Lori Anderson: Tackling our growing obesity issues

Diet programmes may initially help people to lose weight, but may not be the best answer to keeping it off. Picture: Getty
Diet programmes may initially help people to lose weight, but may not be the best answer to keeping it off. Picture: Getty
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For some people, every Monday is D-Day. The day for rebirth, to set out once more on that most arduous of ascetic pilgrimages, where salvation is granted by an indifferent binary god – the bathroom scale.

Diets, like gods, are eternal and now the NHS would like more of our portly neighbours to embark on one with the added assistance of Weight Watchers.

The National Institute of Health and Care Excellence (NICE, perhaps the most charming of acronyms) is advising more doctors to consider offering patients 12-week slimming courses with the likes of Weight Watchers with the state picking up the bill. NICE would like to see not only patients who are “obese”, but also those who are merely “overweight” be given the chance to shed pounds in the company of like-minded dieters.

The Scottish Government already spends £1.5 million each year funding healthy weight programmes for patients, including Weight Watchers, and considering the obesity epidemic that is currently engulfing Britain, few would argue that every option should be available.

Last week, a report in the Lancet by the Institute for Health Metrics revealed that British girls under 20 were the fattest in Europe with 29.2 per cent classified as “overweight” or “obese”. Boys were the tenth fattest in Europe with 26 per cent classed as “overweight” or “obese”.

There is much to praise about Weight Watchers and other slimming clubs. They can educate those ignorant of calories and nutrition, provide a structured plan and, most importantly, a sense of camaraderie and mutual support for what is often a lonely road. Those who don’t like public meetings can now be supported online with similar benefits.

Losing weight is hard, but once you have achieved your goal and wriggled into that new dress or successfully buttoned up the trousers on the new suit, you have a golden hour or so in the sun to enjoy your triumph and then, only then, does the real daily grind begin.

For while it is hard enough to hit a target weight, keeping the weight off is the real challenge and that is where dieting differs from other addictive habits.

Quit smoking or alcohol and you need not be met with your nemesis three times a day – unless you are really running with the wrong crowd. We do, however, tend to eat three times a day. For the person with weight issues, that’s three opportunities every day to over-indulge and that is the bare minimum, with most people adding a couple of extra snacks into the daily quota. Constant vigilance, willpower and discipline that would stretch a Spartan is required to fight back against the flab.

It is for this reason that, when examined over the long term, Weight Watchers, like every other diet or diet programme, ends in failure. When the Lancet studied 772 overweight and obese people who attended Weight Watchers, they found that 39 per cent dropped out but that on average over the course of one year the average person lost 15lb or the equivalent of 1lb every three weeks. On paper that looks not too bad, quite good in fact, but according to the British Journal of Nutrition when examined over a longer period, only 50 per cent of life-time members maintained at least 5 per cent of their initial weight loss. So, barely half managed to hang on to 1/20th of the weight they had wanted to lose. I don’t think that these poor statistics are the fault of the Weight Watchers programme, but the company does benefit financially from just how difficult a task the obese and overweight face.

I’m not sure that offering free membership to Weight Watchers or other slimming clubs will make much of a difference. If something is free, then often people attach little value to it – regardless of the cost to someone else.

In contrast, paying your monthly membership is an act of commitment that just might help you to stay the course. Yet, over-eating can be triggered by myriad social and emotional reasons – from stress to depression to learned reward behaviour – and all of these root causes need to be examined and tackled if there is ever to be any hope of a person retraining their eating behaviours.

It has also been shown that, to really break a habit, you need to replace it with a new habit, whatever that may be. It may not work for the vast majority, but the NHS is writing this script in good faith and changing one’s lifestyle is a more organic and healthy route to weight management than gastric bands and diet drugs.

At the end of the day, the costs of obesity to the national purse is now so great, around £5 billion per year, that even minor weight loss could result in a saving of both millions of pounds and lives.