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Published 16 December 2008, doi:10.1136/bmj.a2877
Cite this as: BMJ 2008;337:a2877
Mark Petticrew, professor
1 Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT
Correspondence to: mark.petticrew{at}lshtm.ac.uk
Cripes, said Bunter, what will the government do next? Mark Petticrew investigates
"Come in!" barked Mr Quelch, form master of the Lower Fourth, in response to a tentative knocking at his study door. He set aside the history of Greyfriars School on which he had been working and peered over the top of his glasses at the rotund form that sidled into his office.
"Ah . . . Bunter. What do you want? This had better be important. And if it isnt . . ." He flexed his cane meaningfully, glancing in the direction of Bunters ample rump in a manner fortunately now absent from stories about bespectacled public schoolboys.
Bunter blinked owlishly behind his thick, pre-NHS horn-rimmed glasses.
"Sir!" he squeaked. "Its the school vending machine. Theres something wrong with it."
"Wrong, Bunter? What could possibly be wrong with it?"
"Sir," went on Bunter nervously "You know how it usually dispenses Mrs Bloaters Carbonated Cordials? Well, the bottles now only seem to contain this colourless, odourless fluid. . ."
He waggled a plastic bottle at Quelch. "I think shes trying to pull a fast one, Quelchy—I mean, SIR" he corrected himself quickly. "I think this is. . ." he leant forward conspiratorially ". . . WATER!"
"Of course its water, Bunter you dolt!" exploded Quelch. "Junk food has been banned in schools since 2006!"1
Bunter blinked, his mouth a surprised "O."
"Anything else, Bunter"?
The Fat Owl of the Remove nodded. "Er . . . yes, Sir. We dont like this new healthier food regime—Harry Wharton, Coker, and some of the other chaps would like to you bring back Mrs Miggins Whopping Offal Pies, and her Big Yankee Burgers."
"No, Bunter."
"But why, Sir?"
"Well, Bunter, Id like to tell you what was in those burgers, but that will have to wait until we discuss the bovine reproductive system in biology classes. Lets just call it non-lean meat for now."
Bunters eyes grew moist as the implications sank in. He looked down at his ample stomach. "Goodbye, old chum," he whispered sadly. Then his face brightened. "Still, theres always the tuck shop! In case, I mean, a chap was a bit peckish . . . starving, actually. And Ive got my hamper from home every term . . . and some of the chaps are getting emergency deliveries of chips through the school railings."
"Listen, boy. Itll do you good to lose a bit of weight. A third of children are now overweight or obese, and, as the so called Fat Owl of the Remove youre definitely one of them—more than one, probably.2 Whats your waist:hip ratio?"
"I dont know sir. At my last school medical the tape measure didnt reach all the way round."3
"I think that means youre fat, Bunter."
"Ooh, Sir, you cant call me that!" admonished Bunter. "The Department of Health doesnt allow that sort of beastly language to schoolchildren anymore. You have to say overweight."4
"Nonsense, boy—run along and get some exercise."
"But, sir, the PE class has been cancelled—Greyfriars sold the playing fields to ObeseCo to build a new hypermarket. So its not my fault Im a little . . . er . . . Rubenesque." And with that Bunter scuttled out.
Quelch gazed out over Greyfriars grounds and wondered whether the school really was contributing to Bunters weight problem. Was Greyfriars an obesogenic environment?5 And if so, then why was Bunter so much fatter than his chums? Was it related to his postal order from home, perhaps? After all, smoking in schoolchildren is related to pocket money.6 Perhaps it was the same for unhealthy eating. And what was the government doing about all this anyway? He glanced through the recent "Healthy Weight Healthy Lives" strategy,2 and noted that the Health Minister "plans to introduce compulsory cooking for all 11 to 14 year olds." Thats a bit drastic, thought Quelch—then again, he reflected, some of them probably deserved it.
He looked across to the new hypermarket rising above the former playing fields and thought back to the lectures given by Mr Redbeard, Greyfriars new politics lecturer, who said that the rot had set in with the removal of nutritional standards in school canteens in the 1980s and the introduction of competitive tendering.7 This allowed children to choose what they wanted to eat, in line with Conservative thinking on consumer choice.7 The Black Report had even warned nearly 30 years ago that "to leave school children to make their own free choices of a meal ... would be likely to lead to "increases in obesity."8 Well, reflected Quelch, the turkey twizzlers had certainly come home to roost now. With an average of 23 junk food outlets per secondary school, promoting healthy eating was increasingly an uphill struggle.9 10
He examined his map of Greyfriars and its surroundings (fig 1).11
Greyfriars certainly showed no lack of green spaces, and the High Street Bun Shop was on the other side of Courtfield Common—hardly an obesogenic environment. Could the school tuck shop be to blame, then? It was right on the school premises after all . . . perhaps he should have a look at what they were selling.12 There were so many potential influences on young peoples diet, he reflected. "Portion distortion," for example, in which portion sizes are stealthily increased.13 14 Worse, in a vicious cycle, overweight children are more responsive to food promotion.15 So, concluded Quelch, the fatter Bunter gets, the more he responds to junk food adverts, which in turn makes him even fatter. Poor Bunter had become the junk food equivalent of a perpetual motion machine. Not everyone, however, believed obesity was a problem. There were denials by some in the food industry,16 and even a class action against McDonalds on behalf of overweight children17 . . . it all sounded vaguely familiar, thought Quelch, as he filled his trusty briar with fragrant "Old Canker" shag and lit up.
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As he leaned out of his office window smoking his pipe he spotted the Fat Owl of the Remove in the tuck shop queue, waving a piece of paper. (Strange that the boy is still at Greyfriars, he mused. He seems rather old to still be at school.23)
"Whats that, Bunter? Has your postal order arrived at last?"
"No sir, its a cheque, from the Department of Health, Sir. They are paying overweight people to lose weight now.2 If I keep my weight up, I might be able to make a few bob."
Cite this as: BMJ 2088;337:a2877
Competing interests: None declared.