Westminster Bridge

A Blind Spot in UK Obesity Planning

Zaher Toumi, AuthorAny day now, we will see a new obesity plan for the UK. Some of the loudest voices in the process leading up to this great unveiling have been focused on prevention. But this is a problem that already affects 64 percent of the population in England.

In my opinion, this focus reflects simplistic weight bias. That is because such thinking does not recognise the complexity of obesity. It comes with simplistic solutions like no adverts for junk food before 9 pm.

Small Steps

All the small steps proposed for preventing of obesity may help, but they will not achieve two things:

1) A big drop in the levels of obesity within the 5 years. Perhaps we might hope for more in the long term – 20-30 years.

2) Significant help for people affected by obesity now.

Conversations about measures to prevent obesity have been bold. By comparison, the conversations about providing care to reduce the impact of obesity have been very quiet. This is unfortunate.

Bias That Will Lead to Failure

The underlying issue that any obesity plan must address is bias against people with obesity and the attached stigma. Weight bias and stigma hinder the efforts to initiate a proper strategy to fight obesity. This is because bias comes from a steadfast refusal to deal with facts about obesity. Bias and stigma make people sicker and stand in the way of progress against this condition.

Much of the UK does not regard obesity as a disease. Instead, many people regard it a matter of personal choice. Thus, the efforts to treat obesity are often discretionary and sometimes “charitable,” rather than essential services. The result is an approach to obesity care that is weak, fragmentary, and postcode dependent.

A False Choice

Obesity prevention must be the cornerstone of any forward-looking strategy to reduce obesity. A prevention strategy should have good evidence that it can work, be free of weight bias, and recognise the complexity of obesity. Because obesity is complex, its prevention is complex, too. Very likely, small and gradual reductions will come from strategies focused on long-term outcomes.

But to address our current obesity pandemic now, obesity treatment must be the cornerstone of the upcoming plan. If one considers the most clinically and cost effective treatment for obesity – bariatric surgery – the UK performs poorly. Utilization of bariatric surgery (relative to the population) in the UK is the lowest in the western world. We have only one licensed obesity medication. Furthermore, we have very few obesity care providers (physicians, surgeons, dietitians, and psychologists).


A high prevalence of obesity has made the UK more vulnerable to COVID-19. A large portion of our population is at risk because of untreated obesity. And yet, obesity is very low on the list or priority conditions for the NHS to treat. In some cases, the NHS barely even acknowledges its medical significance. Right now, as all efforts “must go to COVID first, emergency second, cancer third, everything else fourth, and obesity last.”

Thus, NHS and independent health care providers restrict and delay access to bariatric surgery. Large portions of the UK populace remains vulnerable to severe complications and death from COVID-19.

If we want a healthier UK, our obesity plan must address the health needs of people living with this condition.

Today’s guest post comes from our friend Zaher Toumi, who is a surgeon, author, speaker, and leader of the OBSMUK forum on Twitter.

Westminster Bridge, photograph © Andy Sedg / flickr

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July 24, 2020

One Response to “A Blind Spot in UK Obesity Planning”

  1. July 25, 2020 at 10:39 am, Fernando Pérez Galaz said:

    This problem is not exclusive to the UK. In Mexico we have the same issues regarding obesity bias. The Government recently initiate a campaign against obesity, but it shows the typical images of a overweight individual struggling to get on a bus. This bias comes from the Health ministry! He publicly said that obesity is reponsability of the individual who consumes sugar beverages and junk food!!!!