How deluded are you about your body?

The spring of 2015 saw middle class types up in (lycra-clad) arms over Protein World’s ‘Beach Body Ready’ campaign. The billboard advert featured a toned woman with a perceived air of smugness, as, in her bikini, she towered over the not-so-beach-ready passers-by. The term ‘beach body’ was seen by many as harmful, but the ASA had already approved it prior to launch. In their view, it described “feeling sufficiently comfortable and confident with one’s physical appearance to wear swimwear in a public environment”.

However much we aspire to be one of those ‘comfortable’ people, even those who have achieved a level of psychological ‘confidence’ may not, in fact, be getting on so well physiologically. Though 62% of British adults are overweight or obese, the majority of them feel fine and their size causes them little concern. This group is at much higher risk of heart disease and type 2 diabetes – which is particularly concerning as the NHS already spends £8.8 billion a year treating type 2 diabetes, almost nine per cent of its budget.

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But how can we square this alarmingly high number of people whose lifestyles are causing them serious illness in a country where spending on gym membership has increased by 44% in the last year1http://www.theguardian.com/lifeandstyle/2015/aug/18/uk-gym-membership-spending-up-by-44-per-cent and food supplements are a multimillion pound industry?2http://www.hsis.org/faq.html#19 The answer may lie in what we see around us and consider ‘normal’.

This year, an ethnographic study allowed us a full immersion into the (unhealthy) lives of working class individuals aged 40-60 across England. During my time on fieldwork I was seduced by people’s eating and drinking habits. Despite my usual obedience to health, I was won over (albeit temporarily) by their collective rationale for overeating, avoiding the gym and smoking. Their rationale was accompanied by compelling anecdotes, such as “My grandpa lived to 105 years old, even though he sat in a chair for most of his life and smoked 50 a day”. These are the sorts of stories that can make an illogical argument stick, especially amongst friends, family and colleagues.

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Aside from showing my susceptibility to influence, this experience demonstrates that unhealthy behaviour can be infectious outside of a community. Amongst this particular group, the Beach Body messaging is unlikely to have made an impact, because an overweight appearance and unhealthy behaviour have become normalised and part of everyday life. The woman in Protein World’s advertising is likely to have been perceived to be a ‘health freak’, ‘too skinny’ or ‘weak-looking’ across this particular community. She was an aberration rather than an aspiration. The importance of social norms should not be underestimated and, as Hannah Shrimpton explains on page 120, learning about norms and using them to change behaviour can help make people live healthier lives.

Public Health England (PHE), our client for the ethnographic study, has a mammoth task on their hands in tackling this particular set of community norms. How can you address unhealthy behaviours when perceptions of norms are so skewed? People not only need to be nudged into acknowledging their unhealthy behaviour, but also they need to question whether their bodies are ‘long and healthy life ready’ before being empowered and supported to make healthier choices.

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