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The Obesity Row

Dr Matthew Capehorn looks at whether or not it's fair to label videogames as chief culprit

That children are becoming, on average, increasingly overweight is a fact that nobody can argue with - but what's the real cause of the so-called 'Obesity Epidemic'? For many, videogames are a prime target - they encourage a sedentary lifestyle and children generally need little encouragement to sit and play for hours at a time.

But is that fair? Is it the fault of the games industry, of parents, of the government, of fast food chains? Some questions are impossible to answer fully, but here - in the first of a two-part look at games and health - Dr Matthew Capehorn, board member of the National Obesity Forum, explains the extent of the problem, discusses the controversial Change4Life campaign, and ponders whether games could in fact be a solution.

The Scale of the Obesity Epidemic

The prevalence of obesity in this country is increasing to epidemic proportions and is linked with significant physical and psychological problems. The Health Survey for England reported that in 2006, over one in four (25 per cent of men and 29 per cent of women) adults were obese, and over two in three (68 per cent of men and 71 per cent of women) were either overweight or obese. More people had an unhealthy weight than a healthy weight, and projections to 2010 suggested this was likely to increase and one in three adults could become obese. Given the rising levels of childhood obesity, this is only likely to increase further.

The National Child Measurement Programme (NCMP) provides high-level analysis of weight, in Reception (aged 4-5 years) and Year 6 (aged 10-11 years). The 2007/08 school year results have recently been published and show that in Reception, almost one in four children were overweight or obese (22.6 per cent) and one in ten obese (9.6 per cent), and that in Year 6 one in three children were overweight or obese (32.6 per cent) and one in five obese (18.3 per cent). The percentage of children who are obese is almost twice as high in Year 6 than in Reception.

Differences between boys and girls were significant but very small for both years. It has been calculated that these figures may in fact be an underestimate of the problem due to the effect of children opting out of being measured. The participation rates for 2007/08 reached approximately 88 per cent of those eligible.

The 2007 Foresight Report projected that by 2050, over 50 per cent of the adult population could be obese and 90 per cent overweight, and that two in three children could be overweight or obese. Clearly something needs to be done, and the Government has launched the Change4Life public health campaign to raise awareness of the problem.

The Change4Life Campaign

No one would disagree with the need for more public health campaigns to help raise awareness of public health problems such as smoking, alcohol consumption and obesity, however the Change4Life campaign has not been without its criticism.

Unlike the smoking and drink-driving television campaigns, which are deliberately hard-hitting to get across the potential harm caused by these conditions, the obesity campaign is more 'consumer-friendly' using attractive graphics to appeal to adults and children alike.

The campaign has been estimated to have cost GBP 75 million. One criticism has been that this has been a very expensive campaign to inform overweight people that they may be overweight and the possible consequences of this, when in fact that probably already know this. In fact, it is true that many people underestimate their weight, and those that think they have a healthy weight are in fact overweight, and those thinking they are a little 'chubby' are in fact obese, and so there is a need to reinforce this basic information.

Regrettably for some, and especially given the cost of the campaign, it does not go far enough with the management of the problem, and further resources need to be provided for structured weight management programmes for those people who require help in losing any excess weight.

Furthermore, the advertising campaign has been criticised for its content. Initially it implied that obesity is the main cause for diabetes, without distinguishing this 'type 2' diabetes from the 'type 1' which is due to a problem with the pancreas not producing enough insulin - which is not obesity-related. It was felt that this was confusing and could potentially be upsetting to these sufferers of type 1 diabetes.

The campaign was right to focus on how we have started to become 'lazy' as a society, so much so that our more sedentary lifestyle has now been given a name - the "obesogenic environment", ie the surroundings in which we live are helping to add to the obesity problem.

Over the last few decades we have embraced technology, and look for everything to be remote-controlled or designed for our convenience. We look forward to the day when robots do everything for us. We all want to drive our cars, even for short trips, rather than walk, and all park as close to the front door of the supermarket instead of consider walking an extra few hundred yards. We want to drive our children to school rather than encourage then to walk or cycle to school because society has caused us to be scared of the 'bogeyman' and harm coming to our children. We go into a shopping centre or hotel and there is a prominent escalator or lift, whereas the more healthy stairs are often very hard to find.

There are numerous examples of how our society has changed to result in us burning up far less calories than previous generations of adults and children did, and perhaps it is human nature to look for the 'lazy' way of doing things. However, one particular concern that I have is the implication that certain childhood pastimes, like gaming, is a cause of the obesity epidemic.

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