Globally 2.8 million people die prematurely every year as a result of their excess weight, and in Britain half of adults are now obese or overweight. Professor of Endocrinology at Oxford John Wass sets out how we can solve this pressing health problem.
Professor Wass believes that Britain has the potential to become the first country to meet the weight loss challenge
By Olivia Williams
You may recognise Professor John Wass, author of the Oxford Handbook of Endocrinology, from his television series The Fantastical World of Hormones. He is a hormone specialist, which led to his fascination with treating the modern scourge of obesity. Now he and the rest of the Obesity Health Alliance are on a mission to get our collective weight back under control.
While he does not believe in a single cure, Professor Wass is confident that Britain has the capacity to become the first country to meet the challenge. However, we are yet to spend the necessary money on intervention, he argues, even though obesity has the same economic impact as smoking, and a greater impact than alcoholism.Professor Wass, one the country's leading hormone experts, related the science behind the modern scourge of obesity
In recent years it is a crisis that has really gathered momentum. The number of obese adult British men is roughly double what it was in 1993. Then the figure was 13 per cent, now it is 26 per cent. There is also a social element to the phenomenon, with a higher prevalence among poor people, and in the north of England (11 per cent) compared to the south (8.5 per cent).
Medically, the threat is clear and manifold. The list of associated conditions that Professor Wass outlines is extensive, among them: osteoarthritis, type 2 diabetes, cardiovascular disease, a fivefold increased risk of being hypertensive, dyslipidemia, gall bladder disease, fat deposits on the liver, infertility in women, and sleep apnoea. In terms of cancer, bowel cancer is increased by 24 per cent, breast by 12 per cent, particularly after the menopause, and uterus by 59 per cent.
What to do about it
The Obesity Health Alliance, of which Professor Wass is a member, is a coalition of over 30 organisations who have joined together to fight obesity. Among them are the Children’s Food Campaign, British Heart Foundation, British Medical Association and Royal College of Physicians. They are currently hard at work pointing out gaps in government policy.
Their report Childhood Obesity: A Government Plan for Action was enthusiastically backed by David Cameron. Professor Wass thought that it would be Cameron’s legacy but he left just before it was published in August. Professor Wass and the rest of the Obesity Health Alliance are keen to keep the momentum going.
In the next year or so he hopes that the so-called 'sugar tax' will come in. He points out that similar levies have worked in France, Denmark, Finland and Hungary. It should help children in particular, he argues, as 30 per cent of children’s daily sugar intake is from soft drinks. British children consume three times more sugar than recommended, and more than any other country in Europe.
The Alliance is also working towards a ban on advertising food or drinks that are high in fat, salt and sugar before 9pm to avoid marketing influencing children’s choices. This would be operated alongside industry targets, with sanctions, to lower salt and sugar in food. Voluntary versions of this in the past have not been very successful. So measures need to be enforced, according to Professor Wass, who would like to see the industry challenged to reduce sugar in particular by 20 per cent by 2020.
Focusing on childhood obesity is a vital part of Professor Wass' early prevention angle. Nearly one third of children aged 2-15 are already overweight or obese, and 90 per cent of severely obese children go on to become obese adults. His main proposal is a joined up effort to monitor pupils' BMIs (body mass index) at school, and for GP surgeries to intervene immediately if children are found to be gaining too much weight.
In cases when obesity has already taken hold among adults, Professor Wass suggests more spending on medication and surgery. Almost every week new drugs are being tried, and huge numbers are in the pipeline. In terms of surgery, gastric banding and bypassing start to work within a few days, and only very occasionally do patients need a follow-up operation. In the UK 140 000 patients would qualify but only around 7,500 operations annually go ahead, he lamented.
In his talk, Professor Wass argued that medical leadership is essential, and that we need a more co-ordinated government effort
Professor Wass' wishlist
Individual BMI limits to be measured and documented for everyone
Food and alcohol labelling to make the nutritional value of the product even clearer
Education of both the public and doctors on nutrition and exercise
More cooperation between GPs and schools for children with weight problems
One minister, or public health committee, to coordinate between governmental departments such as health, transport, education and environment
Healthier food options within the public sector, hospitals and schools, and the NHS staff to lead by example in cutting down high rates of obesity
Children to be encouraged to do an hour a day of physical activity