Tom Waterhouse is an Associate Director at Public First.
The Government is rapidly coming to the conclusion that the country’s obesity levels are a big reason the UK has been hit so hard by coronavirus. Current research shows it’s the second-biggest risk factor, after age. It was reported last week that some senior ministers and aides in Number Ten 10 want to consider extending the sugar tax – a levy on the amount of sugar in fizzy drinks. But this is not the answer.
The health of the nation is in crisis. Almost 65 per cent of adults are overweight or obese. Shockingly, so are 34 per cent of children aged 10-11, and 22 per cent of 4-5 year olds. That means we have millions of children whose current obesity levels mean they will die before their parents. It represents one of the greatest policy failures of successive governments of modern times.
Health policy in recent years has been dominated by gimmicks. The sugar tax, bans on advertising on the London Underground, school proximity policies – they haven’t made a jot of difference to obesity rates, and yet seem to pass for some kind of strategy. They have distracted from doing the hard thinking about how we help people improve their health.
It is, after all, actual people we are talking about. Not a threat to the NHS that needs diverting. Not a liability on the nation’s balance sheet. We’re talking about improving people’s quality of life. I qualified as a personal trainer six years ago to train people in my spare time. You realise your greatest challenge is breaking down the barriers people face to getting fit and healthy.
Knowledge is an obvious one. Confidence is a big one. So is time, money, old injuries, their lifestyle. Sometimes it’s deeper than that, such as lack of self-worth. But these barriers won’t be overcome by putting an extra 20p on a packet of Monster Munch.
My hope is for two things.
The first is that, with a Prime Minister motivated to take action because of his life-threatening experience of Covid-19, the political momentum created allows the opportunity to challenge the fundamentals of how we approach nutrition. If the Government engages with the likes of the excellent Dr Zoe Harcombe and concludes she’s wrong, then fine. But we should be asking why obesity was so low in the 1970s, and whether doing a U-turn on our dietary advice has something to do with today’s epidemic.
My second hope is that the promise in the Conservative Party manifesto to “extend social prescribing and expand the new National Academy of Social Prescribing” is fulfilled quickly. Here’s why.
The NHS offers a number of ways to help people lose weight, one of which is a GP’s referral to a weight loss group. It’s called ‘social prescribing’ and chances are, if you search the NHS website for a weight loss group in your area, it’ll be Slimming World.
Back in 2000, they partnered with the NHS in Derbyshire to run a pilot referral scheme, proving that a commercial weight loss management company could offer an effective solution to reduce overweight and obesity levels in the community. Paid by Clinical Commissioning Groups (CCGs) and subsidised by Slimming World, they have helped hundreds of thousands of people to lose weight. This is an incredible achievement, and one that’s effective as well as low cost.
But there’s a problem. It’s well-documented that these types of services are not always designed for men, and research has consistently shown an under-representation, both in those referred and enrolled in programmes. Slimming World has previously told the Health Select Committee that of their 250,000 members, just five per cent are men. Given that men are more likely than women to be overweight or obese (67.2 per cent of men, 61.5 per cent of women nationally) that’s a big challenge for the Government to overcome if it’s to tackle obesity.
In a major study undertaken by the National Institute for Health Research into the management of obesity in men, a key finding was that reducing diet did not affect long-term weight loss. What gave the most effective results was the right diet, plus physical activity and behaviour change.
An expanded Social Prescribing Academy could be working right now with the health and fitness industry to create more partnerships between the public and private sector to do just this. Competition and consumer choice in gyms has arguably never been better and has driven greater accessibility and affordability.
The likes of Puregym, Bannatyne’s Health Clubs, Anytime Fitness, David Lloyd Leisure and The Gym Group are just a few of the operators who are perfectly placed to offer the personnel and facilities for men – and women – to be referred to, that could help them break down the barriers to achieving better health outcomes.
There are hundreds of smaller operators who could do this too, if the right framework and criteria were created for them to comply with. We could be finding more low cost, effective solutions like the one pioneered by Slimming World by working with the nation’s gyms operators. And given the Government may well have to make gyms wait until the very last phases of lockdown before re-opening, a boost of this kind for the industry is sorely needed.
The Government also needs to find a way to incentivise doctors to do something very awkward, but vital: tell people when they need to lose weight. But having told them, GPs also need to have the right services to refer people to. Not just for men, as mentioned above, but for children too. This is, again, an area that an expanded Social Prescribing Academy could be put to work on.
My instinct is that the Government in the end won’t extend the sugar tax. It’s bad politics to be raising taxes on ordinary people in any case, but especially at a time when a great many more people’s finances have become precarious. It’s also bad politics to be smacking the food & beverage and hospitality industries with higher costs, threatening the jobs they support, after they’ve been amongst the worst-hit sectors by the pandemic. But most of all its bad policy – that will not help tackle the health of the nation.
Instead, let’s hope policies from the Conservative manifesto win through.