Government forecasts
The obesity news coming from the
The public has been told that this report was based on impartial, knowledgeable experts using a rigorous analysis of the scientific evidence to bring a wider breadth of understanding of the causes and impacts of obesity. This report said it joined as many interests as possible, “to develop a shared understanding” of what the future could bring if the government doesn't act and what actions are needed. But, a closer look reveals that the predictions and proposals were based on no scientific evidence at all, and are an incredible series of assumptions, contradictions and speculations.
The Foresight Tackling Obesities: Future Choices Project report made doomsday predictions that have made all the news and don’t need repeating. The report’s “Summary of Key Messages” proposed immense governmental intervention and oversight: The obesity epidemic cannot be prevented by individual action alone and demands a societal approach. Tackling obesity requires far greater change than anything tried so far, and at multiple levels: personal, family, community and national. Preventing obesity is a societal challenge, similar to climate change. It requires partnership between government, science, business and civil society. The Foresight review, which described the justification for the report’s proposals, began by describing the Stakeholders’ working premise: Our analysis starts with the contention that obesity is caused by an imbalance between calories consumed and expended through physical activity. There was no attempt at all to examine the science or to support this premise. In fact, in sharp contrast to what the public was told (page 61 of the report) about their strategies being based on a “rigorous analysis of the evidence for [obesity’s] causation, prevention and treatment,” the Foresight Programme literature review specifically states: This paper does not attempt to explore the biological aspects of weight gain or look in detail at the future provision of medical interventions and treatments of obesity. This paper concentrates on the contention that the trend towards higher prevalence of obesity in the UK at the population level is driven by increased calorie consumption relative to physical activity in the UK’s population. So much for science. As far as the belief that they used objective sources for information, the review negates that, too, admitting: “The International Obesity Task Force appears to be the most abundantly referenced source.” Their literature review even illustrated the troubling classism prejudices behind the obesity issue, essentially working from the belief that fat people are under educated and misinformed, lower class and junk-eating gluttons; disregarding even recent British research showing the poor eat just as healthy as the general population. Instead, it said: Social trends indicate there may be continued polarisation of the population, into the junk-food eating, less-educated poor and functional food eating, better-informed higher classes. The negative correlation between education and obesity may suggest that improving education for the poorest groups is an intervention that could help reduce obesity. The Foresight review simply skipped over the science to suggest the public is in denial about the seriousness of the obesity crisis, citing an unpublished paper saying that “two thirds of overweight and half of obese people do not believe their weight poses significant health risks.” It then quoted a 2005 workshop given by professor Greg Maio (with 20 attendees) during which he talked abut the need to remove “unhealthy temptations” to change behavior because information is not enough “to make people adopt a healthy lifestyle” and make the choices that are good for them. The Foresight Programme review went on to introduce a WHO suggestion to create “national institutions to promote nutrition and coordinate health messages, policy development, legislation and taxation.” Except, regarding any evidence for the effectiveness of any interventions, they repeated several times: We found insufficient evidence of effective programmes that have reduced obesity, from which learning might be extrapolated and applied to other situations. Indeed, we were told that these do not exist. ...We have found no programmes with effective monitoring and evaluation, that show long-term obesity reduction. Never the less, modern life has created an “obesogenic environment,” according to the Foresight authors, requiring societal interventions that combine “sticks and carrots.” Their review acknowledged that the Department of Health predicted that “Government must be prepared to act and intervene more forcefully and more directly.” [I]t is possible the state could provide tax rebates for healthy lifestyles, and provide free services on demand only for the poorest... children’s BMIs measured annually at school, results sent home in confidence to their parents, with lifestyle advice, follow-up checks and referral to more specialised services... supermarkets, responding to government regulations similar to those on cigarettes and alcohol, arbitrate on which customers can buy high fat foods... ‘healthy living agreements’ between people and health providers... Robotic or electronic devices, coupled with Internet-based, interactive medimechanics and detailed individual background data, may lead to more effective personal monitoring and management of health... electronic ‘fat quota’ ration cards may keep a closer eye on obese people’s food purchases and ration specific items; it could even be used to identify overweight teenagers that should attend government-run summer fitness camps... Optimists forecast that in ten years’ time scientists will reliably and cheaply test for a thousand different genes, and foresee patients’ records available on networked metabolic and genetic databases that allow ‘cyber physicians’ to diagnose, treat and monitor patient illness in a tailored way... public acceptance of drugs as tools for tackling obesity, and the full the harnessing of computing power and genetic profiling in developing individually tailored treatment... As Dawn Primarolo, Minister of State for Public Health; Kevin Brennan, Parliamentary under Secretary of State for Children,Young People and Families; and Gerry Sutcliffe, Minister for Sport; wrote in the Foresight report’s Preface: “We will therefore jointly be acting on the findings of this project, taking a system-wide approach with Ministers across Government and with professionals and policy makers...”
The most disturbing aspects of the Foresight Programme obesity project and its suggestions for the future are found in the 42-page review of the literature that it used to base its policy proposals. It describes a future that can only be described as Orwellian. You’ll want to see what they invision, as well as just what they used as evidence.
In fact, this review was primarily a compilation of beliefs. For instance, it cites the Commons Select Committee repeating that same claim that “this will be the first generation where children die before their parents as a consequence of childhood obesity.” Yet, interestingly, the Foresight Programme review said “it is unclear whether they mean ‘at an earlier age than’ rather than ‘at an earlier date than,” but they made no effort to clarify or find any support for this claim. Nor did they review any medical research on if fatness was a health crisis, citing only that “most commentators believe the upward trend in weight is damaging human health.”
Incredibly, the review presented only one example of a government program that it suggested “may have effectively helped alter personal choice” to address obesity: the Singapore National Healthy Lifestyle Program. It was reviewed here. It included testing schoolchildren’s BMI and those who “fail” are assigned to mandatory running or aerobics programmes. The Foresight review also suggested Singapore's program of forcing overweight adults into 6 weeks of boot camp, on top of the usual 10 weeks of basic training as part of its compulsory national service.
Just what those interventions might include, according to the Foresight review, is where things begin to get really 1984:
When I can pick my jaw up off the floor, maybe I'll think of something brilliant to close with, but I can't right now.
© 2007 Sandy Szwarc
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