Wales is getting heavier

John Osmond ponders a mounting obesity crisis that is threatening to overwhelm the NHS

It first really hit me just over a year ago in Ebbw Vale. I was sitting on the IWA’s stand at the Eisteddfod on the first Saturday morning when, you’ll remember, the people of Ebbw Vale were invited in for free. And they responded in their droves. It seemed as though the whole town was milling past, lots of families and push chairs, everyone having a good time.

What suddenly became noticeable was the size of Ebbw Vale. It seemed as though every third or fourth person was very large indeed.  Once I’d clocked this I couldn’t stop noticing. What I was seeing was, so to speak, the statistics in action.

Wales is overweight and getting heavier by the year. In fact, Wales is the most overweight country within the United Kingdom where obesity has more than doubled in the last 25 years. More than 50 per cent of adults in Wales are overweight and around 27 per cent of us are obese. The body mass index, a measurement which compares weight and height, defines people as overweight (pre-obese) if the ratio is between 25 and 30 kg/m2, and obese when it is greater than 30 kg/m2.. The proportion of us classified as either overweight or obese is predicted to increase to 85 per cent by 2020 unless remedial action is taken.

The trouble is there’s very little sign that our policy makers have much of a clue what to do about it. In the Programme for Government published last week obesity gets a mention, but only in terms of it being just one among a number of problems that the Welsh Government wants to tackle, including smoking, teenage pregnancies and drug and alcohol misuse.

But, as health policy makers in the Government well know, obesity is a time bomb steadily ticking away with the very real prospect of undermining the NHS within ten or twenty years. A shed load of chronic illnesses and health problems accompany obesity, in particular type 2 diabetes, cardiovascular disease and some cancers. Taken together, they could well treble the cost of running the NHS within a decade unless we discover a way of combating it. Derek Wanless’s 2007 report Our Future Health Secured? A review of NHS funding and performance warned that unless further action was taken, obesity had the capacity to cripple the NHS financially. The question is, what further action can we take?

It seems to me, a layperson in these matters to be sure, that this may be the biggest long-term health issue we face. It is common across the western world, and especially in the United States where obesity has taken on epidemic proportions. Within the UK  its incidence, as I say, is highest in Wales.

Last week I attended a seminar on obesity at Tecniquest in Cardiff Bay, organised jointly with the Wales Gene Park at Cardiff University. The main focus of the discussion was the relationship of genetic inheritance to obesity. Its an interesting  question but the reality is that fewer than 5 per cent of those who are obese can blame their genes.

For the rest of us it’s simply that we eat too much of the wrong kind of food and don’t exercise enough to burn off the calories. As one of the speakers at the seminar Dr Jeffrey Stephens, a consultant physician at Morriston Hospital, said, “Too many people are eating too much food, eating food with high fat content, eating fast food, eating bigger portion sizes, eating in front of the telly, eating late at night, and drinking too much alcohol.”

About 60 people attended the seminar and as far as I could tell none were overweight, let alone obese. But, apart from knowing what obesity was and what causes it, no-one present could offer a solution. You can tell people to eat less and exercise more until you’re blue in the face but how can you make them? Pass a law to say its illegal to be fat?

Experts tell us that we live in an ‘obesogenic environment’ in which a combination of economic, social and cultural factors make it difficult for people to maintain a healthy weight. At the IWA we shall be making a point of studying all this in the coming months to see if we can come up with some new thinking.  Suggestions below, please.

John Osmond is Director of the IWA

3 thoughts on “Wales is getting heavier

  1. When I wrote this piece at the end of last week I didn’t appreciate it would be so topical, at least in terms of Denmark. Danes who go shopping today will pay an extra 25p on a pack of butter and 8p on a packet of crisps, as a new tax on foods which contain more than 2.3% saturated fat comes into force. Everything from milk to oils, meats and pre-cooked foods such as pizzas will be tartgeted. The additional revenues will fund obesity-fighting measures.

    Reporting this development The Guardian quotes Tam Fry, spokesman for the National Obesity Forum as saying, “Its not a question of whether we should follow the Danes’ lead – we have to. If we don’t do anything about it, by 2050, 70% of the British population will be obese or overweight and that would result not only in the downfall of the NHS but also of our national workforce.”

    Is this something the Welsh Government could take a lead on? Certainly it would have more impact that imposing a 5p tax on plastic and paper shopping bags.

  2. Yes indeed this is something the Welsh Government could, and must take a lead on – and Local Authorities even more so. What is needed is some vision, courage and determination. A lot to ask, I know – but serious problems demand serious solutions.

    For a start, every venue and activity run with public money (swimming pools, leisure centres etc.) should be required to actively promote healthy eating in the cafeteria areas and make sure that affordable, tasty and healthy food is always available as an alternative to the ubiquitous burgers and chips. A similar change could be made to the contents of vending machines. This would be powerful and easily achievable opportunity to contribute to a change in Wales’ food culture. As it stands, these public facilities promote junk food to children from an early age, and subtly reassure parents that such food is acceptable and ‘fun’. If this policy put an excessive strain on cafeteria balance sheets, the Government could provide a subsidy – which would cost money in the short term but lead to a saving in the health budget in the long term.

    Similarly, schools could completely get rid of crisps and biscuits on the school premises – even for special occasions! – and give children the chance to experience and enjoy the fabulous taste of fresh fruit, for example, as a ‘treat’ instead. Cooking and nutrition classes should be introduced into the school curriculum right away – as food prepared at home can be cheaper as well as much more nutritious, but many parents no longer know what to do with fresh vegetables!

    There is so much that can easily be done to have an impact on poor diet – especially with young people. Riverside Market has run numerous projects in local schools which have shown how easy it is to stimulate children’s interest in eating fresh healthy food. With our ‘Real Fit – Real Food’ project, for example, we brought medal-winning Welsh athletes in to local schools as role models to to explain to children why their fitness regime includes eating well and steering clear of junk food. The response was fantastic – with many children leaving the session highly motivated to emulate their heroes’ eating habits and promising to pressure their parents in that regard. (The irony of McDonalds and Coke sponsoring the Olympics, and the McDonalds and KFC outlets situated at he entrance to Cardiff City’s ‘Healthy Stadium’ is a powerful one – as they are promoting and selling ‘food’ that none of the actual sportspeople would let anywhere near their digestive systems).

    It really is time for the Welsh Government to bite the bullet on this issue, and put some of our money where our mouths should be. This IS ‘rocket science’ – luckily that tasty salad (along with so many other delicious local grown fruits and vegetables) is easily and cheaply available in Wales!
    (All puns intended, with apologies).

  3. The foods to tax are, first – sugar (which is useless to health)
    – trans. fats (why not ban it)
    – biscuits and cakes (make it too expensive to eat)
    – white bread and white flour
    This would be a good start.

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