Time to supersize control efforts for obesity

November 01, 2007

An apolitical, cross-departmental approach is required for the UK to tackle the obesity epidemic, and further inactivity will only magnify the consequences of the epidemic, states an Editorial in this week's edition of The Lancet.

The Editorial describes the report The Health Profile of England 2007, released on October 22, as "an unflattering account of the nation's health", and refers to the frightening statistics that obesity has increased 30% in women, 40% in men, and 50% in children in England in the past decade. 23% of adults in England are obese compared with 12.6% in other pre-2004 EU member countries.

The Oct 17 report Tackling obesities: Future Choices, by the UK Government's Foresight Programme, adds further fuel to the obesity fire, estimating that 50% of the UK population could be obese by 2050. The Editorial says: "Berating people to eat less and exercise more is futile when energy-dense foods are cheaper and more readily available than healthier alternatives, and when cities have been designed for cars rather than for recreation. More nutritious foods and healthier activities must become so desirable and readily accessible that their uptake is normal, and unhealthy options so inconvenient and unfashionable as to discourage their use."

The Editorial describes the Foresight report as defeatist since it suggests that, as contemporary lifestyles pre-dispose people to obesity, behavioural change becomes an insurmountable challenge due to barriers perceived as by-products of modern lifestyles and beyond an individual's control. The Editorial says obesity should be a preventable and reversible condition to which the population, a motivated government and a conscientious food industry can respond. It highlights the example of Finland, which once led the world in cardiac mortality but now has 94% of its 19-65 year-old population taking regular exercise, children receiving nutritious meals at school, fruit and vegetable consumption up three-fold, and where adult obesity has fallen to 12.8%.

It concludes: "This is a time to consolidate best practice -- by promoting breastfeeding, fruit and vegetable consumption, low glycaemic-index diets, and smaller portion sizes -- and to explore new interventions, which should be evaluated carefully to inform future practice…..just as individuals require initiative, time, income, and multiple interventions to overcome and obesogenic lifestyle, so too will a country's efforts require adequate leadership and resources involving many agencies."

In a related Comment, Andrew Jack, journalist for The Financial Times newspaper, UK, criticises the 162-page Foresight report as a "triumph of vapid political style and shabby prose over meaningful substance", adding: "That does not bode well for a new approach to policy generally -- not to mention public health -- under Prime Minister Gordon Brown's fledgling administration -- after the spin-led style of his predecessor, Tony Blair. This state of affairs is pitiful, as there is no doubt about the urgency of the need to reverse obesity."

Jack also criticises the UK Department of Health's communication ability and draws attention to the feeling that he and other journalists had that the report, while it had worthy aims, did not reveal much new information. He concludes: "That the UK government is paying fresh attention to the enormous challenge of obesity is welcome. But if policymakers are serious, they should start by communicating more clearly, which begins with having something meaningful to say. First, the government must translate prevaricating consultant-speak, hesitant scientists' views, and hand-wringing into action."
The Lancet Press Office T) +44 (0) 20 7424 4949 E) pressoffice@lancet.com

Andrew Jack, The Financial Times, T) +44 (0) 207 873 4106 E) Andrew.Jack@FT.ComThe paper associated with this release is available at


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