Why the UK Government is Getting it Wrong on Obesity

The Guardian recently reported the UK Government is planning to launch an “emergency drive” to reduce obesity rates in anticipation of a second Covid-19 wave later this year.

There’s concern Coronavirus disproportionately affects overweight and obese people. According to the article, the Government programme will be “based on encouraging people to reduce their calorific intake and lose weight rapidly”.

If accurate, the UK Government is acting on a dangerously incorrect assumption – that obesity is purely a physiological, rather than a psychological, issue.

It’s a mistake that’s made often.

It’s now widely understood there’s an eating disorder which involves seriously undereating for psychological and emotional reasons (Anorexia). However, it seems hard for many to accept there’s also an eating disorder that involves seriously overeating, again for psychological and emotional reasons (Binge Eating Disorder).

If you’re suffering with obesity, the general view is it’s your fault for being greedy and you should just stop eating so much. Either that or you’re simply ignorant about how to eat healthily. Few people stop to think you might actually have an eating disorder.

Researchers Julia Buckroyd and Sharon Rother estimate the eating behaviour of almost half of the obese population is emotion-driven.

If 13 million adults in the UK are considered obese, that’s a significant subgroup.

And it’s this subgroup, many of whom will be battling with Binge Eating Disorder, which is in serious jeopardy with the introduction of any knee-jerk government weight-loss drive in response to the Covid-19 crisis.

It’s not just the Government letting down people struggling with emotion-driven overeating and obesity. An exploration of the NHS website also reveals a lack of joined up thinking.

In the section devoted to eating disorders, there’s an acknowledgement of the link between dieting and Binge Eating Disorder with the warning: “You shouldn’t try to diet while you are having treatment [for Binge Eating Disorder] as it can make your binge eating worse”.

On the same website, you can find reviews of “Top Diets” which include evaluations from the British Dietetic Association. However, there’s no equivalent psychological evaluation about the danger of dieting, especially if you binge eat.

If the NHS understands dieting can make binge eating worse, why is there no warning on the page about dieting for people with potential BED?

The NHS website also states: “many fad diets are based on dodgy science or no research at all, prescribing eating practices that are unhealthy and can make you ill” and “most do lead to fast – sometimes dramatic – weight loss, but only for the pounds to creep back on again at the end of the diet”.

This is true.

So why is the UK Government considering launching a rapid weight loss programme – surely the very thing the NHS is warning against?

The Guardian reports the Government is planning to enlist the help of organisations such as Weight Watchers in their “war against obesity”. Weight Watchers has “reimagined” itself in recent times, with more of an emphasis on “wellbeing”. However, they’re still a diet and weight loss programme.

On their website, under the heading “Health and Safety”, the organisation prohibits the participation of “individuals who have been diagnosed with or treated for anorexia nervosa or bulimia nervosa in the last year”. However, there’s no mention of BED, or the potential harm to those suffering with this serious psychological illness if they participate in the programme.

Is it that Weight Watchers haven’t heard of Binge Eating Disorder? Or do they deliberately exclude it? And why would the Government partner-up with an organisation that – either intentionally or unintentionally – fails to demonstrate responsibility to people with BED?

It’s the failure to join the dots in this way that’s costing people suffering with BED and obesity dearly.

The NHS website clearly states “If they think you may have binge eating disorder, your GP should refer you to an eating disorder specialist or team of specialists”.

Unfortunately, such is the lack of awareness around BED, if you go to your GP concerned about binge eating and weight gain, you’re more likely to be given a free pass to Slimming World, rather than a referral to an eating disorder specialist.

Sending people with Binge Eating Disorder to Slimming World is like prescribing cigarettes to patients suffering with lung cancer.

The Guardian quotes a Government official who says they need to think about longer term strategies for obesity.

Absolutely right. But I doubt we’re on the same page as to what that looks like.

• We need a well-thought out plan of action to help people with suffering with emotion-driven overeating and obesity.
• We need a screening system to recognise and diagnose people struggling with Binge Eating Disorder and other disordered eating.
• We need appropriate psychological interventions to help these people resolve their issues, rather than weight loss initiatives that will only exacerbate them.

We also need to get rid of the BMI, diet culture and the obsession with thinness – but that’s a whole other blog post.

Obesity is a serious health crisis but it’s also a serious psychological crisis.

If we address the psychological implications effectively, we stand a good chance of genuinely helping people.

We stand a good chance of improving their emotional, psychological and physical health.

And we stand a good chance – for once – of getting it right on obesity.

©️ Julie de Rohan 2020.

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Reference

Buckroyd, J. and Rother, S. (2008) ‘Psychological Group Treatment for Obese Women’ in Buckroyd, J. and Rother, S. (eds.) “Psychological Responses to Eating Disorders and Obesity”. Chichester: Wiley.