Super NHS

A UK Obesity Plan for Obesity Care in the NHS?

Anticipation is growing. A UK obesity plan is coming soon from Boris Johnson’s administration. Johnson has latched onto a conviction that Britain must slim down to fare better in the next wave of the coronavirus pandemic. It’s not a bad idea. But will it be all about inspiration and exhortation? Or instead, will it bring evidence-based obesity care into Britain’s beloved NHS?

We’ll know for sure soon enough. The early signs are encouraging.

Bariatric Surgery?

Today the Telegraph reports that ministers are preparing for a dramatic increase in the NHS capacity for bariatric and metabolic surgery. Right now, this is just talk. But if it becomes a fact, it will be a powerful signal that Johnson is serious about bringing real change.

Right now, people living with severe obesity spend years ticking boxes and clearing hurdles to gain access to surgery. These are people who will not – regardless of good intentions and wishful thinking – overcome obesity any other way. Surgery, if done in a timely way, can put type 2 diabetes into remission and yield dramatic improvements in health and life.

In fact, the hard facts of outcomes for obesity treatment tell us that it is the single most uniformly effective treatment we have to offer. No, it’s not a cheap miracle. But it’s the best we’ve got.

Even so, obesity is a chronic condition. So surgery is not a one-and-done proposition. People need good care before surgery and good long-term follow up.


There’s a lot of talk about measures to regulate food and food marketing. Fast food and ultra-processed food seems to be a target for the policy makers. Sugar, of course, is the big villain of the day. These are not terrible concepts, but healthy eating is something with a spotty history. Everyone thinks they know what it is. But population-wide initiatives for healthy eating have a very spotty record for reducing obesity.

For example, sugar consumption has been declining now for two decades in the U.S. However, all the while this was happening, obesity prevalence continued to grow. Thus, we agree with Camilla Cavendish who wrote in the Financial Times on this historic opportunity. Among other things she called for experimentation that measures outcomes to find what really works. Imagine that!

The Bias Problem

One thing gets in the way of objective curiosity about what really works. That’s bias. Everyone has strong opinions about obesity and many of those opinions start with blame and shame. Our research on public attitudes in the UK tells us that people are quick to blame folks with obesity and reluctant to accept that it’s a medical condition.

This gets in the way of real problem solving. In fact, it leads to worse health outcomes. Most people dealing with the physiological challenge of obesity have been trying to solve it “on their own” for years. Only they find that fat mass is often no more likely to shrink through the sheer force of will than a tumor mass is.

We see a glimmer of hope that the UK may be ready to move toward more evidence-based strategies for obesity. It’s quite promising.

Click here, here, here, and here for more reporting on the plans taking shape. We also suggest following #ActOnObesityNow on Twitter.

Super NHS, photograph © Loco Steve / flickr

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July 20, 2020