Battle of the Bulge

27 Aug

We have been going through a sharp learning curve over the pandemic.   Personally, I have become much better at navigating the internet, for instance.  Also, much as I like people, I have had assiduously to practise physical/social distancing.  Further, with the lockdown, my wife/partner and I have been growing old together, and it is turning out to be a very pleasant exercise.

However, one of the down sides of the pandemic is that people are easily bored and when they are bored, they eat.  When they eat mindlessly, they become overweight if not obese.   This plays into the hands of the Covid-19 virus, for if there is one thing the virus loves it is overweight people.

A victim has been Prime Minister Boris Johnson who had a wake-up call when he was felled by the virus and rescued by the medics at St Thomas’s Hospital who placed him in intensive care.

“I’ve changed my mind on this,” said Johnson when referring to the issue of obesity, in a conversation with some of his most senior ministers and advisers towards the end of July 2020.  “We need to be much more interventionist.  He is now leading the country in the Battle of the Bulge, which is antithetical to the stance he had been taking not so long ago when he objected to “nanny state” interventions.  We can recall the time when at David Cameron’s first conference as Tory leader, Johnson was supporting mothers who pushed pies through school railings while protesting about the promotion of healthy lunches.

In the 2019 Conservative leadership contest, he attacked the sugar tax for being ineffective and detrimental to the poor.    However, on a day in April 2020, Johnson had a blinding experience on his Road to Damascus as he all but left this planet for good.  Since recovering, he has apparently shed a stone and a half, though, perhaps, he needs to lose even more weight.

After age, obesity is the biggest coronavirus risk factor.  More than 25% of the British are obese. In South Korea only 6% are.  Is it any wonder that they have handled the disease much better than us?  A government source stated, when commenting on the ministers’ policy for dealing with Covid-19: “This virus is here to stay and we’re going to have to live with it. If obesity is the biggest driver after age, we need to be doing more right now to deal with it.”

In England, 9.6% of children in the Reception were obese in 2019.  Among children in year 6, 20.1% were obese.   In May 2017, Public Health England (PHE) published data indicating that 63.8% adults had a body mass index (BMI) of 25 or over[1] with the most overweight region being the North East where 68% were in that bracket.  Close on its heels was the West Midlands where 65.7% were overweight.  By the end of this year (2020), half of all children will be overweight if not obese.  And obesity is one of the biggest public health threats that the country is facing.  Sadly, there is a strong correlation between deprivation and obesity.

I           The Proposals

So, what are the government’s proposals? Mr Johnson is keen to promote cycling. The government is already spending £2 billion on this. It will certainly help a bit with controlling obesity and ease overcrowding on public transport.

There were other measures that he announced on 27 July 2020.

(i)         Buy-one-get-one-free deals on unhealthy products will be banned and a 9.00 p.m. watershed imposed on junk food advertising.

(ii)        Compulsory calorie labels at restaurants and takeaways, including the proportion this represents of a person’s daily intake, will be imposed over the next 12 months on all chains with more than 250 staff.

But the health campaigners do not think these measures will go far enough. Documents published in late July 2020 showed that ministers were considering extending these rules to all businesses serving food. They are considering including smaller businesses in this measure. Meanwhile, businesses are encouraged to calorie label.

While officials calculated that this policy will cost businesses tens of millions of pounds, making a total of £2.2 billion over 25 years reducing the calorie count per person by only 12, the health benefits over this time would be worth £5.7 billion to individuals and a further £4 billion to the National Health Service.

At the time of writing, it was reported that a separate consultation was to be launched on compulsory calorie labelling on alcohol bottles.

Mr Johnson said he had lost more than a stone by starting the day going for a run with his dog Dilyn. “Quite a gentle run but getting faster and faster now as I get fitter,” he said on a Twitter video.

“The great thing about going for a run at the beginning of the day is that nothing could be worse for the rest of the day. If you really go in hard, if you really take some exercise at the beginning, the rest of the day will be a breeze.”

II          An Assessment

Making it simpler for people to exercise is the easy bit. No one is going to object to more bike-hire schemes and cycle racks.  Also laying down the law on banning buy-one-get-one free for unhealthy products and placing a curb on advertising unhealthy comestibles on television and radio before 9.00 p.m. are no brainers.   Much more difficult is trying to stop people eating and drinking the things that lead to their putting on weight in homes. And price does not seem to be a deterrent.   So far, the research has shown that extending the sugar tax — a levy on the amount of sugar in fizzy drinks introduced two years ago — has had little impact.

Boris Johnson’s special adviser on health, William Warr (27), did postgraduate work at Oxford on the powerful impact of doctors telling people that they need to lose weight. Despite this, Warr’s research showed that most obese patients couldn’t remember being offered advice on how to do this by their GPs. Besides, GPs are reluctant because they don’t see it as their job or because they worry that it will hurt their relationship with the patients. One thing that is particularly awkward, but also vital, is doctors warning parents that their children are dangerously overweight. (Most parents think that their children are the cat’s whiskers.) This becomes even more difficult when some doctors themselves are overweight.

Telling people that they are too fat is an awkward enough conversation between friends, let alone between a prime minister and the voters. But as one of Boris Johnson’s longest-serving allies argues, his own waistline gives him “permission to speak”. He isn’t some skinny politician but someone who has always struggled to pass the cheese. He admitted two years ago that he had been prompted to lose weight by a doctor telling him that he was 16.5 stones. But he has told friends he was even heavier than that, 17.5 stones, when he was admitted to hospital.

Tackling obesity does not only making it less difficult to live with coronavirus (while scientists try to find a cure and/or a vaccine for the virus), but also eases pressure placed on the NHS to deal with type 2 diabetes, which costs over £5 billion a year to treat. The new slogan of government is: “Lose weight! Protect the NHS! Live longer!”

A while ago, I wrote about the problem of tackling childhood obesity, to enable us to live longer, healthier and happier lives.  I highlight the main points below.

(1)        All school and academy caterers must provide healthy lunches.

(2)        Parents insisting on packed lunches must be encouraged to provide their children with much more fruit and vegetables and much less chocolate and no crisps.

(3)        Secondary pupils should be discouraged from heading towards fast-food chains during their lunch breaks to purchase unhealthy takeaways or to the corner shops to buy – your right – chocolates and crisps.

(4)        Schools and academies must educate pupils in the Personal, Social and Health Education (PSHE) about the importance of healthy eating and how vital it is not to overeat or comfort-eat.   Meals can be both, healthy and tasty.

(5)        School and academies must go tough with pupils who bully their overweight peers making fun of their sizes.   This includes name-calling, pushing and shoving, being “out-casted” and sometimes having clothes and belongings spoiled or stolen.  This occurs during lessons, in corridors, on the playground and when travelling to and from school/academy.  Overweight children who become the butt of taunts and criticism tend to overeat to comfort themselves.

When this happens, overweight youngsters are shamed and keep low profiles.  Those who fight back are sometimes viewed by staff members as being aggressive.  Where overweight pupils report the bullying to the parents and the parents take up the cudgels on their behalf, staff members occasionally overreact with either the parents or the bullies.  This redounds on the overweight children who again take to comfort-eating enormous quantities of pizzas, crisps and chocolate.  A vicious circle!

When researchers talked to overweight youngsters, they said that sympathetic teachers and team leaders were key to helping them.   More helpful was having good friends.   Supportive folk in institutions could help overweight pupils turn the vicious circle of their engagements with peers into virtuous ones. This in turn, would help them control their appetites.

(6)        Exercising helps; regular sporting activities – even more so.  Chinese pupils start their school day with exercise.  It tones their bodies and gears them for learning.   Pupils could also be encouraged to walk or cycle to school/academy. Apart from helping these youngsters it will help the nation if there is less traffic on the roads.

(7)        Last, but by no means the least, headteachers and school/academy staff members must “walk their talk”, by keeping trim and engaging in exercise.

When the researchers talked to overweight youngsters about what they wanted from their teachers and parents to help them deal with excessive calories, they listed the following.

(a)        Talk to us as people about the health risks of being overweight, without scaring us. (I know of a case where a young person was so scared by what he was told about overeating that, to calm himself, he immediately consumed a pizza.) Do not lecture us. Support us.

(b)       Use plain English.

(c)        Be sensitive to our problems and needs.

(d)       Pay more attention to the mental health of some of us who are overweight teenagers and others who are teenagers.

(e)        Provide us with useful advice and information. Do not be condescending. Rather, be friendly and sympathetic.

(f)        Take time to listen to us and understand our needs though we know you are busy.

(g)        Do not be blunt or lose your temper as it could scare us.

(h)       Encourage us to achieve little goals at a time.

(i)         Do not bombard us with information, albeit leaflets alone may not be enough.

If we catch them young on healthy living, we will have a healthy nation in 10 to 20 years’ time, and the Prime Minister will be pleased to have achieved this objective.   We all know that he is on record stating that he lost over a stone.  But let’s look at the statistics. When he was admitted to St Thomas’s Hospital for Covid-19 on 15 May 2020 with a height of 5 feet and 9 inches, his weight was 17st 7lb, his body-mass index (BMI) was 36.2.   The optimum ideal BMI is in the 18.5-to24.9 range.   Boris Johnson is now 16st and his BMI is 33.1 – which places him in the obese category.   He must lose another 3st and 13lb to reach the top of the ideal range – i.e. 24.9.  Some way to go for the PM before he can start educating the nation.   A case where the teacher is hardly an exemplar of good practice.

 

[1] A BMI of over 25 makes one overweight.

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