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ascertaining whether any relationship existed between social class
and obesity. Adults forming the sample were selected so as to
correspond to the social class distribution of the city as a whole.
It was found that the prevalence of obesity was significantly
related to social class, age and sex. In women, obesity was
inversely proportional to social class, that of the upper class being
only one half of that of the lowest. Men showed a similar but
less pronounced trend.
Local information is limited to schoolchildren. During 1969, in
routine examinations carried out at Greenwich schools, 92 children
were noted for treatment and 308 for observation in connection
with obesity. This is equivalent to a rate of 10.10 per 1,000 of
the school population which is perhaps somewhat less than
informed current opinion would have led us to expect.
Identification of the population at risk is a prerequisite to
any preventive programme. Somewhat unexpectedly the problem
turns out to be one mainly concerning the older women in the
lowest social class and young children.
Prevention of obesity is difficult for, in a relatively affluent
society, over-eating is usual and even stimulated by high pressure
salesmanship exerted via the well known advertising mediums.
Threatened with malnutrition of all kinds from avitaminosis
and trace element deficiencies to a lack of energising carbohydrates
if certain foods are not ingested, with minimal attention to a
balanced diet the cossetted off-spring is quickly weaned on to
cereals and encouraged to over-eat by anxious, over-zealous but
conditioned parents. Later, the child's diet is further adversely
affected when increased pocket money enables the attractions of the
tuck shop to wreak their seductive havoc. Replete with a host of
bad dietary habits the child advances towards adulthood with all
the disadvantages of obesity often to a life of miserable disability
or one prematurely shortened by disease. Evidence clearly points
to the fact that the "fat" child is extremely likely to become an
obese adult.
An intrinsic difficulty in the relief from obesity lies in the fact
that it demands a modification by the individual of habits from
which some satisfaction is derived. Naturally, this change is more
easily accomplished at the earlier ages when habits are flexible
and the problem is not so great. To be effective, preventive efforts
must begin at the ante-natal clinic and continue through school to
adulthood. At this particular stage one useful feature of society
is that, in preferring the slim and perhaps more aesthetically
desirable figure, it subscribes to our aims and encourages the
adoption of dietary control, especially among women whose