Saturday, 30 July 2016

"It's better for health if everyone loses a pound or two" - introducing Bradford's evidence free obesity strategy


The presentation from Bradford's public health officers began with an observation that, while obesity is a problem there was very little evidence showing which, if any, of the assorted interventions, actually made any difference. About twenty minutes later, having reviewed the full gamut of interventions without even providing even contested or limited evidence to support them, the presentation concluded with the argument that we had to do all these things (even the ones like new taxes, bans and so forth that we had no power to introduce). I guess the alternative is that we all become vast semi-mobile lard buckets for whom the only hope is very expensive bariatric surgery.

The problem is that what evidence we did actually see didn't support the officers doom and gloom. Once you'd got away from the conflation of overweight with obesity (done solely to make the problem an all-population problem rather than one for just a part of the population) we discovered the following:

1. Rates of obesity among children in Bradford had fallen for 5 year olds but remained static for 11 year olds.

2. There is a direct connection between rates of multiple deprivation - poverty in layman's terms - and levels of obesity (rates at 11 in wealthy Wharfedale were 8% whereas in poor Manningham hit 30%)

3. Although this was denied, there seems to be an acceleration in overweight in children from the Asian community from 5 years to 11 years.

It is clear to any but the ideologically blind that this requires a targeted approach for obesity combined with efforts to reduce levels of poverty. Bradford spends over £2 million on obesity interventions (that's just the council) but we've no idea whether any of these interventions are making any difference and we refuse to target the actually obese. The sheer stupidity of the policy was summed up by the strategy's 'clinical lead' (he's a GP) who, in dismissing my suggestion that we might target our efforts and actually look at the evidence, made the sweeping observation:

"I fundamentally disagree with Cllr Cooke's argument. It's better for health if everyone loses a pound or two."

The limited evidence we actually received was ignored in favour of signalling that we are "doing something" about obesity. This is despite that "something" being a strategy based on things like planning controls over fast food takeaways, fussing about portion sizes in restaurants and promoting inadequate dinners for primary school children. None of which ideas has any evidence demonstrating its effectiveness in reducing rates of obesity.

Put bluntly, we will (well not me but a majority of the Health & Wellbeing Board) agree to waste over £2 million of public money every year just to indulge an ideological, all-population approach to obesity that isn't justified by the data or supported by evidence. And if this is repeated across England that probably means over £200 million of your and my taxes spend to indulge the ignorant ideological vanity of public health. Why its not a scandal defeats me.



Anonymous said...

Public health are out of control, they need to be closed down hard and reinvented.

Unknown said...

I was born in 1931 and sort of grew up in the war years. I don't remember anyone being overweight in those days so it seems to me that the best way to go would be to re-introduce rationing!

George Speller said...

I worked at an NHS facility where there were notices on the lifts. They said "you can lose 10 pounds a year by using the stairs". This always seemed strange to me as it eas obvious that some long serving staff would disappear completely.

asquith said...

Who's going to tell the sellers of Asian sweets that we're all health-conscious & aware now, so they should cut down a bit?

Not me, I like nothing more than a trip to Regal and I don't think any health strategy or "concern" will stand in my way :)