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.