PM to tackle obesity

The Prime Minister is reported to be considering how to tackle the obesity levels in Britain. It seems Boris Johnson’s brush with death has opened his eyes to the serious implications that being overweight has, not just for the individual, but also for the National Health Service. The PM is said to be convinced that his weight is to blame for the fact he needed intensive care treatment for coronavirus while his slimmer colleagues Matt Hancock and Dominic Cummings did not.

Medics and scientific researchers are still learning about coronavirus. The range of symptoms seems to be large, and not everyone who is infected reacts the same way (some don’t even have any symptoms at all), and the severity varies greatly. However, what is now known is that people who are obese are not only more likely to become seriously ill with the virus, but their risk of death increases the more obese they are[1].

Obesity is a risk factor for a whole range of health conditions, including type 2 diabetes, coronary heart disease[2] and respiratory conditions[3]. That’s not particularly surprising. It’s fairly easy to see why carrying excess weight could affect your heart function and your breathing. What may be surprising to some is that in England one third of adults are obese, and nearly 70 per cent are overweight[4] and that has implications which reach far beyond the current pandemic.

It’s also unsurprising that Boris Johnson’s apparent awakening to the seriousness of the country’s weight problem has polarised opinions. It’s been welcomed by some in the medical profession, like the outspoken Dr Aseem Malhotra who criticised Krispy Kreme Doughnuts and Domino’s pizza for donating free food to key workers, while others see it as another potential piece of government interference. Writing in ‘The Spectator’, the journalist Christopher Snowdon accused Public Health England of ‘contributing to the drive towards shrinking chocolate bars and taking the flavour out of food’ in what he called ‘doomed efforts to control people’s waistlines’[5].

But this isn’t about the occasional treat. This is about lifestyle and it’s about poverty. Unlike Boris Johnson, most people who are overweight or obese live on low incomes. They are not overindulging in rich meals or fine wines. They are working long hours for low pay, and the food they can afford is low quality, highly processed and full of sugar. Shrinking chocolate bars isn’t really going to make a huge difference. Making healthy food cheaper and more available, and helping people, not criticising them, is far more likely to have an effect.

I usually buy my fruit and veg from my local market but haven’t been able to do that since lockdown. It is far more expensive at the supermarket. I am fortunate that I can afford to spend a bit more from time to time, but it would have been a lot cheaper to fill up my trolley with cakes and biscuits than apples and oranges, and many families just don’t have the choice. There is strong link between deprivation and obesity in children, and the government already has a plan in place to reduce that[6]. Perhaps no-one had told the PM.

I hope Boris Johnson is serious about tackling the obesity problem and that his new-found enthusiasm for health and wellbeing will be backed by a commitment to invest in support and education for those who need it, whatever their background. Without tough measures to ensure the food industry adheres to higher standards though, any good intentions may have little result. The question is, will it be possible to persuade manufacturers to put health before profit?

The coronavirus pandemic has given many of us time to reflect on what really matters; we’ve watched our frontline health workers risk their lives to save others, and it’s rightly been headline news every day since the virus took hold. Yet before the pandemic, hundreds of thousands of people were being admitted to hospital every year with obesity-related health issues, from heart disease to joint problems[7], with relatively little press or government attention. Boris Johnson’s illness has brought the matter centre stage and I hope it stays there when the coronavirus crisis is over.

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[1] The OpenSAFELY Collaborative, 2020, ‘Factors associated with COVID-19-related death in the linked electronic health records of 17 million adult NHS patients’. doi:10.1101/2020.05.06.20092999. [2] NHS, 2019, ‘Obesity’. Available at: https://www.nhs.uk/conditions/obesity/. [3] Dixon, A. and Peters, U., 2018, ‘The effect of obesity on lung function’, Expert Review of Respiratory Medicine, 12(9). doi:10.1080/17476348.2018.1506331. [4]NHS Digital, 2019, ‘Statisitics on Obesity, Physical Activity and Diet, England, 2019’. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2019. [5] Snowdon, C., 2020, ‘Boris’s war on obesity is a mistake’, The Spectator. Available at: https://www.spectator.co.uk/article/boris-s-war-on-obesity-is-a-mistake. [6] Nuffield Trust, 2020, ‘Obesity’. Available at: https://www.nuffieldtrust.org.uk/resource/obesity. [7] NHS Digital (n 4).