Sat, Jul-22-23, 23:58
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Plan: Muscle Centric
Stats: 238/153/160
BF:
Progress: 109%
Location: UK
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‘I’m a doctor – here’s how I would solve Britain’s obesity crisis’
Posting this article as Dr Chris van Tulleken is a contributor.
Quote:
‘I’m a doctor – here’s how I would solve Britain’s obesity crisis’
From a GP to the head of the behavioural 'nudge' unit, three professionals give their opinions on how to tackle our weight problem
For 30 years, curtailing obesity rates in Britain has made it onto successive prime ministers’ agendas – yet it’s proven to be the nettle none can grasp. Fourteen strategies, 689 policies and a further 14 bodies specifically set up (and then disbanded) later, waistlines in the UK are only growing, with nothing seemingly able to halt the trend.
A report this week found that menu calorie counts, introduced with the idea of encouraging customers to cut back, are often way off the actual number of calories contained, making it appear little more than a tick-box exercise. Boris Johnson’s plan to ban junk food deals has also been scrapped, with Rishi Sunak saying that a cost of living crisis is no time to further increase food prices. At the same time, obesity now affects two thirds of UK adults, at a cost of £6 billion to the NHS each year.
The current Government’s manifesto pledged to give everyone “five extra years of healthy, independent life by 2035 and to narrow the gap between the richest and the poorest”, as well as promising to halve child obesity and reduce the condition among adults – yet current figures suggest we have never been further from the mark. Here’s what three experts think we should do to ensure a healthier future …
The behaviourist
Prof David Halpern
President of the Behavioural Insights Team
‘Let’s give the power back to the consumer and ask them what they want’
We’re the fat men and women of Europe, and we broadly know what kinds of choices we need to make to put that right. Yet instead we are leaving the NHS to pick up the pieces of our unhealthy lifestyles, and spending an absolute fortune on the likes of diabetes treatment, cutting off limbs and pulling out teeth. We need to be able to have a mature conversation about overriding the current situation – created by an evolution of our genes and behaviours, and market dynamics – in order to achieve lasting change.
I head up the Behavioural Insights Team, also known as the Nudge unit, which was set up by the government in 2010 with the idea that nudging people towards better choices without regulation or force is the best way to spark change long term. (We are now fully owned by Nesta, a charity.) We suggested nudges, such as the sugar tax in 2014 (implemented in 2018), and placing high-calorie foods away from checkouts in supermarkets. We also backed junk food advertising bans and an end to buy-one-get-one-free deals on such products, which were both announced as Government mandates – and then withdrawn. This week I have also co-signed the Covenant for Health, a paper outlining the policies that can reform the nation’s health over five to 10 years, including a sugar and salt reformulation tax, which could help to cut daily caloric intake and halve obesity prevalence by 2030.
People may not like the idea of nudging, but while they’ll say they want to be healthier, our environment makes it hard to achieve that, so it’s right to make these kinds of changes on a wider level. We should be comfortable making tweaks that are in line with people’s long-term desires that will ensure the health and wealth of the country.
It is evident that information, exercise and willpower will not reduce levels of obesity. What we need is upstream interventions that address the underlying factors that lead to poor health. I believe that people want to live more healthily, but this requires making it as easy and thoughtless to pick the option that’s good for you as it currently is to select the one that isn’t. We know some of these nudges have worked: reformulating drinks following the introduction of the sugar tax has led to a rise in lower-sugar soft drinks sales (meaning business interests and, to a degree, health is protected), and we could do more. Many of us order food online now, and changing a regular-sized meal to mean “small” could also lead to a reduction in calorie consumption. These might not seem like major changes, perhaps the equivalent to eating one less chocolate bar a day, but the cumulative impact would be vast.
I don’t believe this is tantamount to a nanny state, but the reverse: let’s give the power back to the consumer, and ask them what changes they think should be made, rather than getting hung up on personal responsibility or lambasting people for not paying attention or exercising enough. Asking people what they want, and giving individuals access to information procured by industry groups, the Government and researchers, will allow everyone to make up their own minds about how to shape our environment, and our future.
The GP
Prof Kamila Hawthorne
Chair of the Royal College of General Practitioners
‘GPs need to show patients they’re committed to helping them lose weight’
Two thirds of adults are overweight or obese in Britain, and as doctors, we’re worried about what this means for the future of chronic diseases. We need to raise healthy food and healthy eating on the nation’s list of priorities, and to do this together.
That starts with GP services, who need more resources to be able to support their patients in losing weight to improve their health. We need better access to dietitians and to psychological support to help people lose weight – it isn’t an easy thing to do, and neither is keeping the weight off once it has been lost.
GPs can and already do play an important role in curbing obesity, by taking the time to show patients how committed we are as their doctors to helping them lose the weight that they need to lose, and convincing them that it’s actually worth doing. I only get to spend 15 minutes with a patient – other GPs will likely have less time – and for the rest of the day, they’re surrounded by all kinds of other influences. What I would really love is if they left my surgery and saw a public health campaign advertised on a bus, reiterating the benefits of weight loss, building on what we’re doing in consultations.
I often say to people that if they can make these changes for themselves, they can do more for their health than any doctor can.
I work in a post-industrial town in the Welsh Valleys, and the high street is full of fast- food outlets. Obesity is closely linked to poverty, and ensuring healthy, low-carb and low-fat foods are accessible and local would make it far simpler for people to make better meals at home. There is a common perception that eating well is too expensive, particularly in a cost of living crisis, and that shouldn’t be the case.
Teaching people how to eat well is vital, and we need to start this education young, because by the time I see patients with chronic conditions who are already very overweight, it’s much harder to reverse the negative health outcomes that could have been avoided in the first place. In my view, prevention is far better than dealing with the aftermath.
The anti-upf evangelist
Dr Chris van Tulleken
Author of ‘Ultra Processed People’
‘We need a revolution and to treat food companies like tobacco companies’
We are in the grip of a child health emergency – one that’s been steadily growing for three decades – and I’m not sure we’re doing anything much about it. We know that what drives weight gain and other diet-related diseases in this country is eating foods that are ultra-processed, high in fat, salt and sugar; yet at the moment, children see marketing for all of the above everywhere they turn. When they go into any shop, when they walk down any street, on their bus tickets, on their music apps, on their games that are funded by the food industry, their televisions, on YouTube. The situation that we’ve allowed to develop is absurd, unaffordable and morally repellent.
We need a revolution, and my proposal is simple: treat food companies like tobacco companies. They sell addictive products that they know damage human health, and they market them to vulnerable people; they also fund research, skewing it in their favour – which is no more valid than a tobacco company paying for studies. We need to make real food affordable and accessible for people, and to restrict the marketing of ultra-processed, high fat, salt and sugar foods. This is not anti-growth – the pharmaceutical industry, which is tightly regulated, has seen huge economic success since stricter guidelines were brought in, and the same can be done here.
Education around nutrition is important, but ultimately comes in relatively low on my list: there’s less value in teaching children what they should be eating if they can’t afford to do so in the first place, or are surrounded by aggressive marketing telling them to pick up the foods that are contributing to excess weight, which is the leading cause of death globally.
Countries like Mexico, Colombia and Brazil are beginning to better label food – they don’t use our confusing traffic-light system, rather big black hexagons on unhealthy products, so you can spot them immediately. They also ban cartoon characters on packaging, to make them less appealing to children.
We need to avoid eating rubbish food from cradle to grave. At the moment, people don’t have a choice.
Practical tips to trim the fat
Rewire your brain for weight loss
Do the jellied-eel test
“Before you eat, ask yourself, ‘Am I actually hungry?’ Would you eat a jellied eel, or anything else you dislike, if that was to hand?” says nutritionist and weight-loss coach Pippa Hill. “If the answer is no, drink a glass of water instead.” Lots of us eat when we’re bored, but that feeling will pass, along with the urge to grab a biscuit.
Always eat proper meals – at a table
“If you graze in front of the television, you’ll keep eating and finish the packet,” says Hill. “In the 1970s we didn’t eat like that. We had breakfast, lunch and dinner, that was it.”
You can’t exercise away a bad diet
“Your body weight is 80 per cent diet, 15 per cent exercise and 5 per cent genetics,” says Hill. “Exercise alone won’t get your weight down.”
Think: ‘Daytime need, nighttime greed’
During the day we need energy and at night we need to give our digestive system a rest and let it wind down for sleep. Don’t eat after 8pm, 7pm if you can.
Can the diet drinks
“Sweeteners cause our bodies to release insulin. They make you crave sugar and don’t help you lose weight,” says Hill. If you’re thirsty drink water, or a cup of tea
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https://www.telegraph.co.uk/health-...obesity-crisis/ |
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