Obesity and the modern lifestyle:

what can we learn from history?

Continuing our History & Policy series, Dr Ina Zweiniger-
Bargielowska considers if the past can offer any solutions to the dietary
crisis we are experiencing today
Submitted by: David Matthews

What is the problem today?

Obesity, a major risk factor for heart disease, diabetes and premature
mortality, is a leading public health concern today. National surveys have
measured the BMI (Body Mass Index, the ratio of weight to height)
periodically since 1980, when the first fully representative survey showed
that the majority was of normal weight or underweight (BMI under 25)
and six per cent of men and eight per cent of women were obese (BMI
above 30).
Subsequently, obesity has increased to 13 per cent and 16 per cent
respectively in 1993 and 23 per cent and 25 per cent by 2005. Since the
mid-1990s about four men out of 10 and nearly a third of women have
been overweight and the proportion of people with normal weight has
declined. Female obesity is inversely correlated with social class and
income – obesity is highest among low income women in unskilled
occupations – whereas socio-economic factors make rather less difference
to male weight.
These trends occur in the face of a multi-million pound slimming
industry. Health education advice has proved ineffective and tackling
obesity is now a key government priority.
Is this new?
This is not unprecedented. In the 1920s the chief medical officer Sir
George Newman held “excessive and unsuitable food combined with lack
of fresh air and exercise” responsible for sowing the “seeds of
degeneration”. He accepted that some persons “no doubt” were “under-
fed” in 1931, but argued that many were “over-fed – giving their poor
bodies little rest, clogging them with yet more food”.
Doctors took increased interest in obesity and The Lancet noted in 1933
that in “these days of ‘slimming’ there was no more popular subject of
discussion among the laity than the reduction in weight”. Such a
preoccupation appears incongruous at a time of economic depression,
high unemployment, hunger marches and working-class poverty.
Obesity and slimming draw attention to inequality in interwar Britain.
Excess weight affected the middle class, the first social group to
experience the affluent, sedentary lifestyle often associated with the
postwar years.
What evidence do we have about obesity in the interwar years?
There are no statistics of obesity rates, but several 1930s dietary surveys
document excess consumption among professionals and high income
groups with daily intake of about 3,500 to 3,600 calories per man. This
contrasts sharply with only 2,000 to 2,300 calories per day among the low
paid and unemployed and was well above the recommended 2,700
calories for sedentary workers.
An abundant middle-class diet frequently resulted in weight-gain and
there was a flourishing market for popular weight loss manuals, several of
which became best sellers during the interwar years. Anxiety about excess
weight was exploited in advertisements of “slimming” foods such as
Ryvita crisp bread, remedial products such as Linia Shorts intended to
massage away the abdominal “danger curve” and vibratory machines
which promised to exercise “All the body without effort” and reduce
obesity “without drugs or dieting”.
A stock character was the fat middle-class man who was suffering from ill-
health, threatened by premature death and represented as an ugly,
ridiculous figure. Obesity was associated with middle age and, according
to George Orwell, the middle-class endeavour to maintain a youthful
appearance was a recent development and one of “the few authentic class
differences… still existing”.
While fat women were mentioned, the typical female slimmer was not
necessarily overweight but restricted her diet in order to emulate the new
female fashions of the 1920s. Doctors considered this practice harmful
and portrayed women’s “thin and scraggy” figures and “haggard, drawn
expression” as the very opposite of beauty and a threat to women’s
responsibility as “race” mothers.
In 1929 dietary expert WF Christie described the obese as a “deviation
from the normal”, but norms and ideals are culturally constructed and
change over time. During the interwar years the body beautiful,
represented by scantily clad young and slim men and women, was
celebrated. Aesthetics were not just a female concern but also mattered to
men, and obesity conflicted with the dominant Greek ideal of male
beauty.
As another obesity expert Leonard Williams put it, “No man has any right
to be really fat; no woman has any right to be really thin”. Thus, the self-
indulgent middle-aged man and the vain, emaciated woman were
subjected to a moralising discourse that condemned women’s excessive
slimming in the pursuit of fashion and castigated obese men’s greed as
subverting the idea of masculine self restraint.
The weight loss culture disappeared following the outbreak of the Second
World War when policymakers, nutritionists and housewives struggled to
eke out meagre rations to maintain civilian health and morale. Doctors
lost interest in obesity, no dieting manuals were published between 1940
and the early 1950s and remedial products disappeared from popular
advertising during the war and difficult years of postwar reconstruction.
What does history teach us?
The prevalence of obesity is closely associated with the emergence of
modern lifestyles in Britain. In 1900 Britain was already the world’s most
urbanised and one of the wealthiest countries, with a large service sector,
expanding public transport network and thriving mass consumer culture.
Despite high unemployment and economic depression, living standards
continued to rise during the interwar years. With falling prices and
smaller families, real incomes per capita increased by about a third.
Britain’s growing prosperity was not shared equally and substantial
sections of the working class continued to suffer from under-nutrition.
In this period, obesity was associated with the comforts of suburban
middle-class life, plentiful food and a rapid rise of car ownership. Since
the 1950s, the British diet has been characterised by ever more abundant
cheap food. In recent decades the traditional three meals at home pattern
has been replaced by snacking, junk foods and takeaways, contributing
towards weight gain.This has been compounded by a decline in physical
activity with expanding car ownership and new forms of home-based
entertainment.
After 1939, the introduction of extensive rationing and regulation of food
supplies resulted in reductions of sugar, meat and fats as consumption
shifted to bread, potatoes and milk. This massive state intervention,
which was only possible in the context of total war, amounted to a major
turning point in the history of the British diet.
The policy has been described as a revolutionary transformation because
it largely eliminated the disparities between the social classes with regard
to energy and nutrient intake documented in the 1930s.
Middle-class calorie consumption declined and there is extensive
evidence of grumbling about the lean, monotonous diet of the period,
while wartime diarists fantasised about generous helpings of meat, bacon
and eggs, buttered toast washed down with coffee laced with sugar and
cream. Activity levels rose due to longer working hours, increased
walking, reduced motoring with petrol rationing and schemes such as Dig
for Victory.
This erosion of class differentials in food intake persisted after the end of
rationing in 1954 and weight gain was no longer confined to the highest
income groups. The episode points towards the limits of personal
responsibility with regard to dietary restraint and highlights the
significance of a heavily regulated food regime in the 1940s.
In interwar Britain, weight loss manuals did not focus on calorie counting.
Many did not even mention calories but prescribed a diet of loosely
defined portions. This was not due to a lack of understanding of calorific
content of food, but rather a holistic perspective which saw weight loss as
part of a wider transformation in lifestyle based on self-discipline and the
golden rule of moderation.
Thus, the key to weight loss was the adoption of a comprehensive hygienic
regimen which involved moderation in eating and drinking, daily exercise
and personal cleanliness. Manuals advised avoiding sugary and fatty
foods and recommended consumption of lean meat, boiled fish, fruit and
salad.
They also emphasised the importance of thorough mastication and
regular bowel movements. Constipation, exemplified by a bloated
abdomen, was closely linked with obesity and could be avoided by means
of regular habits, abdominal exercises and a high fibre diet. The
cultivation of health and beauty was not simply beneficial to the
individual, but was represented as a patriotic duty because the British
Empire required a nation of fit men and women.
Losing weight is difficult and a Department of Health campaign of 1995
which set a target to reduce obesity rates to the 1980 level by 2005 has
failed spectacularly. In October 2007 the Government renewed its
ambition to reverse the trend with a strategy that combines the promotion
of healthy eating with lifestyle changes such as physical activity goals,
resembling the holistic approach of the interwar years.
Three lessons from history
1. The history of consumption and living standards in Britain during the
20th century points towards the close relationship between obesity and
modern affluent lifestyles characterised by abundant food and
increasingly sedentary habits.
2. Extensive rationing and controls of food reversed these trends during
the 1940s. The policy was only possible in the context of war and does not
offer a practical solution for the public health problems of the early 21st
century.
3. Interwar weight loss manuals did not pay much attention to calorie
counting, but rather emphasised a holistic approach to transform
lifestyles by adopting healthy habits as the key to successful, permanent
weight reduction.
Ina Zweiniger-Bargielowska, Department of History, University of
Illinois, Chicago, is author of Austerity in Britain: Rationing, Controls,
and Consumption (Oxford, 2000).She is currently writing a book
entitled Managing the Body: Beauty, Health and Fitness in Britain,
1880s–1939.