The head of the British Medical Association caused something of a ruckus this month when he shared his thoughts about tackling rising levels of obesity in the best way. Hamish Meldrum’s observations came in two parts. First, he made an argument that obesity has fallen hostage to surgeons and pharmaceutical firms. Bariatrics, the medical branch concerned with obesity, is so new that it has yet to find its way into the Oxford English Dictionary. Its first surgical procedure was only carried out in 1954; today it’s a multibillion-dollar industry.

At the same time, drug companies are extending their grip on our food through nutraceuticals and unguents designed to stifle appetite. These products are the equivalent of proposing improved gunshot surgery to fix gang violence.

The bit that got Meldrum into trouble came from the second part of his thoughts, in which he noted that “doctors, teachers, social workers and other professional groups can try to help obese patients change their lifestyle, but it is very difficult to do this if people are unwilling to take any responsibility themselves”. The solution would involve straight talk from caregivers who should not shy away from calling the obese what they are: greedy.

Meldrum’s view is widely shared and deeply flawed. Today, common sense about diet is that nothing can be socially shaped. We’re all free individuals swimming in an ocean of uncoerced choice. Yet those choices are shaped by the food industry, by the rhythm of our lives and by the architecture of the modern world, all of which induces us to snack, gobble and dash. In forgetting to think about how our environment shapes us, it becomes easy to think that our food is made for us. The truth is that, increasingly, capitalism makes our food.

People on low incomes are as likely as higher income groups to be overweight — but they are less likely to consume fruits and vegetables. As an antidote, it doesn’t work very well. A moral panic, such as the one around working-class consumption, is not assuaged by fact or contradiction. Yet a shift in thinking is urgently needed if we’re to tackle the social basis of weight gain. The prescription: less bariatrics, more sociology; less morality, more politics.