Tuesday, 11 August 2020

Opportunities missed?

Readers in the UK will be aware that our government has recently- with great fanfares, bells and whistles - announced a "fight against obesity" - and yes - it was inevitable that I was going to talk about it on here at some stage wasn't it! We're told this has been prompted by Prime Minister Boris Johnson becoming convinced that his weight was a factor in him ending up hospitalised when he contracted Covid-19 a few months ago. Plenty of others have already covered the fact that there is NO reason for him to think that - so I'm not going to go into that too much aside to say that the stats do NOT back up his thinking there. 

I'm going to stick a hand up and suggest another possible reason for Boris being so badly affected though - stress. He contracted the virus but continued to work. Even when clearly pretty unwell, he was still  working including appearing on TV briefings etc. One thing we know for certain is that one of the major factors in giving people the best chance of successfully fighting off viruses is rest - stepping off the hamster-wheel of work and indeed just everyday life if they possibly can. Stress impacts on the immune system - and if we contract something like Covid-19, or even standard flu, we need our immune system to be firing as strongly as possible. This would have been a wonderful opportunity for the government to normalise people taking time off work when unwell - which surely should be a given, but let's face it, clearly isn't, in the UK at least. Ask the majority of people how having to call in sick to work makes them feel and the answer will be guilty, awkward, and in some cases downright scared. Of course most people don't want to let their colleagues and employers down, but equally we're not giving ourselves the best chance of a swift recovery if we're spending time stressing, feeling guilty and worrying whether there will be implications to being off, generally followed by feeling pressured to return to our desk before we probably should.  One thing that is going to have to change now is the reaction that some employers give to someone with a heavy cold for example - that high temperature and cough that most people would simply have worked through now is going to be something that employers should be actively insisting that people stay at home with!

Having roundly missed the chance to do something to tackle the huge amounts of stress that so many people in the UK are under a lot of the time, even when ill, instead the government has decided to play the full guilt card on those in bigger bodies.As usual it takes a broad-brush approach - referring to "people who are overweight or obese" based on BMI, rather than instead focusing on health. And using the emotive "protect the NHS" tagline - suggesting that those in bigger bodies are single handedly responsible for threatening it. (This may be a good time to mention that malnutrition costs the NHS more each year in the UK than obesity does). On a personal note the BMI approach means I am classified as overweight - in spite of the fact that I'm fit, healthy, and pretty much nobody looking at me would suggest that I need to lose weight. I'm not going into numbers here because that can be incredibly triggering for those struggling with eating disorders or disordered eating - and goodness knows there is enough in this whole campaign already that seems designed to adversely affect those people! 

Anyone who has done ANY research into diet culture should be aware by now that it is incredibly harmful - the tendency for people to "go on a diet" and lose weight rapidly (something that the Government has gone on record as saying they are looking for) only to then "come off the diet" and put that weight back on again - plus more on top quite often. That yo-yo effect has been shown to be harmful, yet currently we don't seem to be seeing anything to explain how that will be combated. It also totally ignores the other factors involved with why people may put on weight, and why they may struggle to lose weight, too. Poverty is a prime driver that may see someone eat a less nutritionally dense diet - the oft repeated fallacy that it's cheaper to eat heathily is, for many, just that - false. A single example - I buy a couple of packs of apples per week - costing me usually around £3 and providing 12 apples. Those last us - a household of 2 - a little over a week, however if we added even a couple of children into the mix, that spend might only last a few days. In comparison, a bag of 30 packets of crisps costs that same £3 and yet might see that family of four covered for snacks for a full week. Clearly in an ideal world most people consider it better to eat an apple than a bag of crisps, but not everyone has the financial privilege to enable fruit being constantly available. A bag of 5 donuts comes in cheaper than a bag of 5 oranges. A meal of salad with some protein and carbs added is going to prove far more expensive for that family of 4 than fish fingers, chips and beans, and will probably not fill everyone up as much either. It's important to acknowledge that there is absolutely nothing wrong with ANY of the foods I've mentioned here - fish fingers, chips and beans is a firm favourite tea in this house for sure - but we tend to eat that once a month as a treat, not weekly as a staple because it fits in a tight budget.We buy the crisps as well as the apples, and yep, LOVE a donut from time to time as well! All that stuff can fit perfectly well into a balanced diet - but shouldn't in an ideal world be the main components of someone's weekly diet. 

It's all well and good to ban supermarkets from doing "buy one get one free" offers on high fat, sugar or salt foods, but you also need to provide them with an incentive to instead do those offers on more nutritionally dense foods. Otherwise all you are doing is increasing the profits of the supermarkets from the shoppers who can afford to buy those "healthy" foods while isolating those whose budgets simply will not stretch. The irony here is that the government's own policy document acknowledges that those children growing up in deprived areas are twice as likely to be "overweight" as those living in the richest areas - yet they do nothing to explain how their new policies will tackle this disparity. 

You don't have to get very far through the policy document before the good old "eat less, move more" rhetoric raises it's head - again something which anyone who has done that research into diet culture knows is an over simplification. For full disclosure - on a very simple level, yes, if you take in less calories than you use in a day, then yes you will lose weight. It's the method I used when I decided to get healthier a few years ago - note "get healthier" NOT "lose weight" - and yes, it worked for me, BUT I have the privilege to be able to afford to buy nutritionally dense foodstuffs, to be able to cook my meals from scratch, possibly most of all for me to be able to educate myself about portion sizes and for some foods even use scales to educate myself what those portion sizes look like, and to be able to spare the time and afford the kit to get more active. I could chuck on running kit and go for a run after work - because when I finish my working day my time is my own, this is not true for everyone. I have cooking facilities at home - not true for everyone. I live in an area where there is a good choice of supermarkets from the mid range to the budget, and I have a car, meaning I can buy in bulk and prices tend to be fairly low. And this brings us onto food deserts - and yes, even in 2020, these DO exist! Those deprived areas we were talking about earlier tend not to be the sorts of places where too many supermarkets feel a huge urge to put their stores - and many of those living in those areas do not have their own transport to get to the larger stores further afield, so can be reliant on little local convenience stores. In turn, those stores don't have the competition that they would if they were in the town I live in for example (5 branches of major supermarkets plus 2 budget stores all within a 3 mile radius) and so there is no incentive for them to keep prices low. There is also a tendency for those sorts of stores not to stock a great range of fresh fruit and vegetables,what they do stock may not be good quality or at its best due to slow turnover, and that lack of transport may well mean that frozen is not an option either. 

There is a lot to be said on this subject - but for me it just feels incredibly sad that the focus here is all about appearance, and numbers on a scale, and that there is no acknowledgement that you can be fit and healthy while still having a number on the BMI chart that doesn't sit neatly between 18 - 25. I dislike the disingenuous references to excess weight making someone more likely to be more severely affected by Covid-19 - in a healthy individual this is simply not true. "Unhealthy" is about so much more than what someone weighs or what they look like - and this is a point that seems to be roundly missed here. So many opportunities to educate people on what healthy really means, the benefit of movement, making better choices where that is possible and also to reduce weight stigma (which in turn may well mean that moire people actually DO lose weight!) but all of them missed. 


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