June 25, 2020

As I lie out in the sunshine in my shorts, I am more conscious than normal of my scars. One that runs some six or so inches straight up my chest, and another that runs the length of my left leg, from ankle to groin. I tell my boys I was attacked by a shark.

It is now three years since I had my heart attack, and a brilliant surgeon had to take a vein out of my leg and use it to replace the ones servicing my heart. But that quadruple heart bypass did nothing to address the underlying condition: obesity and diabetes. I didn’t do anything to address them either. Until the fear of coronavirus made me.

We need glucose for energy, but too much of that good thing rots us from the inside. Not that I took much notice. Sometimes my eyesight would lose focus and I couldn’t read a newspaper. But generally, there weren’t any obvious day-to-day symptoms, so it’s easy to just go on as if it’s not really there. And in the West, and also in places like China, type 2 diabetes has been growing fast.

According to the WHO, the number of people with diabetes globally nearly quadrupled between 1980 and 2014 — from 108 million to 422 million. It’s a disease of affluence. Bodies schooled by evolution to store energy to survive periods of famine are badly adapted to manage extended periods of plenty. Type 2 is nature’s way of saying we have had enough. Our prosperity is killing us.

So, since lockdown began, I have been on a mission. No bread, no pasta, no rice, no potatoes. And I have been pretty religious about it. I have allowed myself the breadcrumbs around a fish finger and the body of Christ, but apart from these I have cut out bread and those other foods completely. I have lost over three stone. Where low fat diets have never worked for me, low sugar (ie low carbs) really makes a difference.

Yesterday, I received a letter from my GP which said that my blood sugar average over the past three months has been 6 — compared with the 12 it was this time last year. I have dramatically reduced my diabetes medications. And, hopefully, I am getting close to pushing it into permanent state of remission.

Before lockdown, I was too scared even to verbalise the fear that I might not be around to see my youngest children into their teenage years. Now I can watch my little one learning to walk without feeling guilty. The relief feels wonderful.

I used to find it so reassuring when other people would fail at their diets, thus justifying my own repeated failure. There is nothing quite so comforting as the thought that deep change is impossible because, well, I am the way I am. Change is scary, failure a relief. So there’s no need to try too hard. I’m glad I was forced to confront that.

Because there is a deeper question of moral philosophy about the management of what we eat, and that involves our whole approach to limit and privation. If diabetes is the disease of over-supply, then to address it we need to think very hard about our attitude towards the very idea of having enough, to limit.

In what has to be one of the most American things I have ever read, the megachurch pastor Rick Warren promoted his own wellness eating plan as: “it’s about abundance, not deprivation, and this is why the plan is both transformational and sustainable.”

No, that is why the plan is a lie. Only a church that has sacrificed a belief in respecting limits to the capitalist gods of unlimited growth could so laughably badge up their own diet plan as having nothing to do with deprivation. Type 2 diabetes is the disease you get when you no longer believe that there is such a thing as having enough.

But although Type 2 is recognisably a disease of affluence, of over-supply, what makes the socio-economics of diabetes complicated is that it is the poor and those with African or South East Asian backgrounds who disproportionately suffer from it the most. This does not contradict the thesis that diabetes is a disease of affluence; rather it highlights the fact that in the West, the victims of our philosophy of endless growth are often those at the bottom of the pile. And this should also make us wary to moralise type 2 diabetes too quickly. For although I cannot help but do so in my own case — after all, my own diabetes was caused by too many long lunches — we should be extremely uncomfortable about pointing the finger at others. This can too easily become a version of blaming people for their poverty. Or indeed for their ethnicity.

Yet for me, my own diabetes is a symbolic disease that perfectly embodies the moral failures of free market fundamentalism. The metaphors that dominate our economic body politic continually emphasise the importance of growth, as if the purpose of life were somehow to take up more space. “I hope you are not going to disappear” people tell me, jokingly. And I wonder whether behind this well-meaning quip may lie deep seated fear: less is a threat, it represents our extinction, an intimation of our eventual translation into nothingness.

But it’s not just the need for more and bigger that is being triggered by our desire for a larger share of the pie. Sugar itself seems to have played a continual role in our moral degradation long before capitalism reached its modern form.

“I OWN I am shock’d at the purchase of slaves, And fear those who buy them and sell them are knaves; What I hear of their hardships, their tortures, and groans, Is almost enough to draw pity from stones.
I pity them greatly, but I must be mum, For how could we do without sugar and rum?”
(William Cowper, Pity for Poor Africans)

Wilberforce and his group helped force a debate on the morality of slavery by boycotting the ‘big sugar’ of his day. Our developing sweet tooth, as much as our economic greed, was responsible for the growth of the slave trade, with human beings trafficked from Africa to work on the sugar plantations of the Caribbean and Brazil. Our excessive love for sugar led us to treat other human beings as objects whose only purpose in life was to service our greed. So sugar has, from the very get go, eaten away at us from the inside — morally and now literally.

During lockdown I have had the chance to reconsider my priorities. The emergent philosophy has been for a much simpler life. Work less, cuddle my children more. Do the little things well. Be content with less. And it terrifies me that as more places open up, I will be sucked back into the sort of self-destructive lifestyle I had before. But I will continue to test my blood sugar every day. And if it starts to rise again, it won’t just be medical questions I will be asking myself.