Anti-obesity Strategies

Lord Bethell Excerpts

Monday 14th September 2020 Lords Chamber

[Baroness Bull]

To ask Her Majesty’s Government what assessment they have made of the impact of anti-obesity strategies on people suffering, or recovering, from eating disorders.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, eating disorders are serious life-threatening conditions, and it is important that people have access to the right mental health support in the right place and at the right time. We carefully consider all views on our measures to reduce obesity. This includes feedback from a wide range of experts in response to our public consultations on specific policy proposals.

[Baroness Bull (CB)]

My Lords, as the Minister says, eating disorders are indeed serious mental health issues, but their relationship with obesity is complex. Many obese people also live with eating disorders, which means treatment is not always as simple as rebalancing calories in and out. Does the Minister accept the expert advice that elements of the new strategy, like food labelling and calorie counting, are dangerous triggers for eating disorders, and that slogans emphasising personal responsibility stigmatise people whose obesity has more complex roots than a failure to get a grip? Will he agree to meet with me and eating disorder specialists to discuss how this important strategy can be more effective for its intended audience and avoid collateral damage for those people for whom “Eat less, exercise more” is a dangerous message?

[Lord Bethell (Con)]

My Lords, I entirely agree with the noble Baroness that serious eating disorders are complex, and we need to resource the medical attention required by people with serious mental health issues. However, I do not completely align with her view that all obesity is not a matter of personal responsibility, nor that the education of people about the content of their food through labelling cannot be an important part of our battle against obesity. Covid has spelt it out clearly to all of us. Some 67% of the country is overweight in some way or another. But this is a policy that we are determined to get right, and I would very much welcome the opportunity to meet with the noble Baroness and her team.

[Baroness Thornton (Lab)]

My Lords, following on from the noble Baroness’s question, do the Government have eating disorder experts, including those with lived experience, advising them as part of their anti-obesity strategy? It seems to me that is one way of making sure that the messages do not disadvantage those who have eating disorders. There is a reason why advocates for those with eating disorders have been very critical of the language being used. Could the Minister commit to reviewing the campaign in light of this?

--- Later in debate ---

[Lord Bethell (Con)]

The noble Baroness is entirely right: we do rely on the advice of charities, academics and experts in eating disorders. We do not do anything without full consultation with those who have expertise in eating disorders. We review the campaign regularly, and we will be taking into account the view and feedback of those experts, charities and patient groups as a part of that review.

[Lord Truscott (Ind Lab)]

My Lords, what action are Her Majesty’s Government taking to tackle eating disorders, especially among the young, whose mental health may have been severely impacted by the current Covid-19 pandemic?

[Lord Bethell (Con)]

My Lords, the Government are committed to ensuring that everyone with an eating disorder has access to timely treatment. That is why we set up the first waiting times to improve access to eating disorder services for children and young people so that, by 2021, 95% of children with an eating disorder will receive treatment within a week. Figures show that in Q1 of 2020, 87.7% of children with an eating disorder received treatment within one week in urgent cases, and 86.8% within four weeks.

[Baroness Warsi (Con) [V]]

My Lords, I welcome the Government’s recent announcement of additional funding for community-based mental health initiatives and ask my noble friend whether the Government can ensure that their latest obesity strategy is mindful of and responsive to the underlying emotional issues, as detailed by the noble Baroness, Lady Bull. The causes are often far more complex than the Government’s current approach.

[Lord Bethell (Con)]

My Lords, I completely endorse my noble friend’s views. When it comes to mental health challenges and connections between obesity and mental health, the resources need to be put in place and the sensitivity she speaks of applied. I return to my earlier comments: 87% of the country is involved in this. Not all have mental health issues; some simply need to take responsibility for their weight.

[Baroness Parminter (LD) [V]]

The National Audit Office’s report last week on tackling obesity confirmed that there is limited evidence that calorie labelling in restaurants reduces total calories consumed. How will the success or otherwise of the Government’s proposed calorie labelling in restaurants be evaluated? Will it take into account the potential harm caused, given that the ability to track calories can be highly triggering for those with or vulnerable to developing an eating disorder?

[Lord Bethell (Con)]

My Lords, we are tracking the success of this obesity strategy, although it should be understood that this is generations in the making and may well take a while to work through. I come back to my previous comments: calorie labelling is a very important element of people’s education about the content of their food and often their drinks, including alcoholic drinks. We support that measure as an important part of our strategy.

[Baroness Verma (Con)]

My Lords, will my noble friend take into account that in the south Asian community there are larger numbers of people with diabetes, heart disease and a lack of vitamin D? Through his campaigning and communications—he has been really mindful of this—will he try to ensure that we are also reaching communities in which exercise and sport do not always come as a first priority? Is he willing to meet with me and a team of people working on this?

[Lord Bethell (Con)]

My noble friend is right, and Covid has really spelt out the challenge in this area to the NHS and the Government. The incidence of serious Covid effects on BAME communities has been more intense because of the prevalence of diabetes and overweightness in many of those communities. We have relooked at our marketing and communications to those communities and need to redouble our efforts. That is why, as part of the obesity strategy, we are putting in serious, concentrated efforts in reaching the communities, as my noble friend advised. I would be glad to talk to her about how we can do that better.

[Baroness Uddin (Non-Afl)]

My Lords, children and adolescent adults with eating disorders battle multiple debilitating physical and mental effects. Eating disorders have one of the highest morbidity rates among psychiatric conditions, causing untold helplessness and grief for families and professionals constantly struggling with a lack of adequate financial resources and services, as evidenced by Ignoring the alarms: How NHS eating disorder services are failing patients, a report by the Parliamentary and Health Service Ombudsman. In light of this report and a significant body of evidence known to health services and experts in the field, can the Minister assure the House that sufficient advice has been sought and a thorough, evidence-based risk analysis undertaken to mitigate the potential harmful, detrimental impact of the public anti-obesity campaign on those suffering and recovering from disorders?

[Lord Bethell (Con)]

My Lords, I am not sure I agree with the premise of the question. It is not my belief that the anti-obesity campaign will generate massive negative repercussions. The NHS’s work in this area has developed immensely and we are putting a huge amount of money into it, including through our mental health strategy. I support the strategy we are applying.

[Lord Rennard (LD)]

My Lords, the need for psychological support for people with such eating disorders is often identified through face-to-face meetings with GPs. Is the Minister satisfied that it is possible, in safe conditions, for people to obtain such meetings at the moment and that, if such a need is identified, sufficient psychological support is available for them?

[Lord Bethell (Con)]

The noble Lord is probably aware that a letter has been sent to GPs inviting them to step up to their responsibilities for face-to-face meetings. Everyone should have a face-to-face meeting if that is what they require and need. One of the surprising and interesting outcomes of the Covid epidemic is that many mental health services have been successfully delivered through video links. It has meant that people who may feel vulnerable about attending a GP’s surgery or mental health clinic have had the opportunity for consultations. We will look at how to expand that kind of interaction.

[Baroness Gardner of Parkes (Con) [V]]

My Lords, I have spoken to GPs about this issue. Particularly in cases of obesity—which they all agree is more common for people living in deprived areas—they say the difficulty now is that patients do not come in person to a surgery. Therefore, if someone tells you their obesity is still well under control, you have no way of assessing that. They suggested that I put it to the Government that there should be better liaison between schools and GPs, because schools see families all the time and become good judges of whether people are putting on weight. They can also provide exercise and advice on diet. GPs are willing to look after these people but say that if you cannot actually see them, how do you know that what they are telling you is the truth? What will the Government do to encourage liaison between schools and GPs?

[Lord Bethell (Con)]

My noble friend makes an incredibly thoughtful, practical point. Of course, it is easier to tell whether someone is abiding by their obesity commitments if you see them face to face. With regard to schools, I remind her about the hundreds of millions of pounds going into school exercise through the sugar tax payment. That is completely transforming exercise in schools and will have a profound effect over many generations.

[The Senior Deputy Speaker (Lord McFall of Alcluith)]

My Lords, the time allowed for this Question has elapsed.