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Is Our Obesity Epidemic as Bad as it Gets?

29 Jul 2016

As Obesity Action Scotland marks its first anniversary, Chair Andrew Fraser discusses how to tackle the obesity epidemic in Scotland.

It is now a year since Obesity Action Scotland arrived on the scene.

A creature of the Academy of Medical Royal Colleges and Faculties in Scotland, hosted by the Royal College of Physicians and Surgeons of Glasgow and staffed by a dedicated 4 people, it has made an early and influential impact on approaches to preventing obesity in Scotland.

The unit’s lead, Lorraine Tulloch, wrote recently about Kirsty, the Holyrood Baby, a creation of Holyrood magazine. This baby has an uncertain future in an environment that encourages weight gain and seems to accept it as inevitable. This future should not be the most likely outcome for babies that we are welcoming into the world in Scotland.

Obesity and overweight is a classic Scots epidemic. It is a social phenomenon with serious health consequences – physical, mental and social. It affects the majority of the population to the extent that abnormal weight has become the ‘new normal’. While we appear to be at the worst part of the epidemic – prevalence of overweight may be peaking – the worst consequences are visited on those who find adaptation most difficult; low income, less educated people with restricted options for eating and being active while living and working in environments that make putting on weight easy.

Politicians realise the scale of the problem but the necessary actions are difficult, multiple and need to be sustained. Clinicians realise the toll it takes on their workload and their patient’s wellbeing, but don’t feel it’s their standard role to challenge and support people to tackle daily behaviour that is deeply ingrained. A large proportion of clinical staff share the problem with their patients. Manufacturers and retailers are selling us a lifestyle – the customer’s friend, plying shoppers with treats, calories we don’t need, in environments that make risks of weight gain not just optional but inevitable.

Something has got to change – well, lots of things. The ideas are there and concern is widespread. Until recently, expectations that any efforts will make a difference were very low. No longer. Obesity Action Scotland arrives at a time when consensus is building that action is essential. Already, people in the most privileged positions are taking their own paths to reduce their weight. An inequalities gradient is appearing.

Designing tactics to prevent overweight needs a broad alliance of parties uninterested in market share, shareholders and profits, but for improved public health and reduced inequalities.

Actions should include:

  • changes in laws
  • levies such as the ‘Sugar Tax’
  • re-designing our local environments so that active travel and leisure is more inevitable than optional
  • re-designing the shopping experience that leads us in the direction of affordable, healthy weekly shops instead of impulse buys

People trust clinicians. The public respects what they have to say, but community-activists also trust each other. Each one – clinicians, community leaders – is an opinion former and leader in their own right, as well as being a family member, shopper and consumer. As a community, clinicians have been at the forefront of societal shifts, most recently on tobacco. Community activism is just as potent a weapon, and their groups choose their own routes to achieve action. It’s time now for weight problems to be tackled by these groups.

Scotland, as the rest of the world, is struggling under the weight of its own creation, created with the active assistance of the food and drink industry.

It is time we designed our future differently.

Obesity Action Scotland is central to plans that make a difference – please support us and work with us as we mark our first birthday.

This article was originally published on the Obesity Action Scotland blog:

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