Consumerism is making America sick - and not just physically, says Peter Whybrow, who believes the UK is displaying similar symptoms

When I was a medical student in London in the 1960s, consumption was a frightening disease. Despite steady progress in treatment, tuberculosis still had the power to waste the body and mind, and to kill.

But times have changed, and consumption has a different association. In the lexicon of the mega-merchant, in a turbocharged world where goods and services are held supreme, we are no longer citizens but consumers. It is shopping, not voting, that lights the path to happiness and social betterment. To consume is to be.

But there is a dark side to this road now travelled. The new frenzy of consumption is potentially no less damaging to public health than was tuberculosis back in the 1960s - at least, that is my conclusion after 30 years in the US as an academic physician. In fact, as Britain increasingly embraces the consumer society, the American experience offers a cautionary tale and an important lesson for those of us engaged in higher education.

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The US is the quintessential market-driven culture. The astonishing appetites of the American consumer determine some 70 per cent of all economic activity in the US. And yet in this land of opportunity and material comfort where we enjoy the 12-inch dinner plate, the 32-ounce soda and the 64-inch TV screen, more and more Americans are feeling overworked, time starved and burdened with debt. The epidemic rates of obesity, anxiety, depression and family dysfunction that threaten to erode public health are grudgingly accepted as the price to be paid for material success in the Fast New World of global capitalism. For many Americans, the pursuit of the Dream has become a competitive nightmare where money and material wealth are no longer a means to an end but an end in themselves.

Britons may find it comforting to dismiss this American mania as the latest example of Yankee madness, but to do so would be short-sighted. In the UK, social trends are beginning to follow the US pattern. The British work on average 8.7 hours a day, compared with 7.9 hours in France and 7.7 hours in Italy. Similarly, the British are moving closer to the American norm of taking shorter vacations. For this extra effort, Britons have a slightly higher disposable income than the Germans or the French, but they are also saving less. Again similar to the American pattern, obesity has quadrupled in Britain in the past 25 years. The average household spends the same on fast foods as it does on fresh fruit and vegetables, with the major growth areas being food-to-go and snacks for children's lunchboxes. I have little doubt that these shifts in British cultural practice are the prodromal symptoms of the same consumptive mania that threatens the social wellbeing of the US.

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This paradox of modernity - that, as choice and material prosperity increase, health and personal satisfaction decline - highlights a disturbing truth about human behaviour. Having evolved under conditions of danger and privation, we are by instinct a curiosity-driven and reward-seeking species. It's a survival mechanism. But in affluent times, when desire is no longer constrained by limited resources, we have trouble curbing our cravings, be they for the fat and sugar of fast food or for the gadgetry of modern technology. This state of affairs comes as little surprise to the behavioural neuroscientist, for it is established that overloading the "reward circuits" of the brain triggers craving and insatiable desire. In short, the human brain is easily confused by abundance. When it comes to self-indulgence, our biology offers no built-in braking system.

There is irony here, of course. The same driven self-interest and craving for novelty that is getting Britons and Americans into trouble also fuels the engine of the market. It was economist Adam Smith who first cogently argued the value of harnessing "self-love" (self-interest) within the give-and-take of a market framework to create a self-regulating economic order. Smith's idea was simple enough: in a free society, instinctual self-love is bridled by learned social sentiment and the desire to be loved by others. Through the adoption of a few rules of behaviour - such as honesty in competition, respect for private property and the ability to exchange goods for money - self-interest is liberated as the engine of economic growth but simultaneously moulded to the common good. And indeed, experience tells us that small markets do produce their own rational order, founded as they are on an interlocking system of self-interested exchange. But such social structures are rapidly eroding in America and Britain.

Since Smith's time, technology has removed the natural constraints upon human behaviour of darkness, sea and mountain and dramatically changed the checks and balances that regulate the market. The tethers that once bound together self-interest and social concern in closely knit economic communities and that gave us Smith's enduring metaphor of the "invisible hand" have fallen foul of a mercantilism that never sleeps. As our core individual identity shifts from concerned local citizen to that of self-indulgent international consumer, the mechanisms of the market are less effective in balancing economic activity to the common good, and the distribution of wealth becomes increasingly skewed, fostering relentless competition, envy and debt accumulation. In our Fast New World, the invisible hand is loosening its grip.

These uncomfortable truths about unbridled consumerism have implications for universities. The American mistake has been to worship the market as an ideology rather than seeing it as an evolving social structure that has much to contribute in an equitable society. Such ideological fervour is to be questioned whenever it emerges. Thus, as Britain embraces a new era of "top-up" fees, the pronouncement by the departing chief executive of the ³ÉÈËVRÊÓƵ Funding Council for England, Sir Howard Newby, that "students are consumers and should be treated as such" must be held up to careful scrutiny.

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As the cost of higher education rises in the UK, introducing substantial personal debt into the equation will distort choice and raise the question of "consumer" value, as it has done in the US. Under such pressure, as James Engell and Anthony Dangerfield note in their book Saving ³ÉÈËVRÊÓƵ in the Age of Money , "parents and students no longer choose the best education that money can buy... (but) are faced with choosing which college... will buy them more money". In a competitive society it is understandable that families ask how their investment will serve to secure a lucrative position in the volatile job market of globalisation. But if in response we offer only a "consumer" analysis focusing upon immediate material comforts or money potentially earned, we will fall short of our responsibility as educators.

Buying an education is very different from buying a refrigerator. Students are more akin to fine craftsmen than to consumers - they do not passively receive the product but create it within themselves through interaction with mentors, peers and those who achieve significance in their lives. The result, a balanced self, is a powerful instrument of economic good. Thus what guarantees employment and happiness in a rapidly changing world is what has always guaranteed it: achieving the strength of character that ensures lifelong learning and responsible citizenship. Honing the qualities that make for such strength, critical thought, analytical skills, social values, a sense of justice and aesthetic appreciation is the central task of higher education. The outcome of such a delicate process cannot be measured merely in market terms, as when one seeks the "best buy" refrigerator.

Smith believed that an effective market society is dependent on the sympathy of fellow feeling and the ability to imagine another's state of mind. These are values little prized in the consumer culture, where we look to advancing technology to support the myth of social progress. But technology is a double-edged sword. While it extends human power on this planet, it also magnifies our instinctual craving.

The good news is that a growing number of students and young people seem to have figured this out for themselves. These "new puritans" march to a different drummer, imposing personal constraint and rejecting consumer excess. As educators we should be listening carefully. This could be the drumbeat of the future, and for Britain the perfect way to avoid a nasty case of consumption.

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Peter C. Whybrow is the Judson Braun distinguished professor of psychiatry and biobehavioural science, and director of the Semel Institute for Neuroscience and Human Behavior at the University of California, Los Angeles. His book American Mania: When More is Not Enough is published by Norton.