NHS Says: “We Cannot Treat Our Way Out of Obesity”

The Rainbow’s SourceIf one is looking for a hint about the cluelessness of the NHS in dealing seriously with obesity, they can find a double dose in reporting on priorities of England’s 42 integrated care boards. First there is the analysis. More than 85% of those boards think obesity is not a priority for health. Two of them make no mention of it whatsoever. But even more disturbing is the response to this report from NHS itself. “We cannot treat our way out of the obesity crisis,” said a spokesman.

They seem to believe in a false dichotomy of treatment versus prevention. Choose one and neglect the other.

An Outdated Cliché

Of course, this is not a novel perspective. It guided decades of ineffective health policy in the U.S. All over the world, it leaves people with obesity having little access to obesity care. As the saying goes, “Can’t never could.”

That was understandable when the primary treatment options were relatively ineffective behavioral programs or surgery. Most people have tried diet and exercise strategies and found them inadequate. Many people flinch at the prospect of surgery. It may not be justified, but this is a very human response that comes from bias about obesity and fear of surgical procedures.

But the treatment-is-futile excuse no longer passes even the most generous credibility test. It makes the NHS sound absurdly out of touch with the biological reality of obesity.

Just “Live Healthier Lives”

Perhaps the most telling words from the NHS on this subject was the assertion that the service will help people “live healthier lives.” But that’s about it. In lieu of serious efforts to treat obesity, NHS suggested the emphasis should be to “stem it at source.”

A Lame Excuse

Honestly, this is a lame excuse for doing nothing about the most prevalent chronic disease facing England and, indeed, the world. For one thing, any serious obesity scientist will tell you there is no such thing as “the source” of excess obesity. It is multifactorial and wickedly difficult to prevent across the population. Many factors are in play and complex adaptive systems compensate to neutralize efforts to change the prevalence trend.

More important, the excuse is lame because it is no way to respond to someone with a real medical need. Would NHS ever say sorry, we can’t treat your cancer? Or heart disease or diabetes, or any other serious chronic disease?

No way. Because telling someone with cancer to go away and try to lead a healthier life is disturbingly callous. It’s just as bad to say this to people living with obesity at a time when highly effective treatments are available.

“In reality, the UK is doing very little either to prevent or treat obesity,” says John Feenie, CEO of the College of Contemporary Health in London. Sadly, we must agree.

NHS needs to get serious about obesity. So do policymakers, whose empty words about obesity are exasperating.

Click here for the analysis of NHS priorities by Future Health public policy research center and here for reporting on it from the Guardian.

The Rainbow’s Source, painting by John Henry Twachtman / WikiArt

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July 9, 2024

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