Monday 13 January 2014

Obesity: what's to be done about the UK's expanding waistline?

The extent of the problem

National Obesity Awareness Week started with something of a bang on the 13th January when the National Obesity Forum released its State of the Nation’s Waistline report. In the document’s opening address, Professor David Haslam – Chair of the Forum – states that the prediction that half of the UK’s population could be obese by 2050 may, in fact, represent an underestimation of the true situation. Professor Haslam writes:

‘We are now more than seven years on from the publication of the Foresight Report and, if anything, the situation is now worse than it was in 2007. Without action across the board - from government, business, society and individuals – we might feel fortunate if only 50% of the population is obese and the annual cost is only £50 billion in 2050.’

The claims act as a sobering realisation of the scale of the impending health problems faced in this country. On a global scale, the picture is equally as alarming. According to the Oversees Development Institute, the number of overweight and obese adults in the developing world has quadrupled since 1980 and now stands at one billion.  

The problem is somewhat confounded in the UK by the challenges posed to the NHS by an ageing population that will inevitably require increasing levels of medical attention. Given the close relationship between obesity and a whole range of cardiovascular and lifestyle-related diseases, Professor Haslam is entirely correct to state that the current situation is completely ‘unsustainable’.

What can be done?

With the projections coming from the independent think tanks and charities being as they are, the question as to what can be done is foremost. The answer is certainly complex, however the aforementioned report offers a number of practical recommendations, from promoting the nationwide Change4Life programme, to spelling out ways in which GPs could be encouraged to further engage with helping overweight and obese people change their lifestyles. That said, if the market forces stay as they are, there is likely to remain a huge barrier in the way of any real sustained change.

It’s for this reason that campaign groups such as Action on Sugar have a crucial role in the debate and on-going policy making. The pressure applied by the group – whose manifesto and membership can be read here  must be meaningful if we’re to see the appropriate action taken, rather than a repeat of the ways in which the drink and tobacco industries were softly dealt with in 2013.

In addition to getting a grip on the inconspicuously high levels of sugar in many of the foods that we consume, a debate needs to be had on whether we can really afford to allow trans fats to be so widely used in food production. In November, the American Food and Drug Administration moved to ban virtually all artificial trans fats from the American food supply. The result, according to the New York Times, should be to save thousands of lives and potentially billions of dollars in medical and economic costs each year.

For the UK health authorities, taking similar action to ban these extremely unhealthy elements of the food chain could represent an important move in adopting a consistent approach to tackling the issues. The message sent to producers and vendors of processed and fast food needs to be unequivocally clear if we’re to prevent the kind of widespread illness and disease that’s otherwise predicted.

Of course however, the responsibility cannot all lie on government and organisations to alleviate these issues. Ultimately, we’re all answerable for the lifestyles we lead and the ways in which we either abuse or respect our quality of life. In terms of the individual level then, one thing that we might work towards is to reduce the ways in which we willingly sacrifice our long-term health and self image ‘for a few minutes of pleasant mouth feel and belly comfort’. This kind of activity is known as ‘temporal discounting’ and, according to Scientific American MIND, it may well be more modifiable than some of us might be willing to concede. Research conducted at the University of California has shown that:

‘When you evoke people’s moral obligation to take care of a future self who is dependent on them, in the same way we take care of our children and elderly parents, they make better choices.’

The simple idea is that if people are able to envisage a future self as a third person who’s dependent on their behaviour now, the effect on decision making can be surprisingly profound. Despite only being intended as a brief example of the potential strategies that stand to be gained from psychological research, it does attest to the idea that small, yet targeted changes can really add up.

Insofar as the NHS Health Check is concerned, with an increasing emphasis being placed on behaviour change and Motivational Interviewing, the programme is actively moving to incorporate such techniques as its practitioners up and down the country work to tackle the growing health burdens so poignantly demonstrated by this week’s announcements. The more positive support they’re able to get from wider government policy, the better.