The missed opportunity for Better Health

The missed opportunity for Better Health

Sarah Grant
Healthy eating, Public health policy, Health at Every Size

Last week the UK government announced its New Obesity Strategy and launched PHE’s new Better Health campaign, a COVID-related national weight loss programme.

Whilst I’m supportive of strategies to optimise community-wide health, the frightening message at the core of this campaign is that those people who are in overweight/obese BMI categories (so that’s two thirds of the UK population) need to take stock of how they live their lives in the throws of the COVID-19 pandemic.

Here I explore the flaws of this weight-centric campaign as I see them, and provide some perspectives on how as individuals we can approach our health and wellbeing in a more balanced and personal way.

Why is the government targeting weight? 

Public Health England’s Better Health campaign, with its major focus on weight loss support, spring-boards off the premise that body size is a risk factor for hospitalisation and mortality from COVID-19. The thing is, despite some powerful headlines based on biased and misconstrued presentations of the data available, to-date there is NO convincing evidence to suggest that high weight is an independent risk factor in and of itself.

Whilst we know nutrition and lifestyle play an important role in overall health and our immune systems, we’re really only just starting to understand the specific contributing factors surrounding the severity risk of this virus. And one thing for sure is that health, immunity and resilience is multi-factorial.

What’s more, no evidence exists to suggest a weight loss diet is a form of prevention or cure for COVID-19 or any other infectious disease. If you want to learn more about the virus and weight, I really recommend checking out the links and resources at the bottom of my blog.  

Over the last few decades multiple correlations have been drawn between obesity and chronic diseases including type 2 diabetes, high blood pressure, high cholesterol, heart disease and several cancers. Whilst the rise in these conditions is pressing and concerning, always interpreting the correlation with weight as the definitive cause is bad science. Weight is typically a ‘symptom’, not a cause. But the weight blame game has filtered into the public psyche and society has become very accustomed to the idea that fat = unhealthy/health risk, and therefore slim = healthy. However, the reality is the science of our inner workings is far more complex than that (definitely the topic for another blog!).

The problem deepens further as when we work on the simple assumption that fat = unhealthy/health risk, and slim = healthy, then reducing obesity rates becomes the major target for public health action and the “obvious” solution is obesity management and prevention measures – and weight loss diets – exactly the trap into which the Better Health campaign has fallen.

Dieting isn’t the answer

If we believe that the government is well meaning in its efforts to improve the health of the nation and protect us from COVID-19, the irony of the Better Health campaign is the prevailing single-minded and misguided focus on weight status as a health outcome, may ultimately take many people away from overall health and wellbeing, and not towards it.

Whilst I believe that certain aspects of the campaign such as plans to ban junk foods inline with the 9pm watershed and to restrict BOGOF (Buy One, Get One Free) deals relating to foods that are ultra-processed, high in salt, fat and sugar and their availability at check-outs, are positive steps, other measures, such as adding calorie counts to menus and the development of the NHS weight-loss programme are deeply problematic in my view, for multiple reasons.

The pitfalls of driving the nation’s diet mentality and calorie counting

Like the NHS weight-loss programme, most ‘one size fits all’ weight loss plans and diets are geared to promote mass weight loss, not individual health. These plans are generally distinguishable by their promotion of calorie reduction/counting, counting points (based on calories), measuring macros, or the removal of whole food groups. I cringed at one story in The Times at the weekend - the headline read ‘Why Britain needs to go on a diet: how-to guide to lose weight’ and went on to promote one doctor’s (guilt-inducing) 800 calorie plan with a long list of do’s and don’t eats.

As my professional body, British Association of Nutrition & Lifestyle Medicine (BANT) explains here:

“BANT is, (however,) against the use of calorie counting as it is well established that calorie counting is difficult to manage in supporting people looking to lower their risk of obesity. Calorie counting takes little to no account of the nutritional values of different foods and their relation to health and is problematic for those at risk of eating disorders. Not for the first time BANT is asking “why promote a campaign that leads the population to rely on calorie defined processed foods, rather than simple, wholesome ingredients?”. BANT is looking forward to the outcome of work done on traffic light labelling system. The current system has some shortcomings, for example, in that a red label can be assigned to a healthy food e.g. an avocado, making it confusing to the public.”

And this is just one reason why, for me, the big commercial weight loss organisations, such as Weight Watchers and Slimming World (which are based on dietary restriction and rules, but incidentally are both trying desperately to convince their fans that they are lifestyle plans not diets) are in my view also ill-fitting solutions to the nation’s real health challenges.

What’s more, even if it turned out that BMI is a legitimate risk factor for COVID-19 (which as I’ve already remarked is highly unlikely to be the whole story), an overlooked and uncomfortable fact is that it is very difficult, if not impossible, for most people to change their BMI. Evidence from long-term studies reveals that the possibility of an obese person achieving ‘normal’ weight is close to zero and maintaining weight loss is rare.

Weight loss interventions and advice may seem harmless, but ironically restrictive approaches for many can trigger cravings, weight cycling and result in regaining lost weight, plus more.

The risk of sacrificing overall health for weight

Arguably more troublesome still are the effects of weight focus and diet mentality on overall mental health and wellbeing.

Even those programmes and plans that are well-meaning can be damaging to some people’s relationship with food. Obesity has become a dirty word and fear mongering around weight and fat shaming people into action around their lifestyle fuels body dissatisfaction, is known to be stressful, is certainly not empowering, and in itself is linked to increased emotional eating and a raft of eating disorders.

So how can we work towards real health and wellbeing 

We need to stop heralding weight loss as the ultimate health goal.  And we need to ditch the diets that disregard much of the evidence around weight and weight loss and leave us feeling depleted and disappointed with ourselves.

There is ample research evidence to show that health markers can be improved regardless of weight loss occurring. We need to make health our focus and trust our bodies will find their own healthy natural shape and size along the way.

And we need to address health behaviours meaningfully, holistically, without obsession, and individually, where possible within people’s means.

In my own practice, I tried for a number of years (with all the best intentions) to marry weight loss tactics with health in my personalised programmes and plans, and whilst many of clients would get the physical results they desired, for many others the troubling effects of diet mentality and body dissatisfaction dominated our efforts.  

This is why in recent years I’ve taken additional trainings in Intuitive Eating, Acceptance & Commitment Therapy, and Psychological Approaches to Obesity so, rather than fuel any bubbling disordered eating habits, I can really help my clients rebalance their relationship with food, help them prioritise health - mental and physical, and move towards freedom from food and body image concerns. And it’s why I quickly shifted away from prescriptive eating plans towards a focus on balanced, ‘gentle’ nutrition guidance.

Consider your own health and what really matters when it comes to your physical, mental, and emotional wellbeing. Are you honouring or prioritising your health in a way that feels good for you?  

In answering this it would be perfectly natural, given our preoccupation with body shape and size in today’s society, for your mind to immediately default back to your weight. The latest COVID Symptom Study app research reveals almost a third (29%) of those surveyed gained weight since March 2020 with possible contributing factors including increased snacking and alcohol consumption, decreased levels of physical activity and a less healthy diet.

If this is you right now, you may be feeling disheartened and anxious. You may already have troublesome health conditions. And it’s perfectly normal given our societal influences to desire to lose weight. But does this mean that following the misplaced guidance of the government’s weight loss diet is the solution?  

Hopefully you will understand now why I believe not. And why instead I recommend shifting your focus back to your wellbeing at large, developing your self-compassion, listening to your own intuition around your body, and taking mindful, committed action towards your self-care and the healthful, enjoyable lifestyle you really want.

And, if you are you are feeling really stuck in your habits, are struggling with emotional eating or other anxieties around food and your body, please know that support is available.

Next steps

Would you benefit from discovering how to put your mind and body health and wellbeing first? Please check out my Reconnect programme here:

Or contact me for a complimentary 30-minute ‘Making & Breaking Eating Habits’ session:

Resources and references:

Other Gut Reaction blogs which may be of interest:

The immune system & how the colour red can help protect yours

The immune system & how the colour red can help protect yours
Are you a prune or a plum this summer?

Are you a prune or a plum this summer?

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