It’s difficult to review a government policy without getting too politically opinionated, nevertheless let’s try… Last week we saw the UK Government Department of Health and Social Care release their new publication: Tackling obesity: empowering adults and children to live healthier lives.
Some general questions to start with before we get into it:
Are we in an obesity epidemic in the UK? Yes
Would we as a whole country benefit from clear, helpful public health guidance regarding weight management, food and exercise? Yes
Do we as a country have numerous nutrition, health and exercise accredited and qualified people the UK government could utilise to produce this advice? Yes
Are they utilising these people? No
Are they providing clear, helpful public advice? Subjectively, no
What are they providing? This abomination of a strategy which is patronising and smacks of responsibility dodging, whilst showing clear lack of understanding of the real problems the country faces regarding health/food/weight relationships (Oh dear, failed to be objective already, my bad, let’s try again…)
Positive aspects of the report: the spelling and grammar used was mostly correct, I suppose…
The contents page looks as though it should be a great report; positive, helpful, providing real solutions. However, the use of punchy words and phrases focusing on empowerment, fair deals, and children’s futures dissolves to reveal strategy disappointment when you read past the contents page…
Let’s start with who wrote this plan; the Department of Health and Social Care. Who makes up this team? The ministers are listed below with their titles and previous roles/qualifications.
- Matt Hancock – Secretary of state for health and social care. Previously secretary of state for digital, culture, media and sport. Before politics worked as an economist for the bank of England.
- Edward Argar – Minister of state (minister for Health). Previously press secretary and worked in a management consultancy.
- Helen Whately – Minister of state (Minister for Care). Previously Parliamentary Under Secretary of State at the Dept. for Digital, Culture, Media and Sport. Before politics worked as a management consultant.
- Jo Churchill – Parliamentary Under Secretary of State (Minister for Prevention, Public Health and Primary Care). Previously assistant government whip.
- Nadine Dorries – Minister of State (Minister for Patient Safety, Suicide Prevention and Mental Health). Trainee nurse background
- Lord Bethell – Parliamentary Under Secretary of State (Minister for Innovation). Previously a government whip
Also in the department are 7 management members, one of whom (Prof. Chris Whitty) is a practising NHS Consultant Physician at University College London Hospitals (UCLH) and the Hospital for Tropical Diseases.
Finally, special representative is physician Prof. Dame Sally Davies, for the UK Special Envoy on Antimicrobial Resistance.
You could view this as a group of people with numerous years of experience in managing projects and ‘getting things done’ and therefore a good fit to lead a country wide government strategy. Alternatively, you could look at this list and ask why on earth is there only one person with a previous trainee nurse background and two physicians involved?
Yes, it could be argued a full team of medically qualified members would perhaps lack the skills required for producing and implementing a government policy (despite the UK producing Public Health Campaign graduates each year). But surely within the Dept. of Health and Social Care we could expect at the very least there to be an equal balance of medical professionals to ‘others’.
Next, let’s look at this policy and what they tell us they intend to do (and an interruption of these):
- Introducing a new campaign – a call to action for everyone who is overweight to take steps to move towards a healthier weight, with evidence-based tools and apps with advice on how to lose weight and keep it off. (‘YOU NEED TO LOSE WEIGHT; WE’RE GOING TO TELL YOU TO DO IT. HERE’S AN APP, GET ON WITH IT’).
- working to expand weight management services available through the NHS, so more people get the support they need to lose weight. (‘working to expand services’ – not ‘we will provide sufficient services’)
- publishing a 4-nation public consultation to gather views and evidence on our current ‘traffic light’ label to help people make healthy food choices. (Yet again we will spend time and money looking at the front of pack labelling system on food. We will look at it, we will talk about it, we will publish it. We offer no other promises to do anything here)
- introducing legislation to require large out-of-home food businesses, including restaurants, cafes and takeaways with more than 250 employees, to add calorie labels to the food they sell (Make take away food have calories labels – not promising to educate you all on what this actually means for your health.)
- consulting on our intention to make companies provide calorie labelling on alcohol (talk more about putting calorie labels on alcohol – still not promising to educate you all on what this actually means for your health)
- legislating to end the promotion of foods high in fat, sugar or salt (HFSS) by restricting volume promotions such as buy one get one free, and the placement of these foods in prominent locations intended to encourage purchasing, both online and in physical stores in England. (This point has arguable sense behind it – make the less healthy foods less appealing. However, if making cheap unhealthy foods less accessible, is this going to be matched by making the more healthy foods more accessible? There needs to be balance. Where is the balance?)
- banning the advertising of HFSS products being shown on TV and online before 9pm and holding a short consultation as soon as possible on how we introduce a total HFSS advertising restriction online (this again has arguable sense in that reduction of pester power from children to parents may reduce unhealthy purchases, but what about children and adults who have already been exposed and formed habits? Where is the education? Where are the alternative options following the ‘out of sight, out of mind’ approach they are offering?).
Throughout the report they state that obesity rates are highest amongst those living in deprived areas, and list all the complications and diseases which accompany this. The only acknowledged cause is exposure to unhealthy foods. It’s mind blowing this is the only factor they chose to focus on.
The saving grace of this policy is the NHS 12 week plan they suggest to follow, it at least exists and is a source of some help. However, this should not be in place of food, health, exercise and lifestyle education being mandatory in all schools, and easily accessible to all adults. By all means make unhealthy foods less accessible, but where does this leave people with what to do for alternative choices? People need help and guidance rather than additional hurdles.
It’s hard not to read this and think that it has just been thrown together and published quickly in response to obesity being linked to higher covid-19 death rates and the world-wide comparably terrible response of the UK government to the outbreak. Being seen to do something is all very well and good, but ‘empowering people’ should involve equipping people with tools; in this case knowledge through education. Merely identifying one possible cause of poor health and obesity as advertising and restricting it, whilst highlighting calories on labels, is not enough. A policy titled ‘Tackling obesity: empowering adults and children to live healthier lives’, which does not once mention focusing on mental health or education is a failure of policy in more than one respect. Of course, this is only our humble opinion as degree qualified and accredited nutritionist and exercise professionals… read the full report here.