Tackling Obesity: Empowering Adults and Children to Live Healthier Lives
By Louise Ballantyne // On August 13, 2020
Is the Governments obesity strategy going to work?
I’m sure you will have seen the news with the announcement of the UK Governments obesity strategy, so with the help of my Instagram followers, (@lou_loving_life and @livingomni) I’m going to delve into this a bit further.
The thoughts and opinions below, unless otherwise stated, are my own.
Let’s firstly take a look at the stats…
- Two in every three adults are classed as being above healthy weight with over half of them classed as obese.
- One in three children leaving primary school are overweight and one in five are obese.
(Department of Health and Social Care, 2020.)
Without having to do much research, we know that obesity leads to various health conditions and in turn adds strain to our health care system. We also know from recent news coverage that someone who is obese catching Covid-19 is more likely to have to be admitted to hospital, to intensive care and even die than those of healthy weight. Therefore, obesity is an immediate concern and so on 27th July, the UK Government published their policy paper; Tackling Obesity: Empowering Adults and Children to Live Healthier Lives.
My first thoughts on this without delving any deeper into the policy document; Why does it take a global pandemic to treat obesity as a serious issue?
Rates have been rising rapidly with global rates of obesity tripling since 1975. (World Health Organisation, 2020) Obesity costs the NHS over £6 billion per year, with cost to our wider society around £27 billion. Recent estimates suggests that by 2050, the cost to society will be in excess of £49.5 billion and we currently spend more each year on the treatment of obesity and associated conditions than we do on police, fire and judicial services. (Public Health England, 2017)
I could go on and quote many widely available research papers and policy documents and provide a spreadsheet full of stats, but I think if you are taking the time to read this, you will appreciate and understand this growing problem. You can do your own research later if you want to know more of the facts and figures!
So let’s get into the nitty gritty of the new strategy. The government have set out the below actions in an attempt to tackle the issue:
- Ban on TV and online adverts for food high in fat, sugar and salt before 9pm
- End of deals like ‘buy one get one free’ on unhealthy food high in salt, sugar and fat
- Calories to be displayed on menus to help people make healthier choices when eating out – while alcoholic drinks could soon have to list hidden ‘liquid calories’
- New campaign to help people lose weight, get active and eat better after COVID-19 ‘wake-up call’
In addition and not specifically linked to this strategy, however, I feel noteworthy for the purposes of this article, the government have also introduced a ‘Fix Your Bike Scheme’ allowing members of the public to claim a £50 voucher towards the cost of repairing a bike, and of course the ‘Eat Out to Help Out’ scheme offering 50% discount off food and non alcoholic drinks Mondays- Wednesdays at participating restaurants throughout the UK.
I asked my followers on Instagram for their thoughts on the above so will quote some of the statistics below as well as giving my own opinion.
Ban on TV and online adverts for food high in fat, sugar and salt before 9pm
Analysis published by Cancer Research UK from September 2019 shows that almost half (47.6%) of all food adverts shown over the month on ITV1, Channel 4, Channel 5 and Sky1 were for products high in fat, sugar and salt. This rises to almost 60% during the 6pm to 9pm slot – the time slot where children’s viewing peaks.
I’d perhaps question why children are watching mainstream television channels between 6pm and 9pm, but I guess that’s just my personal thought so overall, I think this can only be a good thing. Children are drawn into the bright and vibrant colours used in food adverts and will be influenced by them. However, at the end of the day, it’s the parents or carers who are buying the food, so would a family friendly healthy eating campaign be a better option?, we can all now quote the coronavirus related health and safety adverts reminding us to wash our hands and maintain distance, so could a similar option have more impact? The adverts are from big corporations; what about in times of hardship for many small businesses, these adverts for food high in sugar, fat and salt are replaced with adverts for smaller companies offering healthier, balanced foods or local farm shops and retailers? When I asked my followers if they thought this was a good idea, 56% said yes and 44% said no. Feedback from those who said yes included, “Anything is a positive step,” “I always end up craving things I’ve seen on the TV and then end up snacking at that time on whatever I have similar so it would maybe stop me doing that.” From those who said no, feedback included, “I don’t think adverts are the issue. People will still buy what they want anyway,” and “It’s not enough, we need a big shift in culture.”
End of deals like ‘buy one get one free’ on unhealthy food high in salt, sugar and fat
In the UK we spend more buying food products on promotion than any other European country and a survey from 2018 shows that around 43% of all food and drink products located in prominent areas were for sugary foods and drinks, compared to just 1% for healthy items.
Again, this is a case of anything is a positive! Just like the recent sugar or alcohol tax changes, people will still buy what they want. It is the decision making process that needs to change; the education behind the choices. There’s nothing wrong with foods high in salt, sugar and fat if they are consumed in moderation, in fact I’d never encourage complete restriction from these types of foods, but the fact they are generally cheaper and more prominently placed in shops, isn’t a good thing. My followers were completely divided with this one, with a 50/50 split. One said, “If these foods were more expensive or not part of an offer, I’d probably still buy them unless they were more ‘hidden’ in the shops. I don’t always go in with the intention of buying foods like this, but they are always so in my face, I can’t help it. The promotions aren’t the problem I don’t think, it’s where they are placed.”
Calories to be displayed on menus to help people make healthier choices when eating out – while alcoholic drinks could soon have to list hidden ‘liquid calories’
Calorie Labelling on Menus
Research shows eating out is becoming more common, particularly among families, with 75% of people visiting a restaurant, fast food eatery or getting a takeaway in the past week, compared to 69% in 2010. However, there is often a lack of information about the calorie content of these items and research suggests people consume around 200 more calories a day if they eat out compared to food prepared at home.
This one got us all thinking and a lot of good conversation flowing. This is not a positive thing. I encourage people to build positive relationships with food, learn about the nutritional value of foods, understand how food impacts the body and mind and to enjoy food. Of course, I also promote calorie counting, if this method works for a client in terms of weight management, but it doesn’t work for everyone. Counting calories can cause people to have negative thoughts around food, to become obsessive and can even lead to or make disordered eating worse. If we can’t go out for a meal or have a takeaway once a week without feeling guilty or restricted, will our relationship with food ever be a positive one?
The Instagram question response was almost 50/50 again, with 51% saying it was a good idea and 49% saying it wasn’t. Of those who said yes, feedback included, “I’d be able to go out for a meal without stressing out about going over my calories.” This led to me asking a few questions around this persons relationship with food and in the end they changed their mind, agreeing that this wasn’t a positive attitude to have towards food and has decided to make some changes to ensure her children don’t grow up feeling like they have to count calories! Interesting! Of those who said no, the feedback was mainly around disordered eating. One person said, “As someone who has a history of severe disordered eating, this would cause me a lot of stress and anxiety. I am at the point now where I can go out and enjoy a meal, but this could affect my recovery as seeing the calories would perhaps be a trigger.”
New campaign to help people lose weight, get active and eat better after COVID-19 ‘wake-up call’
– GP/ Health professionals prescribing exercise
In principle, this is great! It’s something that has been happening for a while but depending on Local Authority area budget and patient criteria etc, it’s not always accessible for those who need it. This has to be very carefully coordinated and managed for it to have any impact. As a coach, I know that exercise is not a one size fits all. What works for one person, may not work at all for someone else. What one person loves; another will hate. Careful consideration should be given to a person’s background, experience, interests and motivation levels. Equally as careful consideration should be given for the coach delivering the programmes. Someone who needs to lose weight may have other physical and mental health contraindications and this type of programme needs to take all that into account. At the end of the day, an individual must want to change. If they are simply being told to, this won’t work. I will be very interested to find out how individual NHS Trusts and partnerships aim to roll this out. As an Exercise Referral and Cancer Rehabilitation Specialist, it’s something I believe could have a very positive impact, if it is done well!
The Instagram poll resulted in a resounding 83% saying this was a good idea and only 17% saying they disagreed. Of those who agreed with this, some of the feedback included, “As someone who is obese, if I was prescribed exercise, I’d be more inclined to do it. I’d feel like I had a goal and more accountability with someone to answer to.” Another said, “This can only be a good thing. Encouraging people to exercise will give people a chance to try something new and make some positive changes to their lifestyle. They may even find something they like and make it a habit. But… it’s got to be done right, there’s no point forcing it on people or it will never work!” Of those who said no, one comment was left; “I just don’t agree with this. People have got to want to change. They need to make the decision themselves, not be told what to do.”
– GP/Health professionals prescribing ‘diets’
I won’t lie. This one got my back up a bit and if you have followed me for a while you will know my views. Diets do not work. I believe that diets promote an unhealthy relationship with being healthy. I won’t give any brands the publicity here but if you are counting syns or points, replacing food with juice or taking a magic pill, you do not have a healthy relationship with food. Food is essential to nourish and fuel our bodies but it is also there to be enjoyed. Diets will work if you are prepared to be on them for the rest of your life but as soon as you stop, they will stop being effective. The bottom line is, it comes down to the energy balance relationship; calories in and calories out or simply, the calories you eat v the calories you burn. To loose weight we need to be in a calorie deficit (calories in < calories burnt), to maintain weight we need calories in to be = to calories burnt and to gain weight, we need to be in a calorie surplus (calories in > calories out). Whichever way we do it; syns, points, shakes or pills, we are restricting our calories. So what is my issue with this when I would suggest a calorie control/counting to a client? Calorie control does not need to be nutritional control. Calorie control does not need to be restrictive. We can manage our weight without becoming obsessed with anything other than what we like the taste of and in my opinion, there are plenty of healthier ways to support weight loss without prescribing a ‘diet.’ A lot more needs to be done to educate people properly about food and stop encouraging the vicious cycle of dieting. We should not be referring to foods as good and bad or junk; food is food. Yes, there are foods that are better for us than others but this is what’s important and finding that balance and allowing people to make informed choices will have more impact in my opinion. 1 in 4 ‘dieters’ will develop an eating disorder and over 80% of those who have dieted in the past admit they have a poor relationship with food, resulting in various issues such as fatigue, anxiety, lack of confidence and body image concerns. (Tally Rye, 2019)
On the survey, 15% said yes they thought this was a good idea, but no comments were left and 85 % said they didn’t agree with this implementation. One follower said, “Prescribing diets like this (not mentioning the brand)is a disgrace. The government should be putting money into proper education to encourage people to enjoy food and be able to make better choices, while still enjoying what they like.” Another said, “I’ve been on diets most of my adult life and I’ve had a wake up call recently when my daughter (age 5) started saying she was fat and didn’t want chocolate because it was bad for her. That’s not a way to bring up my child and I’m making some big changes now. Our future generation do not need to live like that!”
Fix Your Bike Scheme
This is not part of the obesity strategy but was announced around the same time and I feel relevant to this discussion. Offering £50 towards the repair of a bike is a good thing in my opinion. It will encourage physical activity in the outdoors which I am all for so what I am about to add is not a negative, simply my ‘out the box’ thoughts. This is only relevant to people who already have access to a bike. There is nothing in place, that I am aware of, for those who don’t have access to a bike and perhaps can’t afford to buy a new one. Cycling may also be a slightly daunting way for someone to start their exercise journey. The health and safety considerations are slightly more than perhaps walking or running. As I say, this is a good thing but maybe an additional campaign for completely free outdoor exercise would better target those related to this strategy? On my follower survey, 85% thought this was a good idea, while 15% said they didn’t agree. I didn’t get much feedback here but included, “This is a great idea as will encourage people to get outdoors and active,” and “I think cycling is dangerous. I’d rather they give us £50 towards a new pair of running trainers or walking boots!”
Eat Out to Help Out
Again, not part of the obesity strategy but I feel worthy of a mention. My initial thoughts are that this is a great incentive. 50% off food and non – alcoholic drinks to encourage people to dine out post lockdown. A winner for businesses to maximise income after a period of closure and a winner for customers to save money while enjoying a social occasion. I was all for this until the media coverage promoted fast food chains while announcing the start of this incentive. Firstly, there are very few fast food chains whose bestselling menus provide us with a healthy, balanced and nutritious meal. I’m not against them; they have their place, but they are renowned for their low prices anyway, and let’s face it, none of these chains suffered too badly as a result of the global pandemic did they? Do they really need to be included in this scheme and do we really need to be able to buy 20 chicken nuggets for less than £3? I don’t think so. The hospitality sector has been one of the most badly impacted during lockdown and small, local, family run businesses are facing financial difficulties that for some has led to closure. So why are the media giving free advertising to fast food chains over small, independent businesses? Why are the media encouraging us to eat foods high in salt fat and sugar (those foods that are at the same time being removed from prime-time TV advertising!) over nutritious, home cooked meals? There’s an issue here that needs to be addressed and I urge anyone reading this to act accordingly. If you want a meal you can order on a touch screen for £3, please go on a Thursday – Sunday. You will still pay less than £5. Support local and independent businesses if you want a meal out Monday – Wednesday! I didn’t ask my followers about this in a poll, but I did get some feedback when I posted about it. This included, “People should make the most of this scheme as it is a great incentive but should use it to try new foods, new places and make healthier choices.”
So to summarise, there’s a lot to think about here. ANYTHING to try and improve the health of our nation has got to be positive but is this all just too little too late? Will it work? I’m not sure. The government need to redefine ‘healthy’ and work from there. Whether you are the Minister for Health or an 8 year old school pupil, you know that eating healthy and taking part in exercise is good for us. What we think is healthy will depend very much on other influences, upbringing, parental beliefs and exposure to media and unfortunately, a lot of this is centred around diet culture, which is not healthy. If children grow up with these food types being part of every meal, it is the norm. They will feed their children the same.
The media industry needs to change their approach too and encourage open discussion on overall health and wellbeing with emphasis being on educating people to allow them to feel confident in their decision making around their own health.
Every single person in our society has a part to play in tackling obesity. Yes, the government need to implement something, but various industries could have a much bigger voice in deciding what will be implemented. If for example, retail, hospitality, manufacturing, health, fitness and education sectors were all on board and in this together, the state of our countries’ health would be very different. We too are influential in this process. We have the power to make decisions about what we buy, what we eat and what we do; all of this will influence these sectors and of course the government to develop a strategy that will bring long lasting change.
If you’ve read this far, thank you. I’d love to hear your comments and thoughts on this so please get in touch!