Could you just start by saying your name and what your current title is?
My name is Stanley Wilson, professor of Human Ecology at the School of Anthropology and Museum Ethnography at the University of Oxford.
Lovely. And also a fellow of some cross currents. And I'm a Phillips and Ross College.
Yeah. And I wanted to ask you to essentially tell me your life story, but in fairly short, short order,
how did you first become interested in the kind of topics that you've been researching?
And can you just give me the kind of headlines of your career steps up till 2020?
Short story. I graduated in biochemistry back in the day and had progressively moved from
biochemistry to nutrition to public health nutrition when it really wasn't a subject.
Way back in the 1980s, I worked in Papua New Guinea.
I was fascinated in this strange and remote place and worked on nutritional ecology there because it seemed that the only way of finding out
why there were such high levels of undernutrition in the place where I was was to look at the practice of food getting in all its forms,
its sociality, the practices themselves, and finding out that the story was actually more complex than I anticipated.
So I worked on nutrition and infection.
I graduated, got my first academic post at the University of Cambridge as a fledgling nutritional anthropologist when it didn't exist as a subject.
They were looking for people and very few to to be found.
There was one of the son, Strickland, who got the other job, which was at the London School of Hygiene and Tropical Medicine.
Neither of us really knew what we were doing, and so we saw fit to write a book together.
So that was our first book. And through writing,
we got to learn what it was we really thought we were thinking about and developing in this field of subfield of nutritional anthropology.
But you were particularly looking at public health through a nutritional lens and in an anthropological context.
Well, it started off in a public health way, but very rapidly became anthropology.
When I met some seminal figures who were out in the field in Papua New Guinea, I never studied with them,
but they kind of became collaborators, co constructors of a way of thinking in the field.
So I was moving towards anthropology. In fact, when I was writing up my doctoral thesis, which was based on largely based on work in Papua New Guinea,
I my supervisor who was a nutritionist, said, If you keep going on like this, you, you should find a supervisor in anthropology.
And I said, No, I'll stay with you. But then my first job was in anthropology.
So funny thing was that somehow I became an anthropologist on the hoof.
The obesity work really came in an unlikely way because I wasn't interested so much in the public health and the medical aspects of obesity.
You don't acknowledge their importance, but that's not really what I do.
I became interested when I went back over two decades later to the populations I'd worked with in the 1980s and found that there was diabetes,
there was hypertension, undernutrition, much less of a problem.
But then emerging overweight over nutrition in a rural place,
a very difficult place where you might not expect to see people develop excess body fatness.
So that was curious in a way. It wasn't the usual story of the people in my country,
whether that country is the United States or the UK or Australia changing, and this has a significant impact on their health.
It was more about, well, it shouldn't be happening.
It seems to be a curious phenomenon and I really want to try to understand the pathway to this particular form of obesity,
which then led me to think about different pathways to obesity, which is pretty much where I am now.
Every country has a different trajectory, and that's what makes it interesting to study.
It's also of huge importance, but it's interesting to study because you can then say, well,
of all the different ways in which obesity could be produced, what are the particular pathways in this country?
This country is different to Scotland, that's England, different to Scotland,
Scotland is different to Italy, Italy is different to Japan where there's very little obesity.
Even though I present there about Pacific Islands, obesity.
I've also worked on the Cook Islands, which has now the highest level of obesity anywhere in the world.
And at that time I presented the comparison slide for Japan and said the rates of obesity are 3% in Japan,
and most of the discussion centred around why is there so much obesity in Japan.
There shouldn't be any obesity in Japan at all, period.
2% is tiny compared with the United States. Totally.
Totally. So. Totally So. Very, very.
Very small issue at all. But as a matter of national pride, too, to be thinking that there should be no obesity whatsoever.
So what are the what are the. You talk about these pathways being different from country to country.
What are the elements of those pathways that you're interested in as a politician?
I worked for the foresight obesity think tank in the early 2000 2000, and this was the grouping that first published on obesity as complexity.
It had been done before, but in a much more limited way. Well, a complex phenomenon is climate change, for example.
Many things come together to create a perfect storm.
And then when something moves from one state of reasonably steady state to another state,
that's called a tipping, you tip into, you know, a another another state.
Nobody sort to nobody thought of obesity at all.
And it seemed to have seems to have emerged in the 1980s 1990s in the industrialised countries.
More recent the nineties 2000 across across the global South.
And in the early 2000 there were over 100 factors that contribute to obesity that were known, had been research had been studied, had been published.
So it tells you immediately it's not if you do this then that it's the agglomeration of factors.
And you know, we can make an analogy with some cancers, for example, where cancer accrues across a lifetime usually.
And it's there are predisposing factors, there could be genetic factors.
And then there are a number of triggers and there may be a singular trigger.
Smoking is, as I understand it, to be a particular singular trigger for lung cancer, for example.
But oftentimes there are multiple factors or multi hit factors.
It's a multi-hit model. Similarly, for obesity, you could think about it as being a multi hit model, but rather than there being,
let's say, ten or 20 known factors that could be those triggers, you have over 100.
And it doesn't have to be all of them. It could be any five or six of them.
Okay. You just pick a few as a sort of examples of those that tend to tend to come up.
Well, I'm just trying to make the example a bit more concrete.
Well, there is life course issues that if you're breastfed, you're protected against developing obesity and then many chronic diseases.
If you are overfed in early childhood, that increases your increases your predisposition.
If you're undernourished in utero, your predisposition to obesity is increased through epigenetics.
And and then there are myriad behavioural factors like if your parents are physically active, if they pattern,
you know, a way of life that involves physical activity or more like a pattern to your life around physical activity,
physical activity is probably less important than food in relation to putting on excess weight, but it's still important because it patterns appetite,
for example, and then a range of factors like inequality, social deprivation, economic, economic deprivation, poverty, child abuse.
All of them are related in some way to behaviours that are associated with obesity.
I mean, you graduated in psychology, so you'd understand that, you know,
many of these psychological factors have many different correlates in other areas, including including eating.
And if we look at obesity in relation to in relation to eating, many people comfort it.
Many people eat for distraction. Many people eat when they're just trying to reduce the stress level.
So I remember as a student, I could sit down and revise and I put a box of cookies, let's call them activities digestives and start to revise.
And 2 hours later the packet was gone. Similarly, in recent times, I would, you know, if I'm driving in a distance,
I would put food next to me and similarly I'd find a whole box of something not very healthy could be consumed without even realising.
Now I still have that behaviour,
but I've simply replaced bad food with fruit and so I just end up eating a lot of stuff that is probably healthy for me.
So there's. All kinds of things that serve to promote obesity comfort, because ultra processed foods,
foods high in sugar, high and fat salt, very ultra palatable foods are extraordinarily comforting.
And they're also very cheap and very, very affordable.
Very, very affordable.
And many stores in the United States, you go to a drugstore in the United States and say, well, what can you buy that you might call food?
Well, potato chips, crisps, all kinds of sweets.
Healthy food. Well, it's rather limited. And yet these are the local corner stores that the people have available to them.
In the U.K., the small shops are awash in sugar.
Awash in sugar. Walk down an island, a supermarket.
You'll see how much sugar and refined carbohydrates rest or masquerading as different kinds of foods that are put together in different ways.
So we have a so-called obesogenic environment that we live in, and that provides another context.
We might have predispositions, might have been, you know, not breast fed, might have been born at low birth weight.
Much of we live in a deprived household.
The food that people can afford is ultra processed food.
And so this becomes the typical diet that then becomes reinforced, you know, across time and across generations, if that's helpful.
Yes, that's extremely helpful. And let's just talk a little bit about methodology, though.
I mean, a vast majority of the interviews I've been doing have been medical science departments.
And, you know, people read labs and do things with pipettes. How does an anthropologist collect data?
Well, I like to think that I and the people I work with practice mixed methods.
I just try to be savvy in both qualitative and quantitative methods.
And that is, we don't necessarily have to know how to use the quantitative methods, but know how to talk to somebody who makes numbers thing.
And so being able to interpret those numbers and to be able to understand what those numbers are saying.
And even there you see out of the numbers have to come a narrative.
So we're thinking about those narratives that emerge out of out of those those numbers.
And the second part of that are narratives themselves, the stories that people tell.
We have storytelling brands. Everything that we tell in life is a story.
I'm telling a story right now.
I'm being encouraged to tell a story right now, which, if you got me to do this tomorrow, might go in a different direction.
But I'm here now and telling my story.
So understanding narratives and, you know, always in relation to what it is you want to know in relation to a pandemic it was shifting towards.
So we didn't quite got there yet. Yeah. Yes. Okay. Yeah.
Well, in relation to narratives, tell us something about the world view of a group of people that tell us something about how people understand a
problem and you become very good at asking people how they see something rather than having an answer yourself.
It's actually a very good managerial tool as well, because often times people have the answers within themselves.
So quantitative. I mean, I used to be good at quantitative methods.
Now I just try to find the best quants people I can and qualitative understanding the narratives.
We have something that I've helped develop called cultural consensus modelling, and that is using a quantitative method to come to the narratives.
So for example, if I ask you the question how many Santa Claus is out there in the world,
actually that's an ambiguous question because this obviously, if I ask you if I ask you the a question, is that thing out there a tree?
He probably would say, yes, yes.
Okay, now I don't need to talk to you, to Georgina's to know that that's a tree is common knowledge that that thing out there is a tree.
So I just need a sample of one. Oh, a better question.
Actually, a better question is who is the Prime Minister? But that's ambiguous.
Too difficult. That's impossible that I can't answer that question.
Yeah, but, you know, usually if I ask the question, who is the Prime minister, most people would come up with the same answer.
So you just need a sample of one.
If something is ambiguous or could have multiple answers, then you ask more people and then you start to say, Well, what is the consensus answer?
What is the consensus view around around this particular issue?
So similarly with narratives, we see how themes emerge.
And usually, you know, in quantitative methods you have power analysis to get an idea of how many people you should.
See for to get a statistically significant effect in qualitative methods.
Apologies in qualitative methods. I'd make the comparison with doing a literature search.
For example, if I want to know something about epigenetics and obesity, I start reading the literature.
I know nothing, but I'm intelligent. I can read the literature, I go read the literature.
And when I get to the point where a kind of citation loop starts to emerge where people are citing each other,
I feel that I've actually surrounded the literature. Similarly with with a narrative analysis.
I ask you a certain number of questions about doing podcasts, for example, and I'll go to the next podcast,
and I last same types of questions again, and I'll get similar answers, but I get some some difference there.
And after I've talked to a dozen podcasters, I might say, Well, the next person I'm going to talk to is going to come out with these three things.
There may be other things, but they will be in common.
And then I'll know that I've kind of surrounded I have the consensus around this particular issue.
So that's how it goes. But you can't always achieve saturation, as you know, as you might call it.
You can't always achieve that level. You can you can do your very best.
And then having done your very best to disclose all your failings in your publications as a good scientist should be very interesting.
Oh, that's wonderful background. Thank you. So I'm asking everybody this.
Can you remember when you first heard that COVID was a thing, that there was something going on in China that looked as if it might be serious and.
I would say it was bubbling around in the media.
I had just come back from Slovenia. I'm a winter swimmer, so I've just come back from the winter swimming championships in Slovenia,
which were not actually that far away from the from the spreading event of COVID 19.
We didn't know that at the time. I didn't develop COVID 19 by February, was it?
Yeah. Yes. Yeah.
And I was down at Days Loch in Oxfordshire, um, down there with them clubs actually going for a swim, would you believe, with a group of people.
And we were crossing one of those country turnstiles, you know, gates where people, you know, come and go.
The gate opens half and people go into gate. It's called the kissing gate.
What are they called a kissing gate? Kissing gate? Yes. Well, I didn't kiss anybody.
And you know what? You know what? You I knew it was probably good enough to kiss anybody at that time, but people were avoiding the kissing gate.
People were suddenly hugely distanced. And and and that was the first that I noticed within a few days we were all doing the doing the COVID
dance on the streets where you were kind of separating yourself from other people crossing the road.
And you could see how people's trajectories were changing and and sometimes not even saying hello because your friend could be your enemy.
And so this kind of hyper sensitivity, this alertness to what was around you and then during the week,
I think later I may be conflating weeks because, of course, you know, like everybody else, I'm trying to forget the pandemic.
Now, the it was the last week of term and a few days later, the university closed down.
The following week. We were told that morning on I believe it was the Tuesday.
I don't say me if I've got this wrong, but it was, you know, in that morning we were told,
grab everything that you need because at 4:00 the department is closed, closed, closed with a capital C closed.
And so, you know, was stopping off with everything I was giving my last lecture of term and it was on eating and obesity.
And what I usually do in this lecture is I hand around chocolate because I get
people to put some chocolate in their mouth and I ask them to think about it.
And I illustrate feedforward mechanisms and feedback mechanism.
So I mentioned chocolate and feedforward mechanisms, neuro feedforward mechanisms.
So, you know, already people are already eating their chocolate in their brain.
They have a sense of what this chocolate will be. And then when the chocolate comes, I get them to describe this particular taste.
And then having described that to other people, if then they say,
I want to eat some chocolate because what they've described is suddenly making them want chocolate.
So going through all of those mechanisms and that because I would go then onto how, you know, major merchants of burgers,
for example, strategise all of these strategies, all of these all of these these approaches behaviours, if you will.
And nobody took chocolate, nobody. Okay.
Zero. That never happened before. Never. Never in my life.
That was a marker. You know, some place full of students refuses to eat chocolate.
That means something's happening on this planet. So that was my kind of.
Okay. And, um. And, uh, you know, I'm still not certain whether I should have given that lecture or not.
But you're there. It's the last lecture term. You want to finish things off and all the rest of it.
It was, you know, just. Just before the pandemonium set in. And at what point did you start to think that that was a research question?
Now, with with lockdown going on, there was something interesting to explore.
The moment lockdown hit. Because I have this group of beautiful people I work with and I'll name them Caroline Potter.
I've been working with her for well over a decade Sabine Parrish, Corinne,
Ellie and a Leavis, Pauline and of it's girl who are part of my research group,
the Unit for Bio Cultural Variation and Obesity, which is studying these modern non-medical aspects of obesity.
And we had just been we just finished the analysis of a study on physical activity in domestic space.
The big question there was how far should public health go?
Where is the public and public health? Should public health actually be in the domestic space with lockdown,
public health knocking down the front door and went straight into the lounge room.
So we said, okay, we've got this amazing team of people.
We've just done a study of physical activity in the domestic space and in Oregon,
and we're using quantitative and qualitative analysis, using the methods.
And then we we said, well, we can we can do something.
So the Social Sciences Division had a emergency response fund from the SCC,
and we put in for this money and we were already placed to do this work because we had a methodology, we had a question,
we had access to the knowledge exchange unit at the UK Parliament and we felt that a number
of pieces were in place to make it work and we got the money and then we were running.
So what was the design of the of the study? It was quite straightforwardly an electronic questionnaire survey.
We put it together from, you know, existing questionnaire surveys.
We validated it with a small number of individuals across the university, and then we put it out using a, you know,
standard platform for questionnaire surveys advertised by the University of Oxford and with the aim of reaching a thousand people
because there were two things the work needs to be done quickly if it was going to be useful and we could have the best survey ever.
But usually this kind of survey takes a year, maybe longer. And we did the survey work in June and July of 2020 and we were reporting on it.
By the end of July. We had things to say that were useful to UK gov and that was the most important thing.
So we have in the platform Sorry to interrupt,
but the platform had already done the work of establishing that your sample of a thousand people was reasonably representative.
Yeah, well the representativeness is tricky. It's always going to be tricky.
I don't think our sample was representative because of course you you get mostly people who have the time to do this.
And of course it's a lockdown. Everybody has the time. But there were some people in really desperate straits and I don't think we reached them.
We reached, I think, predominantly middle class people,
and we had an indicative sample that suggested there were issues going on even among the middle classes.
And therefore, whatever really was going on, there was going to be a lot worse.
So you can't reach everybody. And nor did we have the time to be able to do that.
As I say, it was a bit like an exit poll for for an election.
You can't have better than that. But, you know, it's good enough to be able to say, look,
these seem to be the issues and it seemed from working with government in the UK, but also government in Denmark,
that politicians like to have some sense of what the issues are,
even if they're not really nailed down in terms of in terms of, you know, statistical significance.
Invalidity and so on. Either she needs to be good enough.
And, you know, as I've said, you know, as an anthropologist, you say, well, you know, we know that all of these things are socially constructed.
There's no perfect survey, there's no perfect time.
So we could give ourselves a year to get everything that we want to do a very elegant analysis of what happened across the pandemic.
But we've been reporting it in the Journal of History, and that's not what we wanted to do, and that's not what we were charged.
We were charged to come up with some views on what was happening right now.
So what were the questions that the key questions that you were asking and the key questions were in relation to physical and mental health,
physical and mental health, because it was the way that the government framed the issue.
They were interested in the relationship between the two. So we've very much framed things in those those contexts.
So compared to Pre-lockdown experience, what happened in terms of your mental health,
So anxiety, poor sleep, persistent sadness, binge eating, thoughts of suicide, changes in diet.
Some people ate extraordinarily well, some people did not Quite the opposite.
And even in this middle class sample of a thousand or so people, mostly in the south of England, we got this U-shaped relationship.
You know, if you were in a nice house in West Oxfordshire and had enough yard back yard and had enough space, it could be good.
And, you know, honestly, you know, looking back on it, I think I had a pretty good pandemic.
I had purpose, I had an income, the children came home,
they had their own stories to tell and they were actually having a much worse time of it then than then than we were.
And that was another issue that came out.
The people that seem to suffer most in mental health were young, younger people, young adults than older than older adults,
possibly because younger adults are in a state of insecurity in general life anyway,
that we are in a set of conditions now where young people don't get contracts for life.
People are on short contracts. A lot of people were furloughed, furloughed.
They didn't know. A lot of people lost their jobs. They didn't know what was going to happen.
My son, he had gone to do VSO in Tanzania, had gone for two weeks and was straight back and said, Well, now what do I do?
Well, actually things have turned out pretty quite decently for him.
He took a few risks during not in terms of health, but in terms of finding a job and so on.
And and and things have turned up. There's so much insecurity at that time.
So some people we didn't find there were other people.
What was telling was that I'm. A member of a war.
At the time it was an online choir.
So Saturday mornings we would sit and sing together online and it could be a cacophony, but at least it was the, you know, the usual people.
And, you know, there were people who were in a high rise somewhere in Peckham, for example, and they really couldn't get out, couldn't do stuff.
And, you know, intelligent people, desperate, not able to do anything.
West Oxfordshire one of the wise things I think that came out of the lockdown advice,
although it differed and was so strange at times and tipped backwards and forwards,
one good piece was the one time for physical activity every day because you could interpret it how you want.
What did I do? What do we do as a family? I would cycle five kilometres to a lake swim and then cycle back again.
One piece of activity. So I didn't stop, did it?
All in one go. And I met other people who are doing the same thing in West Oxfordshire.
There are no cars on the road. People on bicycles were happy, They were smiling, they, they, they'd taken the roads and were able to,
you know, express themselves on bicycles and, and get their physical activity.
But other people really did not have that.
So there were two populations really, I think, in terms of physical health and of course eating badly increase in body weight.
It seemed there were two possibilities. There were either angels or devils or there were people who practised angelic behaviour
during the day and devilish behaviour after 6:00 when the gin bottle came out.
And so both of those things seemed to be going on at the centre at the same time.
So it's utility I think was to be able to give timely information that government
might or might not choose to use depending on what the priorities are.
Not the kind of scientist that thinks that what I say or do is the most important thing on the planet.
It isn't the most important thing on the planet. Politicians have to think on their feet and decide what's important and make it at a given time.
But to be able to offer insights into what is going on to help correct decision making.
Of course, I can't speak to how politicians make their decisions,
but they can at least try to be the best social scientist I can to be able to give
the best kind of information that might be acted upon if it's deemed appropriate.
So what I mean was, was that what did you make recommendations for advice that might be given to people
who were in lockdown to support their mental health or their physical health?
Well, the initial insight report, so two of them was simply reporting on what had happened,
which was negative mental health since the start of lockdown measures.
I mean, that can be acted on, say, well, if lockdown is harming people, then we should be thinking about minimising lockdown in any way.
So the balancing act between holding back the pandemic versus locking people down is walking a tightrope because governments just have to think,
well, there is more than one outcome and there's also what people think is an important outcome as well for politician politicians.
Contrast that with a friend of mine, John Speakman, who's a one of the top obesity geneticists on the planet, who works in Shenzen in China,
and he'd been there across and across most of the pandemic where they have just locked people down and sometimes just told a very short notice that,
okay, you're going to be in your apartment. People just took it and they went and locked themselves down.
And of course, more recently, there's been a revolt in China because people have had enough.
It's just gone on such a very long time. Absolutely.
And so that kind of zero-covid approach in China might have seemed appropriate in the early days when China was doing all the right things,
early interventions in a draconian manner.
I have to say it wouldn't happen like that in the UK because people would be too outspoken.
People would probably break lockdown and. Not take part in it and rebel against it.
One of the early reports from UK govt in the first couple of weeks from lockdown
was stated quite clearly that the police would not be able to enforce a lockdown.
That it's unenforceable.
Therefore, we rely heavily on the public doing their duty, that there will be social and moral pressure would enforce the lockdown.
And that actually worked very, very effectively. Yes, very, very effectively.
And, you know, every country is different.
And that seemed to be the right thing that upfront they declared we cannot enforce.
This meant that we have to find a different way of soft policing the pandemic.
Now, if there's going to be one particular outcome from this pandemic, it's in relation to policing, oddly enough.
How should something be policed? And there's an awful lot of consensus policing happens in the UK.
And I think I may be wrong, I don't know. But I think the opportunities for consensus policing have only increased.
And, you know, it's a good thing for civil society, I believe, to to have that decreased physical activity.
Well, that came out early on. And of course, these recommendations for, you know, getting, you know, one piece of physical activity,
whatever you deem that to be helpful, because, you know, my idea of physical activity will be very different to yours, Georgina.
You do what will make you feel better and get out and do what will make you feel better.
So it allows that individualism of choice,
that opportunity to choose how you're going to express your physical activity and then, of course, increase binge eating.
Consumption of processed snacks and increased consumption of alcohol.
There was a comparison made between the mass shopping at the usual mass shopping event in the UK,
which is Christmas time with stockpiling or mass shopping during the pandemic.
So we did some very nice work on on stockpiling.
There's nobody said there was stockpiling. It was always somebody else. And so we we we've got some very good things included in your survey.
Was it the question? Not in the survey, but it's now we're now writing this up for publication.
All right. Yeah. So now we are we're in the stage of our work where we're considering what we have done and to build,
say, well, lessons learned, lessons for the future. What are the things that we need to do?
Alcohol followed later was a Christmas alcohol bongs all upfront alcohol and ice cream all followed after,
you know, stocking up with the you know, stocking up for the siege, dried pasta and tomatoes, toilet paper.
Yeah, all of those things. But also that poor eating and reduced physical activity contributed to the negative mental health in the pandemic,
that it was not just poor eating, reduced physical activity was everything in totality, everything working together.
Did you collect figures on body weight? Tricky to do.
We really, really couldn't. Couldn't segregate the population that well to be able to say, well, it's in relation to body weight.
In fact for the for the insight reports we produced two insight reports.
I don't think it was helpful. But what did happen going into going into June was that after the prime minister of the time developed COVID 19,
I was told very clearly that his personal body mass index would have contributed significantly to his extreme state in intensive care close to death,
he suddenly changed his mind on the National Food Strategy.
The National Food Strategy was something that was being developed in relation to the pendant to Brexit, and that it was a re-examination of,
you know, how we could increase localisation of the food system and how we could become more independent of Europe in related commerce.
And so not a year previously, the Cabinet Office declared that obesity was not going to be in the National Food Strategy is too much nanny state ism.
The moment the Prime Minister was out of hospital, suddenly obesity was back in the National Food Strategy.
So we, myself included, were then racing to bring obesity into the National Food Strategy.
So it became a part a bit into the part. We had to then deal with.
The Brexit breakfast of Part A was about what happened during the pandemic and its relationships to talk to obesity.
So there was, you know, the ill health.
Of lockdown, eating the wrong things, people putting, putting on weight and then developing the disease,
and then the likelihood of of developing a severe form of COVID 19.
Because obesity is an inflammatory state and what the virus did was promote inflammation.
And so you've got this this hyper and I can't even remember what the term is, but it's definitely a term for the for the,
you know, met inflammation that happened with with people who developed severe, severe COVID.
And so, you know, there was a they called a cytokine storm, all of the proteins that were associated with, you know,
getting the the immune system up and running, charging ahead and damaging tissue in many,
many parts of the body, including the heart, including the lungs.
And so respiratory infections because, you know, the respiratory distress, because it was attacking the tissues of the body.
So and obesity was was part of that. Again, not on the medical side of this, but we could see the importance of this and to see how it fed into that.
Um, the economic insecurity was certainly an issue that came out with a subsequent follow up report.
And then when we took into account economic insecurity. Sorry to interrupt.
So you went did you go back to the same people again? Yes, we did.
Yes, we did. Yes, we did. Um, that's a good question.
Um, I think it was I think it was in the second half towards the 2nd of July.
Right. Yeah. As I say, memory gets gets hazier, especially when stuff you really don't want to be thinking about anymore.
I want to be moving on, but, um, I'm.
I'm proud and happy to have done the work, but I feel that, you know, we do now need to be moving, moving into the future.
But when we took into account economic insecurity, the young people still had worse mental health health outcomes even when we control for that.
So it's something that was much more of a much more of a universal thing.
And we had lots of narratives that we we could just put a few of these into the report and the stuff that we are,
you know, putting into the papers now. You know, here's one woman in the South-East, 67 years of age, comfort age to block out the black thoughts.
I come today to stop my brain. Mental health, which has always been my gremlin, reared its head.
No controlling, eating, exercise or life.
Those with. That's just one of many, many, many similar kinds of stories.
Um, increased lethargy, a return to depression that had been under control.
Forgetfulness, irregular sleep, massive anxiety, amplified bad habits, amplified addictions.
That's the man. And that was just so telling story after story after story.
And of course, because we had a narrative section to to to the to the questionnaire, we just said just, you know, say what you feel you need to say.
So and then we find those sections were very fully filled out.
Oh, yeah. Oh, yeah. People were happy to talk.
In fact, I don't believe that people had very many places they could talk in the early in the early pandemic because you had to put on a good face.
And so publicly, you know, you have to put on a good face.
You have to be positive. You have to you know, this country, I believe I've never been in this country when there was a war on.
But we went on to a war, world war, wartime footing where people are, you know, making do and mend.
And they start to say, well, you know, we have to, you know, dig for victory, all those metaphors and so on.
It had that kind of feel to it, clapping for the food, for the health workers, all that sort of stuff.
You know, when people went back home, then they were there with themselves and their thoughts.
And, you know, it wasn't there wasn't a good picture.
Hmm. Um, so what have you moved onto?
I mean, has. I know you say you want to get that work, but has it informed the choices you've made about what to do next?
Well, um, I was asked to give evidence to a House of Lords Committee on post-COVID futures,
and I said, Well, we have to look to multilevel approaches to to overweight and obesity.
We have to move beyond silver bullet responses.
And we some of my group we published in The Lancet on, you know, silver bullet won't do it for the pandemic.
We need a vaccine. Of course we do. But that's not the end of it.
I was I wasn't astonished, but actually appalled by the vaccine deniers that that emerged as as the vaccine was being being rolled out,
that it showed a kind of fission in society that.
Some of the fissures that showed insecurity. Inequality was one of these lightning bolt events that really showed the weakness in society.
And those strengths I mean, the strengths were the things that were was celebrated.
But, you know, there are a number of things that show, you know, we really can do better.
And I think economic insecurity is a major is a major issue for everybody, but especially for the younger people.
And I'm a big fan of the Nordic welfare state,
so I've just come back from Copenhagen where somehow they seem to do all the right things and have a strong economy.
And so why can't we be that kind of neo liberal society that has a strong welfare state, you know,
child centred policies focusing on the things that make people happy, which is actually mostly other people and family money matters?
Of course it does, but it's not the thing I feel we should move away from fetishising money.
It's useful, but it's a tool as an instrument and this operates in relation to obesity.
But I've been working with colleagues in Sweden and Denmark on insecurity and childhood obesity,
and we've developed a new model that shows all the trigger points for the development of childhood obesity,
in which insecurities major So that's been that's been the biggest thing that's that's come out very, very recently carry on work with on obesity.
I'm currently writing a popular book on understanding obesity.
And if you'd have asked me before the pandemic if that would have been a thing for me, probably not.
But actually writing something that can help to explain complexity and why you are not to blame for your fatness is a very useful thing at this stage.
And I think that, you know, I'm I've been told by the publishers just to write what I know, don't think too much.
The risk as an academic is always to overthink things, so simplify things down.
And at the media level, there's always this difficulty in balancing,
not blaming the person for their overweight while still saying it would be better if you were a bit thinner.
Yeah. Yeah. Well, that's that's tricky because people know that they could be a bit thinner.
You're not telling them anything they don't know. And you know when in some places they talk about the war on obesity.
Well, think about if it's a civil war, it's a war on obese people,
and therefore it's against promoting the health and wellbeing and goodness of people who carry excess weight.
You know, it's actually very difficult unless you've got the genes to avoid putting on weight, it's very difficult to keep the weight down.
People who have control of their lives are better able to do that than people who don't do very, very, very simple, very straightforward podcasts.
I did podcasts with some Crosse college people who were involved in some aspect of work against the pandemic,
a number of them, including now Sir Andrew Pollard and police.
And they got to the case and Mike Parker, who's on stage to name but three, Rana Mittal, talked about.
Is that something you just do because of your interest in storytelling?
I mean, this is something you've chosen to do that you do these short podcasts for.
Yeah, well, with my with my obesity and you know,
we've been doing podcasts since 2007 is over 180 that are up on the university
website and and and even more on on on Spotify so or newer ones or are on Spotify.
So there's pretty much a a taste for that and we've been working with that.
So I'm very I like podcasting as a medium. We also did with a former student of mine a series of podcasts called Lockdown Food.
Oh yes. I had a note to ask you about, You know, what was so what, what what was that about?
Oh, well, ordinary people aren't experts. As to Gonzalez, Paddy talked about sugar and how, you know, so easy to overeat on sugar.
She does her research on sugar trials, Yo, you see sort of media scientist in Cambridge.
Talked about eating during the pandemic and his approach to that.
Also, somebody who runs a small distillery in New England who suddenly moved his gin to hand wash sanitiser.
People in the food industry who were suddenly furloughed and not involved in in food service,
the shift of food service provision from the foodservice area to everyday consumption.
So online shopping became a thing and so bigger thing than it ever had been before.
But people weren't just buying from supermarkets, they were buying from, you know, if you could afford it,
you could buy from top end suppliers who would be supplying some of the top restaurants.
I have to confess, I did that and so did Georgio.
But that kind of thing is also has long term implications because people are shifting how they're doing the shopping,
the emergence of smaller shops, of greengrocers as well.
Okay, A middle class phenomenon is not cheap, but it signals a purpose,
a new purpose, which is to return to a sane food system where we know what we eat.
Those are all good things, and I think some of that has stuck. We question what we're eating more.
I think everybody everybody's questioning even people who are, you know, overeating on the wrong kinds of ultra processed foods.
They know what they're doing. They know what's happening.
And actually, I think we're getting closer to a to a to a food system that might actually do us good.
We might get there a bit quicker if we didn't have a cost of living crisis at the same time.
Well, you can't control for that. And the thing is that the crisis there will be more and more.
We did a talk on on, you know, on the pandemic and we said, well, it's the four horsemen of the apocalypse.
Okay, so what if we had okay, the four Horsemen of the Apocalypse are death, famine, war and plague.
Okay. Just when we thought it was safe, the pandemic well is over.
But the disease is kind of normalised in many ways.
But there will be more of these episodes where we get used to these shocks.
Yes, indeed. So that I mean, that was I think it was going to be. My next question is how?
To what extent do you think the country is better prepared for the next one when it comes along?
Because it will come? Everybody says yes, it will come. Likely a five years might be in 15 years might be 50, but the next one will come along.
Have we learnt enough from this one to be more honest? You? Yes, please.
On December the 15th, 2022, that we were very well prepared for a pandemic in the early 2000.
The system for reporting. Potential pandemics was systematically dissolved, maybe not even systematically,
but funding was withdrawn and it became seemingly less important because, you know, other things seem to be more important right now.
I think this country's very vulnerable because these systems of reporting that there's been a lot of lip service.
But I think there's been also talk about the UK. An awful lot of political turmoil.
And I think the political infighting that's been happening hasn't served the country very well.
They want to be political. But I think while the politicians are trying to work out who their leader is, not much else can really be resolved.
Some things can be. But this is an important thing that needs leadership.
And hopefully we have a leader now, and the others, in my view, seem to be a little bit wanting.
It's not for me to criticise. Being a politician is one of the toughest jobs on the planet,
but it's a time for ramping up these things and seeing what what are the things that that need to be thought about,
what needs to be resolved, what systems need to be put in place with a war?
Who can tell? I think one of the important things that I feel ought to be put in place is a move away from just in time ism.
You know that we have systems where production systems with things get there just in time,
including the supermarket shelves, especially the supermarket shelves.
And with a global supply chain that can work beautifully or it can just collapse like it did during the pandemic.
I've spoken to supermarket leaders in this country and in other countries where they are
talking about how to reduce the supply chain and to improve health in that supply chain.
So that means lots of localism. So the localism of having the corner store is great.
It's fantastic. I love the corner store.
But having the major supermarkets also thinking about how that can be done and making it good for business is, is is, I think, hugely important.
Moving away from just in time as some also means a bit more of a Victorian overengineered ring.
In my view, we're still living off the legacy of Victorian times of, you know, having good building infrastructure,
having good roads, overengineered and so many things that actually we've been living off the capital for a long time.
And honestly, I saw broken pipe yesterday and water pipe on the Banbury Road the other day and I thought,
well, goodness me, you know, this system of water delivery is is failing us.
So the complete disaster in Sheffield the other week when the water goes into the gas system.
So yes, yes. Yeah. Well, you know, I wish the politicians and the policymakers and the public service to support all this
the very best in making this work as these this is a time for difficult decisions.
And I think people are probably prepared for it.
But, you know, we need the leadership to be able to and clear vision,
to be able to take us forward and to say the one thing that I can do is supply evidence.
One thing that I can do and understanding obesity, thinking about multi-level approaches to it,
structuring the issue in a way that multiple levels of intervention can be put in place.
I think that's where I would place myself now.
I was at a meeting of the Royal Society just a few weeks ago, turned out into something, turned into something of a consensus meeting.
Causes of obesity.
Privileged to be one of the 20 or so that gave a presentation and it felt very much that we are moving towards that kind of, you know, d.
D blaming the individual. It's very easy politically to say it's individual responsibility.
You don't have to do anything. He just said, Well, it's individual responsibility. Let's look at the systems, who's producing ultra processed foods?
Why have we moved to invent those one people? And how on earth did we get here?
By Kevin Hall in the United States, world expert in obesity physiology.
How on earth did we get here? Well, step by step, I mean, the road to [INAUDIBLE] is paved with bad intentions as well as good intentions.
But we have to pick where we put our feet.
And I mean, this is again, this is a more philosophical question, but do you think sorry if you've got it is impossible.
Do you need to be somewhere else? Do you think there's an increasing recognition that medical approaches are not enough?
That doesn't need to be a much wider multidisciplinary approach to tackling public health generally in obesity in particular.
Well, I think medical approaches are important. And one day there might be a silver bullet for obesity.
But we've seen with the COVID 19 vaccine, the rollout rollout of the vaccine is hugely important.
But it also there are also social implications.
There are people who will be vaccine deniers and there will be people who will do not want to take the medication.
And you can't assume that it will fix everything.
So new technologies offer new possibilities, but we have to think about the context in which those technologies emerge.
So if obesity medication, if obesity medication is developed, who's producing it?
It will be, you know, pharma, probably that's okay.
But then it depends which pharma, who and where. And then it depends which medical system is it feeding into?
Is it going to be into a national health service or is it going to be into a free market?
Free for all Those social contexts are not sort of casual social context.
They all have a history and therefore there is scope for deep analysis of what will happen.
If you if you have a particular kind of intervention, then you have the the markets that respond to a new form of medication.
You know, the vaccine has done wonders for pharmaceutical companies generally, and they're positioning on the markets.
But, you know, there's also the possibility of cheating,
like I can't remember in California the over claiming for one Start-Up and now the the CEO of of that company is I don't know if she's
in prison you might well end up in prison because she's defrauded an awful lot of money and she's given false promises for for,
you know, a device that should be able to diagnose all chronic diseases.
Of course, you know, we want those good news stories.
But, you know, if you're open to liking those stories, if you're open to wanting to have have those sort of silver bullet solutions,
then you might not look too carefully at the small print.
So, you know, in that context, I think the regulators are huge and important that the regulation of anything is properly scrutinised.
And I think also related to that. I mean,
I'm reinventing a world in some ways that the data that is used to validate a new form of medication ought to be somehow public to scrutinised,
you should be available publicly and that would also create new problems because you might say vaccine deniers.
We can go and look at this evidence and say, actually I can interpret this completely differently.
So every step of this is not failsafe problems.
We're into a world where, you know, huge amounts of data is being gathered.
Data is the new gold and. And, of course, you know, the systems that data's used in or are varied and the social implications are a large.
So I don't see an end to the utility of medical anthropology, shall we say, For example, you know something we do very well here at the university.
Yeah, exactly. I think what I was driving at was that the balance between investment in medicalised
approaches and the investment in more socially oriented approaches to to health,
it is is seems to me to be somewhat out of whack at the moment and addressing issues such as inequality and even
things like provision of childcare and children's centres and so on could have a huge impact on public health.
Social approaches to medicine work very well when there's a social approach to society at large.
So social approaches work incredibly well in Denmark, incredibly, you know,
during the during the pandemic, there was a kind of shopping blaming in Copenhagen.
So somebody would go into a into a into a store and buy a two packs of pasta.
And somebody behind him would say, do you really need that second package?
There was no hoarding in Denmark because it was against the common good.
So thinking about what is that common good, I do think, well, if we are giving something up for ourselves, who are we?
Giving it two or four. And I think in the UK there needs to be a strong focus on thinking about what society is.
What kind of society do we want? What kind of communities do we want?
Because these are all under challenge and under question.
Because, you know, especially we have the Internet, we have mobile devices, which means that sociality isn't necessarily local.
We might live in a house where we don't know our neighbours, but we know thousands of people on our different social media sites.
We might even be sitting around the same dinner table checking our phone, therefore being here, but not really being here.
There's no answers to these things, but the question is what kind of sociality would allow a social solution to something?
So I think during the pandemic, lots of people came together and that was beautiful to see.
And the positives of it were were that actually people do value social fabric.
People do value other people. People do value being able to be happy by giving to other people.
And how do you promote that when there's no longer a crisis?
Do we have to go back to business as usual, which is me, me, me, or can we rethink how we do things?
I think there's a lot of that going on anyway.