Obesity, type 2 diabetes at younger ages and changing our food environment

[PuzzledObserver]

I saw this news item and felt very sad.

www.bbc.co.uk/news/articles/cdx8vw5k2x8o

I was 34 when I was diagnosed with type 2 diabetes in 1998 - and that was considered very young then. I weighed 21 stone, giving me a BMI of 46. I had dieted many, many times, lost weight many, many times, and put it back on because of the combination of binge eating, sweet tooth, emotional eating….. all the things, basically.

My BMI has been hovering around 30, give or take, for the past couple of years. I had to fundamentally change what and how I ate. No more snacking between meals. Much less processed food, virtually no sugar. All that - and I’m still not slim. But I have been able to stop all the medication for diabetes and now have blood glucose in the prediabetic range.

What’s the answer for younger women? Some will say WLI. While I have not used them myself, I am glad they exist and many millions of people are benefitting from them. But is that the right answer for everyone? Should it be the thing we rely on most? As a country, can we do something to reverse some of the trends in food environment and eating culture which have driven the rise in obesity and then type 2 diabetes?

Modern ultra processed foods are addictive. The highly processed carbs go straight into the bloodstream, causing a massive insulin response which, over time, causes insulin resistance. Contemporary eating culture (snacks, smoothies, energy drinks, never going more than a couple of waking hours without eating) also drive insulin resistance.

It is POSSSIBLE to change this on an individual basis, but it is extremely difficult. Just as it’s extremely difficult for an alcoholic to stop drinking if they are surrounded by a drinking culture. Far better to take action on a societal level, as we did for smoking. And even that has only succeeded in reducing smoking rates from 50% of adults to 20%.

I would think that there needs to be more research into exactly what changed, culturally/socially during and after Covid to produce such a rapid increase in T2 diabetes and obesity in young people, particularly women. The diagram in that article shows a specific clear increase that now seems to be levelling off.

Is it mental health issues caused by isolation and stress during lockdown? Changes in eating and exercise caused by lockdown? Some combination of both?

Clearly, we also have an obesogenic environment that doesn't help when there are also other factors involved. Producing real societal change is incredibly difficult, made more so by the fact that no government really gets a long term chance to do so.

I take your point about the impact of Covid, now levelling out. But that was a one-time shock leading to an exacerbation of a trend which has been happening over decades. Addressing the food environment is still necessary, surely?

It won’t be easy, it won’t be quick, and it won’t be totally effective. But societal change is possible. It happens all the time, driven usually by commercial interests. By being intentional about it, we have the possibility of moving it in a direction which leads to improvement rather than worsening.

Yes, as I said, we have an obesogenic environment, I wasn't suggesting that was a good thing that needs to stay!

Societal change is hard when it's not organic or driven by a clear need. I would argue that in general people like to talk about making changes to change our society but as those changes might affect convenience and ease for people then unfortunately they are resistant to actually making those changes.

Maybe current and subsequent governments will think that drives to reduce snacking (ad campaigns? health visitor advice? schools?), ban energy drinks/smoothies, ban or heavily tax highly processed carbs, and highlight the idea of insulin resistance will be vote winners. Let's hope so.

It’s about how you present it. You’re right that convenience, and tbf cost, are always going to be powerful forces ranged against doing the healthier thing, even when people agree what that is.

I’m thinking back to campaigns which have made a significant impact in the past. Things like seatbelts, making drink-driving unacceptable, and smoking. Yes there has been government action and enforcement, but there has also been a lot of change in social attitudes.

The challenge as I see it with tackling obesity is how to change the attitudes and behaviour on the eating side, without stigmatising individuals. There’s far too much fat-shaming already.

I find your last post a bit depressing, though. Governments will take action only if they see it as a vote winner :-(. You would hope that safeguarding the health of future generations would be a vote winner…. but history doesn’t give us much cause for hope on that front.

UPF companies sue governments - depressing exclusive from the Guardian today.

‘If all else fails, sue’: how ultra-processed food firms are using the courts to obstruct health rules
**
Exclusive: Global investigation reveals 235 lawsuits have been brought against governments in five countries since 2010

https://www.theguardian.com/society/2026/jul/22/processed-food-firms-courts-obstruct-health-regulations

I am in general very dismayed with the state of UK and world politics, and don't find many of the current crop of politicians to be up to much. That impacts across all areas of politics and policy making. Populism is very damaging.

Right leaning politicians would also generally be reluctant to interfere in what would be considered an area of personal responsibility, imo.

Depressing, as you say. However, I spot a ray of hope: 75% of these lawsuits were eventually lost by the companies concerned.

By delaying the public policy changes, the companies ensure that millions more people will suffer than otherwise would. A legacy of which they should be ashamed, and for which they should be held to account - althought they probably won’t.

But keep on pushing, and eventually the message will get through and things will change.

I wonder if the increase in working from home since Covid, has contributed to this?

I find I snack far more on the days when I work from home. I usually have snacks in "for the kids" and if I'm working on something difficult or boring, I always find myself reaching for a snack.

When I'm at work, on the other hand, I rarely eat anything between when I arrive and lunchtime at 1pm.

It’s a really interesting question. And always complicated to compare with the smoking and drinking campaigns as food is an unquestionable necessity, whereas smoking and drinking aren’t.

I personally think that once the jabs become more sophisticated, and far cheaper for the NHS to prescribe as tablets, then that really will be a game changer. Healthy food is getting more and more expensive, and obesity is so intertwined, at a population level, with poverty, that I think these treatments should be thoroughly embraced.

No government can afford to fight the might of the global food corporations.

I think actual treatment by doctors would be a good place to start. I was officially diagnosed with PCOS when I was 28 but had been going back and forth to the Drs for years before that with all the symptoms. It was only when I was unable to get pregnant that they actually did an ultrasound and blood tests. Even then they stuck with the party line of “well you’re fat so eat less and move more” they didn’t put me on metformin or help me with a proper diet programme just sent me on my way.

I suffered through a year of heavily restricting my diet and being as low carb as humanly possible and lost enough weight to get my periods back and then when I was pregnant was diagnosed with gestational diabetes. Was put on metformin and insulin and the weight fell off. It was miraculous that when they treated my metabolic disease I actually got better!

As soon as I had the baby all the treatment stopped and the weight went back on.

I was diagnosed as Type 2 diabetic 2 years ago and once again put on medication and lo and behold I lost weight. Now a healthy BMI for the first time since primary school and puberty.

@ownedbymydogs

It’s a really interesting question. And always complicated to compare with the smoking and drinking campaigns as food is an unquestionable necessity, whereas smoking and drinking aren’t.

This is why food addiction is more complicated to deal with than alcohol, drugs or smoking. With those, it is clear whether you are indulging the addiction or not. With food, it isn’t. That’s why many members of Overeaters Anonymous identify specific foods, ingredients or behaviours which they abstain from completely, or follow a defined food plan: it gives clarity as to what is and is not allowed, for them.

My own experience is that by staying away from sugar and ultraprocessed savoury snack foods, my cravings are much, much less. Life is much easier when you only have to fight cravings occasionally rather than every waking moment,

@InfoSecInTheCity what a frustrating experience, so glad you are in a good place now, on the right treatment for you.

We are all different, though. I was on metformin for decades and it didn’t prevent me from gaining weight. Low carb allows me to maintain a much lower weight, though still not a normal one.

Maybe one day they’ll figure out a way of testing which will definitively identify the best approach for each individual. Rather than one size fits all, or trial and error.