Weight of words on body weight

by Prof Annie Anderson, Professor of Public Health Nutrition, University of Dundee

I have announced I will retire when all the medical students I teach know the links between obesity, diet, activity and cancer. The situation improves year on year but I am confident I will be around the medical school for some years to come. Decades go by and more and more volumes of words about obesity are written. My shelves groan with the weight of these words. When do we see meaningful action? In the last few months several reports have offered words of concern, guidance and direction but action is quite another matter.

Firstly, The Scottish Obesity Route Map (ORM) review published in October tells us that only a minority of actions in the original ORM Action Plan have been successful in reaching their milestones even where considerable effort has been made to facilitate action. Structural and environmental changes have been slow and require sustained effort. Further action is required on:

• Increasing public awareness and professional education
• Improved national leadership and accountability
• An integrated research strategy

Of the list of emerging challenges it is notable that calls are made for the NHS to be an exemplar,   helping staff who are overweight who could benefit from supportive weight management. Three recommendations are called for including dedicated support of an expert group on the topic, local action led by Directors of Public Health and co-ordination of the action taken on overweight and obesity by key national agencies. It is heartening to see that the SCPN are mentioned as one of these agencies and this means we have to do more than write words about obesity we need to find ways to harness words to action – the challenge is out.

Next up is the weighty text from the UK House of Commons select committee on Childhood obesity. A lot of this report focusses on sugar and sensibly not solely on children (given that most children live with parents who buy the food that they eat).  All of the recent reports highlight that there is no magic bullet to dealing with obesity and that a portfolio of action is needed. The nine recommendations from the select committee really make sense (in words at least).

• Strong controls on price promotions of unhealthy food and drink
• Tougher controls on marketing and advertising of unhealthy food and drink
• A centrally led reformulation programme to reduce sugar in food and drink
• A sugary drinks tax on full sugar soft drinks
• Labelling of single portions of products show sugar content in teaspoons
• Improved education and information about diet
• Universal school food standards
• Greater powers for local authorities to tackle the environment leading to obesity
• Early intervention to offer help to families of children affected by obesity and further research into the most effective interventions.

How lovely it would be to see those marketing and price promotions change but retailers can be crafty! We have watched sweeties disappearing from the till being replaced by KitKats (biscuits not sweeties so that must be ok!) and large tubs of sweeties on newspaper stands (not by the tills so that must be ok!). Retail and marketing action is really long overdue and attempts to limit more on children’s television is too little too late.