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Interesting to do the research for this editorial 'Obese and hungry: two faces of a nation' for @bmj_latest But fitting all into 750 words a challenge! Would like to share some of most striking figures/data underpinning our comments here. (1/n) https://twitter.com/bmj_latest/status/1291345813894037505
Look, obesity is complicated. The Foresight systems map illustrated this beautifully back in 2007. PHE & DHSC have a tough job & acknowledge systems approach needed. No country has 'turned the tide'. Amsterdam possibly biggest success, no peer reviewed paper yet. (2/n)
No single intervention will work, but there is ample evidence for which actions are likely to be most efficacious AND cost effective. This figure from the 2014 McKinsey economic analysis (done for UK!) illustrative. They identify 74 actions & argue for immediacy. (3/n)
A 2nd major point is obesity, particularly childhood obesity, exemplifies the *shocking* widening health inequalities in this country. For 10-11-year olds, the gap in prevalence between the least and most deprived has widened from 9% to 15% in 10 years. (4/n)
Given the strong link between SES & obesity, myself & many other scientists are *very nervous* about the causal inferences being made bet obesity & covid-19. Apart from how *unconvincing* the data are, too many fallacies systematically unpicked here: https://twitter.com/TaylorMcLinden/status/1290726190202802177?s=20 (5/n)
The inequities around obesity underpin our major concern w/current obesity plan: its focus on media campaign, referral to weight loss programmes & food labelling. These require high personal 'agency' & will benefit a select few, reviewed by Adams https://bit.ly/3ikhW5c (6/n)
Not to mention the fact that tier 2 & 3 weight management services rely on public health funding... which has been massively cut in last 10 years--upsettingly more in already deprived communities. Marmot 2020 report on health equity a sobering read. https://bit.ly/2XC1a9C (7/n)
And relates to childhood poverty, hunger & the @food_strategy 30% of UK children living in poverty. We applaud Dimbleby's calls for expansion of school food & holiday food programmes, as well as healthy start vouchers. Early nutrition essential for prevention of obesity. (8/n)
It is beyond sad that it took this amazing footballer to convince the government to feed children from the very poorest (households w/incomes less than £7400/€8200/$9700 a year) this summer. (9/n)
So yes, the new obesity & national food strategies are welcome, but more actions are required to reduce health inequalities. In addition to interesting, it was very humbling to write this report. (10/fin) https://www.bmj.com/content/370/bmj.m3084
