THE BLOG

Wanted: An Army of Food Friends to Tackle Obesity

17/01/2014 14:26 GMT | Updated 19/03/2014 09:59 GMT

What are we to do about the UK's weight problem? Last week the Health Secretary Jeremy Hunt called for some 'real national soul-searching' on the issue, and on Monday, a report from the National Obesity Forum (NOF) painted a grim picture.

It suggested that if current trends continue, by 2050 more than half the UK population could be not just overweight but obese, at a cost to the economy of over £50 billion a year, mainly in healthcare.

Throughout this National Obesity Awareness Week commentators have served up generous portions of blame. The food industry has been targeted by the new Action on Sugar campaign and the Government has been criticised for allying itself too closely with 'Big Sugar'.

Doctors have come under fire for not challenging their obese patients; health campaigns have been attacked for not being hard-hitting enough and Lord Tebbit, veteran politician and offence-causer, has accused overweight people of 'stuffing themselves silly with high-calorie rubbish food'.

Millions of pounds are being spent on resources such as NHS Choices and campaigns like Change4Life Smart Swaps. Yet it seems that millions of people are still not connecting the information they receive with their everyday shopping, cooking and eating habits.

A survey by Nuffield Health this week found that 39 per cent of people said they believe healthy food is too expensive, 14 per cent have no time to prepare healthy food and 10 per cent said they do not know how to eat healthily. Of the obese people in the survey, 48 per cent said they were resigned to staying that way because of lack of willpower.

So who is to fill this information and education gap?

One of the key recommendations in the NOF's report is for GPs to talk to all their patients about their weight as part of 'more proactive engagement'. But there are practical problems with this, given the ever-increasing pressures on family doctors' time.

Dietitians are the health professionals who are best trained and qualified to help people with weight problems, but they too are a scarce resource. There are only 8,342 dietitians registered with the Health and Care Professions Council and many of them specialise in acute disease rather than lifestyle management.

And is being overweight always a problem that needs attention from a trained medical professional? Clearly, patients who are morbidly obese, or who have developed weight-related conditions such as Type 2 diabetes, high blood pressure or obstructive sleep apnoea, need expert care. But for overweight people whose size is not yet threatening their health, practical advice and sustained support may be all that's required to make the lifestyle changes they need.

At a recent conference organised by the British Nutrition Foundation, Professor Gary Frost of Imperial College London noted that weight-loss methods that are shown to work in research settings typically involve regular face-to-face contact and follow-up, which cannot be replicated when rolled out into the community.

Other research has shown that regular counselling meetings in groups or one-to-one, together with advice on diet, exercise and goal setting, can help people with Type 2 diabetes lose significantly more weight than people offered advice but much less frequent support.

It is easy to see why ongoing support may be so important in achieving weight loss success. Research by Professor Brian Wansink at Cornell University has shown that the average person makes more than 200 decisions about food every day. It is very hard to make all these decisions healthy ones, when our food environment is full of high-calorie, fatty and sugary temptations.

Even with unlimited funds, it would be unrealistic for a dietitian to accompany every overweight person to the supermarket.

But is there more to be done to harness the power of peer support in the community? Has the time come to recruit an army of 'Food Friends', who would undertake some accredited nutrition training and be sent out to spread the healthy-lifestyle message to family, friends, colleagues and neighbours?

In England an ambitious precedent has already been set with the launch of the Dementia Friends initiative, which aims to recruit up to a million community-based Dementia Friends, trained and supported by a network of Dementia Friends Champions.

The Dementia Friends project is a concerted response to an urgent and immediate public health challenge, which is forecast to become more acute in future years. The obesity challenge is similar, but so far, apart from some localised projects under the Change4Life umbrella, there has been no national high-profile campaign.

Isn't it time we stopped pointing fingers over the obesity crisis, and started to do more to help people help themselves?