Obesity

Jim Shannon Excerpts

Wednesday 9th November 2011 Westminster Hall

[Mr Gregory Campbell (East Londonderry) (DUP)]

It is a privilege to speak under your chairmanship, Mrs Riordan. I am delighted to have secured the debate. I have come to notice, particularly with health-related issues, that an hon. Member may think they are well informed on a topic when they succeed in securing a debate, but once they have succeeded in securing it, the administrative back-up kicks in and all the groups involved start supplying them with significant amounts of promotional material, and they are even more well informed by the time the debate arrives. I thank all the groups involved with this issue for providing me with information.

Sometimes it is wise to start a very serious debate with a slightly humorous anecdote. I am reminded of the overweight gentleman who was sent along to his local well man clinic by his wife, as men are wont to be. She instructed him to go to the well man clinic and to come back with precise instructions on what he was to do to lose weight. When he came back with a smile on his face, his wife said, “There’s something wrong here. What exactly were you told?” He said, “Well, I’m exactly the right weight—for someone who is 7 foot 8.” Unfortunately, that encapsulates part of the problem.

A sedentary lifestyle is not only costing those members of society who are overweight very dearly; it is costing all of us exceptionally dearly. From the correspondence that I have had and my own research, it appears that obesity currently costs us—depending on whom we believe—between £4 billion and £7 billion a year directly and indirectly. Whichever figure is right, the reality in 2011 is that we are talking about an exceptionally expensive but preventable series of conditions. The situation is bad at the moment, but unless we take radical steps and measures, unless we do something fundamental—I will come to that later—the rates of obesity are likely to double in the next 30 years.

Currently, almost one third of children are overweight, so obesity is not a condition that is the preserve of either the elderly or the middle-aged. All of us in society, right across the age spectrum, are being affected. Only 20 years ago, people who visited America—perhaps somewhere such as Florida—would come back here and say, “The United States has a terrible obesity problem. Thankfully we will never be like that.” But we are, and things are likely to get worse.

For example, 25 years ago, about three quarters of schoolchildren walked or cycled to school; now, less than 10% do so. When giving that figure, I take into account the fact that there have been lifestyle changes, school closures and so on, but the fact remains that there has been a significant increase in sedentary lifestyles. There has been a change in attitudes. The unfortunate reality is that more and more of us are spending more and more time at desks, in front of computers. Many people become couch potatoes—unfortunately, that analogy is all too accurate.

I will give another statistic to show how things have got considerably worse. In the early 1980s, roughly 7% of the population were classed as overweight. That ratio has trebled in the past 30 years. We can see the trend. It is likely to double again in the next 30 years. We must get to grips with a problem that, as I said, is proving exceptionally expensive for us all.

Obesity is linked to socio-economic deprivation. The figures that I have been able to establish indicate that the ratio of children in lower-income households suffering from obesity is twice that of those in higher-income households. Again, we see the repetitive nature of the problem, the cyclical response that is indicative, because many obese children are, unfortunately, the children of either one obese parent or two.

Of course, we all know of the additional and subsequent health risks associated with this condition. We are all aware that heart attacks and strokes, coronary artery disease and type 2 diabetes are much more likely among the overweight. There is an additional cost further down the line, in years to come, as people who begin to be overweight today begin to show the symptoms of those other conditions only in years to come and then of course have to be treated by the NHS.

[Jim Shannon (Strangford) (DUP)]

Type 2 diabetes is one of those hidden diseases that some people do not know they have. The indications are that there will be a 50% increase in the number of diabetics in the next couple of years. Does my hon. Friend believe that diabetes itself needs a direct Government plan in order for that issue to be addressed, because it is a hidden disease that can kill?

[Mr Campbell]

I thank my hon. Friend for that intervention. I hope that the Minister will respond to it. I want to come on to some of the things that Health Ministers throughout the United Kingdom—in the devolved regions as well as here—can do to deal with the issue, but my hon. Friend’s point is certainly well made.

Having diagnosed the problem, as it were, I want to consider what is being done. It is not all negative. A considerable series of measures is being taken, not just nationally but locally. Various councils, various health trusts in Northern Ireland and other bodies are actively engaging in trying to come to terms with the problem. Many programmes that promote healthier food choices are being actively promoted. I am aware of the healthy eating awards, and of course we are all aware of the food labelling issues that have come to the fore in recent years. There have been other programmes aimed at reducing the salt, sugar and fat in some foods. All those things are creating greater awareness among the wider community, but we are fooling ourselves if we think that the measures currently in place will arrest the problem.

I will turn at this point to what needs to be done now and for the foreseeable future. Obviously, the fast food industry is a key player in relation to the problem. Some people in that industry are quite responsible. Some have responded to the campaigns driven locally and introduced more healthy eating options—they are to be commended for doing so—but some have not. We need to see best practice not just nationally but internationally being analysed and then promoted, so that we can see significant progress.

At the moment, there is—certainly in Northern Ireland, and I assume across the UK—a better educational approach in schools. Our young children, particularly primary school children, are now getting information that simply would not have been proper protocol 25 years ago. Many people then would not have even seen the need for primary school children to receive that type of education. That is changing, but again, more needs to be done to increase awareness. We have all seen issues where, for example, healthy eating has gone wrong. Sometimes we see photographs in newspapers that show parents queuing up to give other types of food to children because healthy eating standards have gone awry. We need to ensure that the whole educational process about healthy eating for children is properly assessed and rationally implemented.

When we ally the fast food sector—I do not want to name any of the organisations—with a sedentary lifestyle, I think we can account for 80% to 90% of the obesity problem.

[Mr Campbell]

I agree with that; I was just about to come to the issue of exercising. I love walking, and when I get the time to walk, as I try to weekly, I despair at the rarity of seeing other people walking and exercising.

[Jim Shannon]

Surely, my hon. Friend does not just walk; he marches. When someone marches, they lose more calories, and I understand that he marches often.

[Mr Campbell]

I thank my hon. Friend for bringing us back to basics with a Northern Ireland and Scotland perspective on that. That is true.

I do despair when, for example, I see very few people exercising between October and March or April, and even fewer children.

--- Later in debate ---

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I am grateful for the opportunity to contribute to this debate. I will not speak for very long, but it is worth highlighting some of the issues that have been raised in a comprehensive way. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this debate.

Obesity in the UK is a growing problem. In 1993, only 13% of men and 16% of women were obese, but in 2009, 22% of men—and 24% of women—were obese, which represents almost a doubling of the number of men with obesity. I am not talking about people with a body mass index of between 25 and 30, which means that they are overweight; I am talking about obesity. Almost a quarter of the UK population is obese and I am sure that we all find that unacceptable.

How can we deal with obesity effectively, because whatever previous Governments have done, obesity has not been addressed in a way that has worked or has been effective? First, I will briefly outline how Government policy is moving towards more community-based interventions on obesity, and I will explain how that approach, through the health and wellbeing boards that will be set up under the health care reforms, will be effective and work well. Secondly, I will talk a little about nudge theory, because I am more hopeful and optimistic about it than my medical colleague, my hon. Friend the Member for Totnes (Dr Wollaston). There is good evidence elsewhere, particularly in Iceland, that it has worked, and I hope it will also work effectively in relation to obesity.

[Jim Shannon]

While the hon. Gentleman is giving us his thoughts, and given his experience in his previous job, will he comment on gastric band operations? Just two weeks ago, I had occasion to visit the Northern Ireland Health Minister, Edwin Poots, with some of my constituents. These people had tried everything to lose weight; they had tried dieting and exercise—some of them were not able to exercise, which was the other problem—but they had clear medical and health problems. As a last resort—this really is the last chance saloon, or the last chance restaurant, perhaps—should regions and Health Ministers set aside money specifically for gastric band operations?

[Dr Poulter]

We certainly have to look at how the Government can help people to take more responsibility for their own health care. That is fundamental to obesity issues, and it is a particular challenge in more deprived areas. People often require gastric bands at the point where the medical problems associated with obesity—diabetes, the risk of heart attack or stroke, or high blood pressure—pose a potentially life-threatening risk. Such people may not have that long to live if a gastric band is not put in place, so it is the only feasible mechanism for dealing with obesity in such cases. Gastric bands have been shown to be an effective mechanism for looking after that part of the population, and there is good medical evidence to support their use. There is also good evidence in terms of the health care economics, as helping people to become slimmer will lessen the burden on the NHS.

The gastric band is good for the patient, because their health improves dramatically when it is used effectively, but the challenge with obesity is to bring about long-term lifestyle change, and the question with gastric bands is whether they necessarily deal with long-term lifestyle changes. In a medical sense, there needs to be greater emphasis on the education that goes with the bigger issues around obesity and lifestyle at the same time as the gastric band is fitted. I hope that that helps to answer the hon. Gentleman’s question.