It is significant that Sir Liam Donaldson, the chief medical officer, should sound an alarm about the "burning platform" of obesity, following a woeful litany of national health statistics for England served up both as appetiser and aperitif prior to the Bacchanalian celebrations that we otherwise call Christmas.
The latest Health Survey for England warns us that obesity has doubled, we're drinking too much and we just don't get enough exercise. A different kind of survey, from Professor Terry Wilkin's EarlyBird Study in Plymouth, suggests that for some children today the die is cast long before they reach school.
Rising childhood overweight and obesity levels makes a continuing increase in the prevalence of adult obesity almost inevitable – perhaps as high as the 50-60% level the government's foresight programme predicts by 2050.
Yet as Sir Liam notes there remains a curious sensitivity in many circles to using the "O" word. Even as the US abandoned its farcical terminology "at risk of overweight" to describe the fattest generation ever, the UK is trembling at the thought of reminding parents that their children (and often they themselves) are obese – dramatically increasing the risk of suffering chronic disease with all the unpleasant and expensive consequences.
Maybe publishing the health survey to remind us of the sheer weight of numbers at this time of the year is necessary in order to prick the nation's collective conscience to forego second helpings of turkey, forfeit that extra dollop of double cream on the plum pudding, and go easy on the booze. It still doesn't put many of us off having a seasonal blowout.
But year after year this statistical stocktaking reproaches our increasing girth, our unrestrained drinking habits, and our innate unwillingness keep up with the keep fit fanatics. Of course in the New Year we will ease our belts a notch or two, stare with disbelief at the scales, and resolve to do something to burn it all off … mañana. But how many parents will think of the way the season of overindulgence is shaping their children's future?
Ironically the Health Survey for England highlights seeks to quantify and confirm trends that nowadays are well know. Perhaps that's why Sir Liam sounded a frustrated, if not despairing, note in comments to the BBC. His original warning of an obesity timebomb came in 2002 and we are still pussyfooting around the problem.
In reality the ticking bomb analogy came 25 years ago in a report from the Royal College of Physicians. Then the scale of the problem was much lower – in fact about one-third of the 24% of adults that the latest survey now confirms has become a stable norm. Childhood obesity was not yet on the radar in the early 1980s but, as with adults, we have had to wait until the statistical trend was irrefutable and the problem much larger rather than taking avoiding action.
The most valuable function the Health Survey performs is to give us an opportunity to fit together the jigsaw of percentages and reveals some of the gaps. It is no surprise medical experts that the statistics show that nine out of 10 of those with uncontrolled hypertension were overweight or obese and that waist circumference offered an even stronger association for high blood pressure. But the survey does prompt the question of why a high number of the overweight and obese – obvious candidates for therapy – fall into the untreated category.
Mining deep into the survey's data there are few glimmers of hope. Obesity actually fell markedly for men aged 25-34 over the past seven years but the 15.6% prevalence in that age group is still 50% higher in than in 1993 when the survey began. More troubling is that there is no respite for middle aged men – from 45-54 – whose obesity rate has doubled to 34.5% over the years – higher than women in the same age group. Of acute concern is that morbid obesity – the highest risk category with a body mass index of 40 or more – has risen to 2.3% from a negligible 0.3% of men in that age category 15 years ago.
Once the festive cheer has subsided, the Department of Health's New Year resolution is to urge us all to join in its Change4Life campaign and take heed of the government's guidelines on healthy eating, exercise and alcohol consumption. As the Health Survey for England 2007 confirms, there is a literally large audience in need of persuasion: 15 million of us are overweight, and nearly 10 million are obese. Changing the outlook for children already set on the path to obesity before the age of five is part of the challenge.
No doubt some other survey will note how aware we've become of the slogans and health messages, but we won't really know whether this will translate into falling obesity rates for years to come. We cannot afford to wait to find out. As Sir Liam rightly points out, "doing nothing is not an option".
