"British girls have become the fattest in Europe" was this week's brutal headline. According to a global review published in the Lancet, 29.2% of UK females under 20 are overweight or obese. Males under 20 weighed in at 26.1% – not much better, but nine European countries were even worse, so our boys escaped the attention.
The most striking aspect of the research for me was that no country has recorded a significant fall in obesity levels since 1980. Why have we all been getting fatter since then?
To understand the obesity epidemic we need to know when it started. In 1972, 2.7% of men and women in the UK were obese and we barely needed to record obesity in children. By the start of the new millennium, 22.6% of men and 25.8% of women in the UK were obese. What went wrong?
The short answer is: we changed our dietary advice. More accurately, we did a U-turn in our dietary advice from "farinaceous and vegetable foods are fattening, and saccharine matters are especially so" to "base your meals on starchy foods".
The ideal for healthy eating in the UK is called the eatwell plate. Or as I refer to it, the eat badly plate. You may have seen it on the walls of schools and surgeries, but have you actually looked at it? Chocolate, sweets, biscuits, cake, cereal, baked beans, flavoured yoghurts and even a can of cola. And we wonder why we have an epidemic of type 2 diabetes.
Telling everyone to eat "plenty of potatoes, bread, rice, pasta and other starchy foods" is why we have an obesity epidemic. But why does it affect girls especially?
Just as our dietary advice is wrong, so is our weight loss advice. We have known for almost a century that calorie deficits lead to short-term weight loss, followed by rapid regain – invariably beyond the starting weight. Ancel Keys confirmed this in the 1940s and Marion Franz ended the debate in 2007 with a review of 80 weight loss studies, showing the familiar loss, regain and then some.
This will be very familiar to anyone who has tried to eat less. You probably weren't that overweight when you started the first calorie-controlled diet. You lost weight; gained it back and a bit more; tried again; lost a bit less; gained a bit more. That's what UK adults, women especially, have been doing for the past 30 years and our daughters have copied us.
In 2009 Fearne Cotton made an insightful documentary, The Truth About Online Anorexia, in which she visited a school in west London and talked to a class of 10-year-olds about body image and calories. "I don't like my body," said one girl, "I think I weigh too much." When asked about calories she knew the content of a small Kit Kat and said "calories are bad 'cos you have to try and spend all your time exercising trying to burn them off".
In the UK females are starting to eat less from a younger age and, ironically, that's why they'll end up weighing more from a younger age. Because diets – and the eating disorders that so often follow them – make us fat. Dutch researchers presented recent findings at the European Conference on Obesity this month. Muscle loss on low-calorie diets is substantial, not easily recoverable and contributes to impaired metabolism, hunger and weight gain.
New obesity guidelines published this week by the National Institute for Health and Care Excellence (Nice) acknowledge the failure rate of dieting with targets lowered to a remarkably unambitious goal of achieving and sustaining a 3% loss. Despite this, the advice that is clearly not working has not been updated.
We need to teach young people the difference between real food, provided by the planet, and fake food, provided by manufacturers. We have to ditch every public health document, diagram and web page and replace it with three words: eat real food. We should return to eating the meat, fish, eggs, milk, butter, vegetables and grains in granny's larder and shun the concoctions adorning the shelves today. We need children to know the nutritional content of food, so that they are aware steak is good but confectionery is bad. They should be eating for health and energy; not to fear the calories that they need to thrive.
As in so many areas, we have failed young people. We can't turn the clock back on resource utilisation or financial burden, but we can go back to the diet of our childhoods. And we must.
