my colour and then it would be the fatness. So, you know, at least I had this going on and then that. So that was the fall back.
 
But no there was just absolutely no concept and I remember in the, it’s now, I don’t know what they call it now, Year 6, but then it was the fourth year, so when you’re ten going on eleven, what you could do on a Friday afternoon was choose whatever activity you wanted to do. So, there’s crafts, there was, you know, pottery or there was, you know, and there was an athletic club and I thought, I actually thought to myself, maybe I’ll do that so that I can get better at this. Just, you know, whatever, and it was all boys and one girl, [name], who was quite fit and I didn’t, when it came to dishing out choices, I didn’t have anything. So, I went to the headmaster and said, you know, because he said, “Why haven’t you, why haven’t you been assigned anything?” and I said, “Well I wanted to do athletics and he said, “Yes but your teachers thought you wouldn’t be good at it.” And, you know, think about that now, a ten year old girl, fat person trying to want to improve themselves and they just kind of cut you dead, and it’s just horrible when you think about it.

Work and lifestyle

In adulthood, works plays a large role in how physically active people tend to be and may also affect what they eat, as well as the type of food they can afford. Those who worked long hours spoke of having little time to cook, to eat, to exercise or even to sleep which had consequences for their health and weight. Rosemary told us “particularly when I was working, I would be working like twelve hours, come in really tired, think ‘I’ve got to make tea’ and eat a packet of crisps and then have another four packets of crisps because, you know, and then I would have my tea”. Paul Y described how doing a job “virtually seven days a week” meant he did less and less exercise. Having a sedentary job or moving from physical work to a less active role was a commonly identified reason for putting on weight.

Ellie’s workaholic lifestyle was so sedentary she got out of the habit of moving around. She remembers gradually gaining ‘maybe four stone’ during this period.

Ellie’s workaholic lifestyle was so sedentary she got out of the habit of moving around. She remembers gradually gaining ‘maybe four stone’ during this period.

Age at interview: 69
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

I was a workaholic and I sat at my desk all day from eight in the morning until eleven at night, and I would come down for meals which [husband] had cooked because he worked shifts at that time and if he was going to, he’d finish at eight o’clock and I would cook for him. I would take an hour off to cook and it would always be something quick, like, pasta or something I could put in the oven, so that I could get back to work and I just got out of the habit of moving around. I just sat at the desk day in day out loving every minute.

It was two minutes to my bedroom. I would get from the bedroom to the office. I would go and get washed, but sometimes I didn’t, if the phone went, I didn’t get showered until midday. I just didn’t want to leave the desk. I just loved the work.

Okay, so that was what you, you were mostly doing…..

Yeah it wasn’t that I was eating any more. I was actually eating less because I wouldn’t leave my desk to go downstairs to make something to eat and I kept going on sort of, I used to have a can of coke and that would last me all day or the odd coffee. But that was it, and I just worked the rest of the time. I think back now, it was totally stupid. I should have made an hour at least away from my desk, definitely.

How much did you put on during this period of working from home and not doing much?

It was so gradual, I can’t remember. Maybe four stone, something like that.
 

When David got a more sedentary and highly paid job in his 40s he started to put on weight and developed diabetes and high blood pressure. Success at work meant more money to spend and he started driving rather than cycling to work.

When David got a more sedentary and highly paid job in his 40s he started to put on weight and developed diabetes and high blood pressure. Success at work meant more money to spend and he started driving rather than cycling to work.

Age at interview: 71
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT

I, yes, when I was younger, I used to exercise a lot and I continued to exercise quite heavily through my twenties up until I was sort of thirty-ish sort of time. Then I went abroad, worked abroad for a number of years. I got a much more highly paid job and I got more involved with entertaining clients and I started to put on weight like there was no tomorrow and I ended up in a situation around about forty, forty five, I had a responsible job, basically, sedentary, involving a lot of entertaining. I was eating too much, putting on far too much weight and not exercising enough to worry about. And that was the situation I found myself in and as part of my job, I had a regular medical because I’m a railway engineer, you have to have a medical to go track-side.

And they detected that I was hyperglycaemic and referred me back then.

Okay.

And, at that time, I was not, my doctor, when I was referred to my GP for hyperglycaemia, he was much more concerned about my hypertension and both of which were treated with drugs.

Okay.

But it was it was, yes, I was getting less and less exercise and I was eating more and more because I do enjoy eating, so I was eating more and more.

I think I think there was a tendency, with my generation, because my parents, of course, were restricted on what they could eat through the war and when they started having children after the war, we were all very well fed. My mother used to say we were very well fed. Well fed, by her definition, largely meant a lot of starch and sugar and calories and things like that. Now, when I was younger, of course, that didn’t matter because I burnt most of it off and certainly, when I left school, I joined the military and we burnt off calories like there was no tomorrow. When I left, I still, because I didn’t have any money then, I used to ride a bicycle everywhere, so I quite regularly used to cycle twenty or thirty miles to work and it wasn’t until I progressed through my career, sort of mid-twenties, early thirties, when I, sort of, bought myself a car and didn’t, and drove to work instead of riding to work and continued to eat, so I wasn’t burning calories and I started to put on weight.

For those who had to travel a lot for work, mealtimes became more haphazard, with some of those we spoke to skipping meals and others stopping for fast food or snacking on the road. When Paul Y had a job that involved a commute and travelling around the country to multiple sites, he found himself skipping lunchtimes. He said, “I think sometimes, if I’d had a day when I hadn’t eaten, I’d eat more when I got home because there was that long gap”.

While travelling a lot for work, Stuart got into the habit of eating a couple of times a day at McDonalds.

While travelling a lot for work, Stuart got into the habit of eating a couple of times a day at McDonalds.

Age at interview: 70
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT

Now this has come about because during my working life, I had about twenty years where I used to travel up and down the country. I used to work forty thousand miles a year going to look at projects, seeing clients etc.

So I got into the habit of sort of dri-, you know, your boss wants you to get there and back as fast as you, so going, not eating anything going and then coming back after the meeting just grabbing a sandwich or something or a McDonalds.

Now in fairness it was probably the McDonald’s that put the weight on because I became, in later years, I sort of became addicted to McDonald’s. I, I used to go in for breakfast and, when I say breakfast, 11 o’clock, 12 o’clock and then I’d probably at 3 o clock, 4 o’clock, go and have a burger because I was feeling a bit peckish again.

John Y’s diet deteriorated when he travelled a lot for work. He did not anticipate that he would have an MI (myocardial infarction) in his early 50s.

John Y’s diet deteriorated when he travelled a lot for work. He did not anticipate that he would have an MI (myocardial infarction) in his early 50s.

Age at interview: 80
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT

I was eating on an as-and-when basis because sometimes I would drive 500 miles in a day and do a day’s work. So I would maybe leave home at 6:00 in the morning and drive up to Edinburgh and then do a day’s work with the people in Edinburgh and then drive back home. So it really was you ate when you could. So it could be biscuits or it could be chocolate. It could be crisps or it could be we would go out to lunch with the customer or stay overnight and stay in a hotel and have a two or three course dinner. So it was very much up and down, nothing planned. And basically I think that was because I just never gave a thought to, you know, at the age of sort of early 50s that I was going to have a very serious MI.

Eating around work wasn’t just a feature for those who were travelling, but also for those who were office-based. Hilary described how in the office environment “there was the biscuits and the cake, and it was always somebody’s birthday. It was always somebody’s anniversary. There was always somebody leaving and there was always cakes. “Oh, we’re going out for a meal” and that sort of thing”. Office culture could revolve around frequent cups of tea with biscuits, and meetings which included sweet snacks. On top of this, for some people, work involved socialising outside of the office, whether going for a drink with colleagues, eating out, or entertaining clients.

Zaida’s university job involves a lot of dinners and drinking.

Text only
Read below

Zaida’s university job involves a lot of dinners and drinking.

Age at interview: 67
Sex: Female
HIDE TEXT
PRINT TRANSCRIPT

Otherwise the style of my life is at least 3 or 4 dinner parties a week. That will change I hope with retirement. The, the life of university name academics is a lot of alcohol. A week ago we went to university dinner. And it is amazing the several layers and several different rooms and each room with different drinks and it is more food and more food and then chocolate and this and that. So this kind of life is very difficult, you know, in order to, for me because I am a person that I love to eat [laugh]. You know, I have pleasure eating and I eat. I don’t eat little bits, you know, like birds some people can do that. But when the food just jumps on me I eat.

Retirement brought its own challenges for some of the people we spoke to, including changes in their level of activity. For example, Tref said that since he had retired, he had got “lazy” and while he had tried going to the gym, he hadn’t kept it up.

Changes in the household

Tref had been living on his own since his wife had moved to a care home because of Alzheimer’s Disease. He was no longer motivated to cook for himself and instead bought ready meals from the supermarket. He found himself comfort eating, and with his wife not around to tell him he was getting a bit big and was putting on too much weight.

Tref has gained weight since his wife moved into a care home.

Tref has gained weight since his wife moved into a care home.

Age at interview: 77
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT

If I can but I, you know, as you get older, it gets more difficult and living alone doesn’t help because what you do, you tend to do, is buy these ready-made meals because it’s not, you don’t, you think, well, it’s not worth preparing anything. I can go into Waitrose, I can go into any of the supermarkets and I can buy a reasonable ready-made meal that tastes reasonable, which I’ve tried to stop doing because.

Recently.

Yeah, when my, I mean I, my wife doesn’t live with me.

She’s had Alzheimer’s for two years now, two and a half, well, she’s been in a care home for two and a half years. She had Alzheimer’s I suppose couple of years before that but I’ve always been quite a keen cook. I’ve always enjoyed food. I’ve, I’ve always enjoyed preparing food. I used to always cook at the weekends and probably two or three times in the week. Rather generous portions, I may say. I must have done but my wife was a bit stronger than me. She used to go the gym and do yoga and all sorts and she was very, she was trim.

Okay.

Before she got Alzheimer’s because she used to, but no I got a bit big. It’s all my own fault I mean it’s will power.

Maybe not having my wife, I mean that could be a factor, not having my wife here saying, “Hey, you’re putting on too much weight.”

That’s what happened before. She was.

Well, yeah, she did. She’d remind me. “Hey, you’re getting a bit big.” So then I’d lose some weight, keep it off for a bit and then bang, put it back on again.

[mm] Okay.

But she, my wife, yeah, would say, “Hey, you’re getting a bit big.”

Losing a partner, whether through bereavement, sickness or the end of the relationship, could have a big impact on weight. Sue Y told us how she had started putting on weight after the death of her long term partner from cancer. Colin found that after the death of his wife, he still continued to cook for two: “I couldn’t get it into my head to half the quantities of things”.

Colin was the main carer for his disabled wife, doing the household chores and cooking. After she died he carried on cooking the same volume as before and put on more than three stone before he had a heart attack.

Colin was the main carer for his disabled wife, doing the household chores and cooking. After she died he carried on cooking the same volume as before and put on more than three stone before he had a heart attack.

Age at interview: 72
Sex: Male
SHOW TEXT VERSION
PRINT TRANSCRIPT

Once the wife died, okay at first, I knew what it was. I was still, because she was an invalid, I was preparing meals and doing a bit of cleaning and all the rest of it for her and looking after her generally, and of course, I was cooking, I was cooking for two of us. Once she died, I still continued to cook the same volume. I couldn’t get it into my head to half the quantities of things and I’m one of these people, I can’t freeze food once it’s cooked. I can’t waste food once it’s cooked. I was eating it. So, weight gain was probably my own fault.

Okay.

But I fairly quickly, fairly quickly learned not to and I was fairly active at the time, but I still couldn’t lose this weight and I went up….

How much did you weigh?

I went up to fifteen stone.

Okay. From eleven or ten and a half?

I went up from eleven stone to fifteen and I went up even beyond that.

How long ago was this?

Two years ago when I had the heart attack, I went up to nearly fifteen and three quarters stone.

Okay. So after your, after your wife died, you put on weight and…

Very rapidly.

….you kept it for a while?

Yeah. Yeah, I’ve kept it for a long while and I still, I’m still around about the same now. Still around the hundred kilo mark…..

Okay.

….which is around about fifteen stone.

Sue Y describes the stress and health impacts of looking after a sick loved one.

Sue Y describes the stress and health impacts of looking after a sick loved one.

Age at interview: 69
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

Well, that’s, that’s when I got kind of big health changes when I was under so much stress. So much stress, it was just impossible.

Hm-mm. So you, you, do you think you became an emotional eater at that point?

I think when somebody’s dying and they’re in pain or, and very close to you, or when you yourself are, are ill and you can’t do anything about it because you’re focused on that other person completely. So, you don’t matter. It’s the other person that matters. When that situation occurs, and I should imagine it happens to mothers a lot and fathers. That, that’s really difficult to overcome and I think it’s almost impossible to overcome because you’ve got to go through the stress. You, you can’t help it. You’ve got to go through it. So obviously it’s going to affect your health and it certainly did with me, yeah.

Some of those who were caring for family members, such as children or a sick parent, said there was little time to look after themselves. Lesley said that working full time and running the home meant she never had time for herself and had not found time to make an appointment to see a doctor, even though she was waking up short of breath. Joan felt drained from working full time and caring for her mum, who had had a stroke.

Joan’s eating habits suffered when she became the main carer for her sick mother.

Joan’s eating habits suffered when she became the main carer for her sick mother.

Age at interview: 57
Sex: Female
SHOW TEXT VERSION
PRINT TRANSCRIPT

I felt as if, for a year I felt I was like a hamster on a wheel, you know. I would get up, go to work. Finish work, go to my Mums. Come home, have a shower, wash my hair. Go to bed and it was, my mum never ate a great deal but what she did like was anything sweet, so it was, you would go into the supermarket and you’d look at that high calorie stuff for my mum. So you would go up there and I’d be like, “Do you want a wee bit of scrambled egg or try this or how..?” and it would be, “No, no, no, no, no.” Or it would be “Yeah that’ll be nice,” and you’d make her it and then you’d be lucky if she took a teaspoon of it and then it would go in the bin. But what I find is I was eating biscuits, I was maybe go in and having toast and a sandwich, you know, and it was all kind of ready made foods. Like I would get home here maybe half nine, quarter to ten at night, exhausted. Get to bed and be up at five the next morn.

Overall, the people we talked with emphasised that there was more than just one reason in their personal environment that could explain why they gained weight. Some like Jane, June, Dave and Julie believed that the interplay of several factors – such as family history of obesity, what they ate as children, lack of physical activity and overeating – had contributed to weight gain and health problems.


See also: ‘Ideas about why some long term health problems are associated with being overweight’, ‘Emotions, emotional eating and self-esteem issues’, ‘Environment and cultures impact on weight’.

Copyright © 2024 University of Oxford. All rights reserved.