How to solve the
complex and wicked
problem of obesity?
The Government’s 2016 Childhood Obesity Plan doesn’t make any reference to how to help the 1 in 3 children that leave primary school with overweight and obesity, which is roughly 4.5 million children nationwide. Those most affected by obesity are often in the poorest areas. Unfortunately, the recent 2.0 version also has made no reference to this group or those suffering inequalities.
As well as their weight issues, these children suffer from a complex mix of risk factors such as social, emotional, psychological and physical, which if left untreated, leads to serious, varied and expensive consequences. Children with obesity become adults with obesity and carry a substantial life-time cost for health and social care. The expenditure required to care for those diagnosed with severe obesity is 8 times greater than that for those with overweight.
Earlier this year in May 2018, the Health Select Committee’s report on Childhood Obesity highlighted the need for weight management services and Whole Systems Approaches. These are two areas of work we are leading in nationally and are delighted to see raised.
Prevention is necessary, but it helps those that are not yet diagnosed with obesity. Obesity needs to be addressed via a range of approaches including treatment of those who need it. There are 140,000 children in the UK who are diagnosed with severe obesity. If they were adults, they would automatically be eligible for surgery. We should be treating these children now so that they do not need surgery when they reach adulthood.
We are suffering from a decade of disinvestment, led by austerity and the ideology that obesity is down to personal responsibility. We, at MoreLife, like much of the scientific community, believe obesity is a biological vulnerability to a toxic environment. Obesity is the most expensive Public Health issue yet has the least investment.
Obesity charity HOOP (Helping Overcome Obesity Problems) UK has published freedom of information (FOI) reports for the last few years and has uncovered some quite staggering statistics:
- Despite Department of Health policies, significant numbers of CCGs state that they do not consider they are responsible for tackling obesity. (2016)
- The average allocation of funds for Weight Management Services for children is £37,200 and adults is £99,925, representing 0.00005% and 0.005% of the CCG allocation of funds respectively. (2016)
- Approximately 1 in 3 local authorities is not providing any support for children, young people or adults with overweight or obesity. (2015)
The issue of obesity is a complex problem and complex problems aren’t solved with simple solutions. Systems science is the accepted tool to address complex problems and since 2015, members of our team and Leeds Beckett University have run Public Health England’s Whole Systems Approach to Obesity through Local Government, which ensures the efficient use of resources and action for those most in need.
The nub of this work is that you must engage a plethora of solutions to fix the multi-faceted (or complex and wicked) problem that is obesity. We believe that the problem with the Government’s narrative on obesity is that it’s fixed on simple solutions as outlined in their Childhood obesity plan 2.0. This is worrying and at best demonstrates a lack of genuine action on childhood obesity.
We believe that focusing on those most in need, the ones that will cost our NHS, social care and educational systems the most, need to be part of a comprehensive strategy (i.e. a whole systems approach). We are concerned that single agenda items (Sugar Tax and Marketing to Children) whilst important, are only small elements of the overall mix and their impacts on those already in need is limited (as you cannot prevent something that’s already occurred) yet they take the lion’s share of the media coverage and hence government policy.
We believe those 140,000 children who are already diagnosed with severe obesity need a voice. They need someone to champion their need for treatment. They need an escape route from a complex problem which, unless treated, will last them a lifetime and will rob them of opportunities, good health and self-esteem.