Scenario two — food companies made tasty new food. People started to get fat. By the 1990s, food companies and, more to the point, the pharmaceutical industry looked at the escalating obesity crisis and realized there was a huge amount of money to be made.
Seen purely in terms of profit, the biggest market was not just the clinically obese (those people with a BMI of 30 plus), whose condition creates genuine health concerns, but the billions of ordinary people worldwide who are just a little overweight, and do not consider their weight to be a significant health problem.
That was all about to change. A key turning point was June 3, 1997. On that date the WHO convened an expert consultation in Geneva, which formed the basis for a report that defined obesity not merely as a coming social catastrophe, but as an “epidemic.”
The word epidemic is crucial when it comes to making money out of obesity, because once it is an epidemic, it is a medical catastrophe. And if it is medical, someone can supply what they call a cure.
The author of the report was one of the world’s leading obesity experts, Philip James, who, having started out as a doctor, had been one of the first to spot obesity rising in his patients in the mid-1970s.
In 1995 he set up a body called the International Obesity Task Force (IOTF), which reported on rising obesity levels across the globe and on health policy proposals for how the problem could be addressed.
It is widely accepted that James put fat on the map, and thus it was appropriate that the IOTF should draft the WHO report of the late 1990s that would define global obesity. The report painted an apocalyptic picture of obesity going off the scale across the globe.
The devil was in the detail — and the detail lay in where you drew the line between normal and overweight. Several colleagues questioned the group’s decision to lower the cutoff point for being overweight — from a BMI of 27 to 25. Overnight, millions of people around the globe would shift from the normal category to the overweight category.
Judith Stern, vice president of the American Obesity Association, was critical, and suspicious.
“There are certain risks associated with being obese ... but in the 25-to-27 area it is low-risk. When you get over 27 the risk becomes higher. So why would you take a whole category and make this category related to risk when it is not?” she said.
Why indeed. Why were millions of people previously considered normal now overweight? Why were they being tarred with the same brush of mortality, as James’s critics would argue, as those who are genuinely obese?
James was asked where the science for moving the cutoff to BMI 25 had come from.
“The death rates went up in America at 25 and they went up in Britain at 25 and it all fits the idea that BMI 25 is the reasonable pragmatic cutoff point across the world. So we changed global policy on obesity,” he said.