Obesity has long been identified as an important public health issue causing potential serious health burden (including increased risk of contracting COVID-19 and more detrimental health outcomes), not only for those classed as obese but also to the overall and health economy.
Recently, the UK government announced a new strategy to address obesity, not the first and most likely not the last. In 2007, the Foresight report was instrumental in highlighting that obesity does actually have many causes and that these form part of a complex and intricate network.
So, does the 2020 UK obesity strategy take into account this complexity?
On the surface, there are a number of areas that will be addressed, ranging from displaying (improved) calorie information on food packaging and restaurant menus, introducing a 9pm watershed for showing adverts for foods high in fat, sugar or salt (HFSS), and increasing support for weight loss through the NHS and GPs. However, a lot of the measures suggested are not necessarily new and more importantly rely too much on individuals making ‘the right choices’ for themselves and their families. Admittedly, yet again the food industry and catering outlets are added to the equation and asked to enable these individuals to choose wisely what they eat, to make ‘informed choices’. Whilst behaviour change is one important aspect in weight loss and weight loss maintenance, the new strategy does not acknowledge that behaviour change cannot be implemented if choices are restricted for the individual to begin with.
The discussion surrounding the affordability of a healthy diet is one that is ongoing. A 2018 report from the Food Foundation suggests that more than 14 million households in the UK might have been unable back then to afford a healthy (i.e. also leading to a healthy weight) diet based on the UK dietary guidelines. The uncertainty that the UK exit from the EU brings in terms of short- and medium-term availability and affordability of food with the UK currently heavily relying on imports adds further complexity to the picture. There is certainly awareness of these issues but the impact on individuals being able to afford a diet that will enable them to lose weight and maintain this weight loss seems to be an issue further at the bottom of the priority list. How much will a patient taking part in one of the new NHS weight loss programmes be successful when nutrient-dense foods as opposed to energy-dense food (think mixed salad with tuna and egg versus burger and chips) seem to be prohibitively expensive? Or when availability might be limited, at least for a while?
The new UK obesity strategy is being sold as a response to the ‘wake-up’ call that COVID-19 provided to the UK government, and especially Prime Minister Boris Johnson, who acknowledged himself that his own excess weight might have made his recovery from COVID-19 more prolonged. However, the pandemic also brought with it a rise in unemployment and in reduction of income for a considerable number of individuals and households, potentially adding to those that are struggling to afford a healthy diet .
Yes, ‘Tackling obesity: empowering adults and children to live healthier lives’ is attempting to address some aspects that we know form part of the complex web of causes of obesity. At this very point in time, however, it has to be considered whether this means barking up the wrong tree.
Nutritank is an excellent initiative to address a current shortfall in medical education with regards to nutrition. Optimal nutrition is one of the cornerstones of human health and it is therefore important that medical professionals understand not only the key concepts of nutrition but also the behavioural, societal and environmental aspects impacting the patients and clients that they will be dealing with throughout their careers.
