The government has introduced its new ‘Better Health’ policy which plans to focus on improving the physical health of people in the face of increasing obesity. The policy includes ending fast food advertising on TV before 9pm, enabling doctors to prescribe cycling, and the inclusion of calories on the menus of restaurants with over 250 employees. But will this policy work?
However well intentioned, this new policy has drawn much ire for lacking the evidence necessary for such sweeping changes to be brought in and its focus on ‘losing weight’ rather than the underlying factors causing obesity in the UK. Its most dangerous outcome might be the effect it has on those recovering from eating disorders.
The lack of evidence for the Government’s policy can be seen in its focus on ‘obesity’ and the need to lose weight. The idea that if you lose weight you will be healthier is inextricably linked to the prevalence of Body Mass Index (BMI) as a measure of health.
While BMI may be useful for taking general measurements of a population, it fails to account for the nuances of being human
Put simply, your BMI is the amount you weigh divided by your height in meters squared, the idea behind it being the taller you are the more you should weigh. While BMI may be useful for taking general measurements of a population, it fails to account for the nuances of being human. To take one example, the weight of muscle is not accounted for, this means that many athletes are considered obese by the scale even though they are far healthier than many people with a lower BMI reading.
The founder of BMI, Quetelet, was in fact never looking to study obesity but rather the ‘normal man’ and this norm will often shift depending on the sex, age, and ethnicity of a population. The BMI scale, like a lot of measurements in health was based on (and therefore created for) white European men, none of the initial participants in the study were women or from non-European descent. This makes around 1 in 5 BMI readings inaccurate.
More significantly, Beat, a UK charity for people who suffer from eating disorders, has argued that the Government’s ‘blanket campaign’ fails to account for the fact many people who are obese suffer from eating disorders.
There needs to be a greater focus on the multiple factors that lead to obesity
Beat highlighted the harmful impact that previous anti-obesity campaigns have had on those recovering. The focus on the number of calories in foods can be seen to worsen those who suffer from eating disorders’ morbid preoccupation with weight, food, and shape.
Instead Beat and others have suggested looking at a more holistic approach along with following policies for which there is greater evidence. Rather than simply focusing on individual choices and actions Beat has argued there needs to be a greater focus on the multiple factors that lead to obesity.
A key factor is that those in poverty will not necessarily be able to think about the nutritional quality of the food over giving their children enough calories to survive. Equally, for those working a 9 to 5 job five or more days a week, it is far easier to pick up many of the readily available (often less healthy) ready meals.
In a recent article, The Guardian pointed to the lack of access to space for exercise which many people suffer from, and while anyone can go for a run, it is harder to run in streets clogged with traffic and air pollution. In many areas people feel unsafe. Anecdotally, I am sure a lot of us have heard about friends who tried to go for a jog only to be catcalled and never want to go again.
The effects on mental wellbeing could be long lasting and dire
What does this mean? It means that while the Government taking action to make a healthier population is good, the quick fix approach that is currently being used may lead to little improvement or even have adverse effects. While it is important in the face of COVID-19 to be generally healthy, the effects on mental wellbeing could be long lasting and dire. This could lead to a far longer crisis with mental health services already stretched.
What is needed instead of the quick fix approach proposed by the Government is a social change with greater education about food and nutrition, more time given to families and a subsidising of healthier foods to make them more accessible. Obesity cannot be beaten overnight; it is a problem that has been increasing since the end of rationing 60 years ago. Whilst the greatest changes can come in times of crisis, they need to be changes for all and for the better.
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