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Weighing up the facts about obesity

Sabrina Rafael, Analyst, ZPB Associates

Obesity is a problem across both developed and developing nations. Over half of the population in many countries are overweight or obese, leading to a wide range of health and social costs.

It is often asked, what is the single most important intervention to tackle obesity and to the dismay of most, there is not one. Obesity is the outcome of a complex system of social, cultural, environmental and psychological influences, and if we are to to tackle the problem successfully we will need to identify new approaches and interventions across the ENTIRE system, not just healthcare.

Despite positive signs in some places no country in the world has yet achieved a significant, sustained decrease in the level of obesity across the population. A good starting point however, is through addressing the drivers of what is known as the ‘obesogenic environment’ – changing the nature of the places where we live, work, shop and play to make it easier to be physically active and to reduce the consumption of unhealthy foods.

Some of these drivers include:

  1. the increased supply of cheap, palatable, energy-dense foods;

  2. improved distribution systems to make food more accessible and convenient;

  3. and more persuasive and pervasive food marketing.

Ultimately obesity is the result of people responding normally to the obesogenic environment, therefore the priority should be for policies to reverse the obesogenic nature of these environments.

Governments have largely abdicated the responsibility for addressing obesity to individuals and non-governmental organisations but the obesity epidemic will not be reversed without government leadership, regulation and investment in programmes, monitoring and research.

In recent years there has been a policy shift with the introduction of fiscal measures to reduce sugar-sweetened drinks consumption – as seen in the UK with the ‘sugar tax’. So far evaluations have shown changes in consumer behaviour in both Mexico and Berkley, USA.

Last week news outlets across the UK headlined a study which concluded Leeds to be “the first UK city to lower its childhood obesity rate” which is terrific, except it is not quite true.

The study used data points from the National Child Measurement Programme and child obesity profile on Public Health England’s Fingertips website. The study was based upon four data points, equivalent to four consecutive five-year rolling averages. For Leeds these showed a fall from 9.42 per cent to 8.58 per cent over the reported period from 2009/10-2013/14 to 2012/13-2016/17.

However, there is a fifth data point for the period 2013/14-2017/18 and this shows the prevalence of obesity in Leeds to have risen again to 8.98 per cent. This is because the single-year data for the city in 2017/18 showed a rise to a prevalence figure of 9.5 per cent in the reception age group.

Overall there is still a fall in Leeds but when you examine the figures for let’s say Newcastle, for the time covered by the published study, obesity in Newcastle, by the same measure, fell from 12.10 per cent to 11.24 per cent. And its figure for 2017/18 was 11.15 per cent.

So, between 2009/10 and 2017/18, obesity fell in Leeds by 4.68 per cent, whereas in Newcastle it fell by 7.81 per cent.

So what does this mean?

Is Newcastle the first UK city to lower its obesity rate or was the Leeds data ambiguously over-interpreted?

Either way, there isn’t currently much evidence for the obesity programme in Leeds to suggest it is working. I think, rather than encouraging an individual behaviour choice model, a non-linear system wide approach needs to be taken with robust and intense actions. If not, the burden of obesity will continue to grow not just in Leeds or Newcastle, but globally.

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