I’m Katherine Samaras, your most humble servant, and a messenger from the front line,
I bear ill news. As a doctor and a scientist observing disease, I’m treating people in
their 20s, 30s and 40s with the diseases I would associate with advanced age.
Diabetes, heart disease, cancer, why? I bear news of the culprit, obesity. A relative newcomer
A relative newcomer on the human survival time line. Well, this is rather antiquated view of Australia now.
The folkloric poetry of the bronzed Aussie: Carefree. Healthy.
This is our reality.
And this is our tragedy. Obese parents, obese children, obese domestic canines,
and who are these people? When we look at this picture do we embrace
this as a picture of ourselves, our loved ones, or do we actually judge these people?
They’re obese, they’re weak. Do we really understand, do we have compassion and do we
have any interest? The Venus of Willendorf, the "it" fertility girl about two and a half thousand
years ago but at the moment she’s too frequent a guest at our hospitals.
Obesity basically decimates our health, it exhilarates and causes most preventable diseases.
It will cause heart disease, it is the major cause of diabetes, it is the most common cause
of dialysis dependant kidney failure. And, when we look at this picture, and we think
well is she nobody we know, well she is really. She might be our sister, she might be our
grandmother, she might be the neighbour. Some woman bore her in pain, people raised her
without some difficulty and her family would walk over hot coals for her. We have an investment
in her, and her future is our future, she is part of our tribe.
When we think about health how do we define it? Do we define it only when we start to lose it?
Do we define it in negatives? Do we define it as a cost, the health budget?
Is that really a cost or is that really the disease budget? Why do we never think about
health as a resource? We are miraculously, and rather democratically, born with good
health and then life comes along with its travails and it gradually robs us and it gradually
erodes our health. Don’t we see health as a resource, a human resource, a public resource,
the nation’s resource? Why can’t we put it on a register as an asset, and then we
might protect it a little bit more, like we’re keen on protecting whales, or rainforests,
or the reef, or the soils of the Murray Basin? My view is, that health is our most valuable
public resource, and we should do our very best to actually protect it. So, when I go
to work, it’s a bit like this. I’m actually facing the wave and I’m going into it though,
and cresting over us is heart disease, profound heart disease, cardiac transplantation, kind
of requiring heart disease at my hospital, and there’s diabetes, preventable kidney
failure, preventable blindness, preventable amputation, preventable diabetes, preventable,
preventable, preventable. And so it breaks my heart every day when I go to work and I
say to myself why can’t we do anything about this? And I think it’s really important
to think about why this has developed. Obesity was not wide scale 30 years ago, it should
be preventable, so why does it actually occur? Why do we see obesity today? Well, sure, we
eat too much, that’s it, we just eat too much, but, you know, here we go, what are
we doing about it? Whose fault is it that we’re eating too much? Let’s actually
blame the individual, let’s blame the fat person, again, the victim. Come on, that’s
a cop out, we’re smarter than that, aren’t’ we, I hope we are.
Hasn’t our environment changed? Now this is a hands up, audience participation please.
Who caught dinner last night, hands up. Who climbed some mountains or foraged and got
some seeds and nuts for the family. Come on, are there no hunter gatherers in the TED demographic?
Come on there must be, one please. Who has ploughed a field recently?
No, of course, none of us do, not any more. This is the Oktoberfest, by Pieter Bruegel, the Elder,
and it captures the annual autumnal feast, we only ever had one and the, to earn
the right to sit at that table and enjoy ourselves, freely, we earned the right to. Two seasons
of hard work in the fields and at home, but today, for 12 bucks, you can eat all you want,
any time you want, really. Isn’t this our problem? It’s a very major part of our problem,
and to get to our feasts, we sat in a car park, didn’t we? Well, let’s recognise
that we are all caught in this one environment. I have patients who, they live in dormant suburbs,
who I’m treating them for obesity and usually a myriad of other health problems. And they
live in a community where, it’s a dormant suburb, they’ll have to drive, they might
drive for 4 hours, they ‘d actually rather live in Stanmore or Paddington but they can’t
afford it. So, they get into their cars and drive for 4 hours a day and when they get
to the sort of the being closer to home, rather than being accosted by organic vegetable providores
or a market garden stall, which they’d rather prefer, they have instead, the highest density
of fast food outlets that are strategically placed at their, their exits. And when they
get home, they’d like to go for a walk, but the women perceive it’s actually not
safe to go out, so they don’t, the women would rather live in Neutral Bay or Double Bay,
but they can’t afford to, and the kids, they don’t go out and play in a park because
there aren’t any nearby. And, well, wouldn’t we all rather live on the Northern beaches,
but they can’t afford to. And finally, when we look at their communities, there should
be planners and local governments and state governments but they don’t give a stuff
about the environment that people live in, and they have no obligation to, unless,
of course, these people lived in a swinging electorate, but again, they can’t afford to.
So, here’s the problem, it’s half the problem, our genes are the other. Our genes
describe ,or our genes explain about 60 percent of the difference in body fat between me and
everybody else, genetic differences. And it’s our genes that have actually gotten
us into trouble. We have survived the travails of biology and history and agricultural calamity,
because good survivor genes have been able to hold onto the energy and get us through.
So the people with these really strong genes for energy conservation and the seeking of
food, have been the ones that have sought the food, gone out over the mountains,
walked for 50 kilometres and gotten the food and brought it back for the rest of the tribe.
They’re the reason why we have survived and come to this point in time. And yet, these
are the people that we beat up, and yet these are the people that are the victims and we
seek to discriminate against. We know obesity discriminates, not just because it destroys
our health and creates disability. It discriminates in other, much more covert ways. An obese
child will be marked lower and thought to be dumber. An obese person will be paid and
promoted less for whatever level of qualification. We also know that, on the Jane Austinesque
criterion of feminine survival, obese women marry down the social ladder. And so these
are really important key factors, so that, in this wonderful history of our evolution
and surviving the environment, surviving the famines and the wars and the blockades,
the people that have actually gotten us there are the ones now struggling the most when
we find ourselves in this environment of excess energy in and very little energy out.
So, what are the solutions? Well, part of it is individually, we have to stop eating,
we have to cut back on what we’re eating. But, what if we can’t, and what if we won’t?
Do we, as a society, have an obligation, to stop people from eating? This is a big question.
Do we have that right? Well, when we look at different other areas, we actually already
do this. Think about smoking restrictions, think about alcohol restrictions. You can’t
just buy any amount of alcohol when you’re a 12 year old and consume it where you like,
when you like. Let’s also think about anorexia nervosa. It’s the contra distinction, it’s
in contra distinction to obesity. These people are starving themselves to death.
Because we believe we are a humane society, we will deprive these people of their civil liberties
and we will ram a tube down their nose and force feed them, because they’re gonna die.
Why don’t we think about that with the obese person?
My personal view is that the individual has to take some responsibility and the first
responsibility is to the the right to decline. We have the right to decline fast food, we
have the right to decline junk. We have the right to say to our children “no darling
you can’t have that” when we’re at the supermarket checkout. We have that right to
say no to the 5th drink, no to dessert when it’s the 50th time we’ve eaten out this
year and, let’s face it, it’s not our birthday and we haven’t ploughed a field recently.
[ audience laughter ] So we have that and that’s an individual right
but what about society? Shouldn’t society also play some role in this? Imagine if we had
really enlightened people leading us and saying at a government level well all those high
fructose, high sugar foods, we know that they are appallingly bad for us we know that they
cause food addictions and eating addictions and we know that they create insulin junkies,
let’s legislate against them. Hell, we do it for heroin don’t we? But there’s more
to it. Do we need a state that acts like some super nanny that watches every little bit
of food that we put in into our mouth and says no when we request second breakfasts
like some aimless hobbit. It’s a really interesting question to ask
and this is now where I’m going to now start talking about why we should starve a little
bit, we need to starve to survive. We know when people follow the old faiths, if they
follow the, the intermittent fasts that you see in the old religions that they live for
a lot longer and that’s when you control the other things like wowserism and alcohol.
We know that the Greeks that we see here were the longest livers in the 60s and the 70s
and you might say that that’s the Mediterranean diet, you might say that that’s the extra
virgin olive oil, yeah maybe sure a bit of hard labour helps as well, but these people
would have been following the orthodox calendar and they would have fasted for about 200 days
a week, sorry 200 days a year. Imagine, now that’s light eating, bread and cheese, bread
and olives, bit of fish and vegetables, lentils if you’re taste and righteousness suits
you. So this is what we’re talking about we’re talking about starving a little bit.
It’s really about eating light, and I really want to sort of say, is this the scenario
we have to accept? Do we have to accept this? Is our economy so dependent on stuffing younger
and younger and younger people? Is this what we need? Don’t we have economists, leaders,
corporations that can say we don’t have to do it this way? I suppose it’s not a
question it’s a challenge a messenger has thrown down a rather elegant challenge, a
gauntlet that is a challenge. My actual feeling is that it takes partnerships
between these three entities. The individual has to show discretion and restraint when
they’re eating. Corporations need to show some inspired thinking about the foods that
they’re producing. What if the foods that they produced were an investment in the health
of the nation? That they built, not decimated, the health
of the nation? And what about government? Couldn’t they show much more leadership?
For about ten years the union charter on the rights of the child has been talking about
legislation against advertising and marketing to children, why can’t we adopt that? Why
can’t we make it compulsory for new communities to be built in a way that people would love
to live there, not have to live there? So, I think these are the solutions. So, when
I come back to looking at my centenarians, who appear now on command, I look at their
eyes and think what have these eyes seen. Two world wars, they have seen a great deal
of scarcity, they have seen a great deal of physical hardship, and I wonder wouldn’t
we benefit wouldn’t we live longer to a troublesome rather than troubled old age?
First thing with that thing we are born with: excellent health. I thank you.
[ applause ]