A 10-point plan to deal with meddling medics
It’s not obesity that requires urgent action, but the rising tide of miserable public-health busybodies.
Today’s top story on BBC News, the Guardian and Sky News, among others? Some self-appointed members of the medical profession have, after the best part of a year examining what should be done about the ‘obesity crisis’, provided a 10-point action plan of all their pet policies. This is news?
These groundbreaking ideas include: an ‘experimental’ one-year, 20 per cent tax on sugary drinks; limits on fast-food joints near schools; talking to overweight patients at every appointment about their weight; more weight-management programmes and bariatric surgery (both funded in part by that fizzy-drinks tax); hospitals, and schools that are currently exempt, to have the same nutritional standards as local-authority schools; health visitors to advise parents on how to feed their children properly so that their kids don’t get hooked on sweets; a complete ban on TV advertising of foods high in fat, salt and sugar before the 9pm ‘watershed’.
In other words, busybody medics, who love the idea of getting stuck into our lives through taxation, regulation and medical intervention have concluded that what we need is an increase in taxes, regulation and medical intervention. This is an even bigger non-story than the ‘horsemeat scandal’.
The Academy of Medical Royal Colleges (AoMRC), which produced the new report, is, in theory, a ‘united front’ of the British medical profession. It includes organisations representing surgeons, general practitioners, psychiatrists, paediatricians and so on. According to its website, it began in 1974 as the Conference of Royal Colleges and Faculties. It had 16 members who met quarterly to discuss policy related to doctors and the welfare state, had ‘no full-time officers, no permanent home and a negligible budget’.
By 1996, the website tells us, things had started to get more serious. Now it had two full-time employees and had adopted its current name. Now it has 10 full-time employees, 21 permanent members and aims to provide ‘a clear and sure voice on generic healthcare issues for the benefit of patients and healthcare professionals’. In other words, like everything else in the government-lobbying world of public health, the AoMRC is part of a growth industry.
Yet a short conversation I had yesterday with one of the doctors involved in writing the report put the whole notion of representing the medical profession into some perspective. Dr Aseem Malthotra is a cardiology registrar who, over the past couple of years, has become something of a go-to guy for the Beeb and Guardian on the issue of obesity. Malthotra basic shtick is simple: the food industry is selling us sugary, fatty junk that is killing us, all in the name of greed and profit. His worldview is downright conspiratorial. Hence, tweets like this yesterday: ‘Unfortunately our dietary advice is also co-opted by the food industry who promote the cheapest poor quality products for profit #OBESITY.’
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However, when I tweeted back at him that the medical profession had some responsibility, given that the drive to produce sugary but low-fat foods was in response to official advice, Malthotra replied: ‘Most doctors knowledge about diet & nutrition comes from what they see on TV or read in magazines! #EatRealFood.’ So, if most doctors frankly haven’t got a clue about diet and nutrition, how can this report be sensibly described as ‘representing’ their collective views? And why should we accept the endless nagging about our weight - already implemented by most medical professionals I’ve had contact with - from people who don’t know what they’re talking about?
Nonetheless, in the spirit of debate, here are 10 short responses to the AoMRC report:
- What obesity crisis? Obesity rates have actually been remarkably steady over the past decade in the UK. According to the Health Survey for England, the adult obesity rate rose from 22.6 per cent in 2003 to 24.5 per cent in 2008. After an odd blip in 2010, the rate in 2011 was 24.8 per cent. In other words, the rates have hardly changed. Among children, obesity has, at the least, been steady, too, and may even have been falling. This trend has been repeated across the developed world, too.
- Life expectancies have been going up steadily, despite this apparent obesity disaster, with people living eight years longer today than in the 1970s. If we’re not all dropping like flies - in fact, quite the reverse - what justification is there for claims of an ‘obesity timebomb’?
- Fizzy drinks, and all that other apparently unhealthy food and drink, are already subject to a 20 per cent junkfood tax - it’s called VAT. Soda, salty snacks, chocolate and the rest are subject to VAT; fruit, vegetables and other foods are not.
- As it happens, most people would agree that sugary foods and drinks are mildly bad for us (though not ‘toxic’ as some have claimed). Adding further taxes to sugary drinks will have a limited effect on consumption - people will switch brands or spend less on other items, for example - and an even more limited effect on health.
- There’s also the small matter of what such taxes would apply to: would it include fruit juices, which are just as sugary as fizzy pop, but also count as one of your ‘five a day’?
- The idea that nag-happy doctors, midwives and health visitors could lecture people more about their weight than they do already is simply preposterous. There is a serious danger that the haranguing will get in the way of actually treating people for the problems they have come to have treated - or, worse still, discourage people from seeking treatment for fear of another lecture.
- Before hospitals start trying to provide healthy food, they might start by trying to offer edible food consistently and making sure that patients with difficulties actually eat it.
- The UK already has an advertising ban for TV programmes predominantly aimed at children. The failure of this ban has not led campaigners to question the merits of such bans, but to seek to expand them. Like the stereotypical obese person, anti-obesity campaigners are never satisfied.
- There are already too many local authorities who have taken it upon themselves to impose restrictions on takeaways on the basis of health concerns. Presumably, local planning officers are even more badly informed about diet and nutrition than doctors, so what business do they have telling shopkeepers what they can sell and where?
- We should stop obsessing about obesity. Whatever the health effects of carrying a few extra pounds - which seem to be pretty limited for the majority of the population - the authoritarian, lifestyle micro-managing reaction to obesity is far worse. It has distorted doctor-patient relations, justified the denial of much-needed healthcare for obese patients, limited free speech (yes, advertising is a free-speech issue), led to children being taken from parents, and been used to guilt-trip us all about each and every morsel of food we consume.
We certainly do need urgent action: to get the government, health campaigners and megalomaniac medics out of our lives. Something Must Be Done.
Rob Lyons is deputy editor of spiked. His book, Panic on a Plate: How Society Developed an Eating Disorder, is published by Societas. (Buy this book from Amazon (UK).) Read his blog here.
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Sonoview, 21 February 2013 11:49
“The idea that nag-happy doctors, midwives and health visitors could lecture people more about their weight than they do already is simply preposterous”
Rob, but this is now the whole culture of the NHS - top-down, command-and-control, target-driven, name-blame-and-shame, tick-box ticking!
Massive external regulation has spectacularly failed in Mid Staffs, but what is the proposed solution? Yet even more externally imposed regulation.
Spiked is not the place to get too theological but St Paul summed it up perfectly (letter to Romans). He makes the point that “the law” i.e. imposed rules and regulations, can limit (regulate) evil to some extent, but it cannot make people good! What is required is a change of heart.
The AoMRC have got it completely wrong, as you state. Better ways must be found to encourage people to live a healthy life style, and if they chose not to then so be it!
(I am a doctor)