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Connection Between Obesity and Environment

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Introduction

Currently the NHS spends 5.1 billion a year due to health-related issues caused by obesity in England 1 and the costs to society and businesses are likely to reach £49 billion per year.Obesity is a huge concern economically as it leads to more sick leave and premature death. These figures show what a big burden obesity has within our society and that we should be tackling obesity with interventions to create a safer and more secure future for our society. Many interventions have already been put into place both targeted at individual behaviour such as the program change life and at the environment in which people live such as an increased number of cycle lanes. Decisions need to be made about whether interventions should be targeted at the individual or at the environment to appropriately allocate the money that is spent towards obesity interventions efficiently.

Environmental changes are more likely to create a beneficial change as a society by creating change for everyone, but other factors such as psychological and economic factors that widely effect the environment and the increase in obesity also need to be addressed. By targeting interventions at the environments in which people live our society will receive a wide range of health benefits and by promoting a healthy society through interventions such as the sugar tax, we will not have to worry that the effects will be short-term. Tackling obesity is important because the healthier people are, the less amount of money will be spent on obesity related illnesses, such as diabetes and strokes and more money can be spent on life saving research, treatments, and more medical staff.

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Main body

A lack of energy balance and an active lifestyle is two of the most known causes of obesity3 which has encouraged the introduction of individual interventions such as change 4 life which encourages families to have a healthier lifestyle. With interventions being targeted at individuals, people can make their own decisions about their health, it provides people a sense of free will which can possibly cause more long-term change, as the individual will have changed habits themselves. Change for life offers healthy recipes for free and ideas on active games for kids that target the two most well-known causes for obesity. In a 2012 cluster-randomized trial evaluating change for life’s effectiveness in the UK, awareness increased significantly in the intervention group but only 37.6% of families completed follow-up questionnaires and data, decreasing the validity of the increased awareness as the study was unable to obtain the 62.4% follow-up questionnaires and data from the families.

People who continued to use change for life saw a difference in their awareness but getting families to continuously use change for life is difficult which is evident in this study. Families often use take-away restaurants as a convenience for a busy life or families from low economic backgrounds find it more difficult to follow through with plans. The difficulty of making families change their lifestyle voluntarily is a long process and seems almost impossible if the individual is not willing to change. Gastric band surgery has also provided “substantial and sustained effects on weight loss” but is only available to people who have already tried to make changes with their diet and been unsuccessful, which requires relying on people to make the decision to be healthy for themselves which is not an easy decision for people of low economic backgrounds or people who don’t realise they have a problem, individual intervention does not target people who are at the most vulnerable to be obese and overweight and therefore cannot be the most effective type of intervention. Interventions targeting the environment we live in have also been introduced into society, including the sugar tax and an increased number of cycle lanes. The sugar tax was introduced in April 2018 and involves companies either reducing the sugar in their drinks or the price of their drinks increasing.

There is no choice with this intervention and people who are not obese will also have to pay more to drink sugar, this takes away the free will of people who are not obese and therefore do not necessarily need to drink less sugar, but drinking less sugar isn’t just to benefit obese people. Sugar has been named by the dietary guidelines advisory committee as one of our biggest health concerns. Reducing sugar intake can lower your blood pressure, decrease your heart attack risk and lower your risk of diabetes. Even though individual interventions allow people to make their own decisions about their health and gives people a greater sense of free will, with the cost to the NHS currently it would be in nearly everybody’s interest to decrease the costs spent with obesity to be used in other ways in the NHS. If introducing environmental interventions forces healthy people to be a bit more healthier and is the most effective way to combat obesity then the results can only be positive. Funding for the NHS comes through tax which everybody must pay and “the NHS deals with over 1 million patients every 36 hours”.

Environmental changes don’t just allow obesity to be tackled, it also allows other non-weight-related illnesses to be tackled by creating a healthier society. Although environmental changes create a healthier society overall, there are many factors which contribute to obesity that need to be addressed individually, such as socioeconomic factors, genetic factors, and psychological factors. People in higher socioeconomic positions have more opportunities to lead a healthier life and experience more life changes than people in lower socioeconomic positions whilst people of lower socioeconomic positions have less of a chance to lead a healthier lifestyle, with places like McDonalds and KFC promoting cheap quick food. The majority of studies have also concluded that there is a relationship between eating disturbances and depression, many people comfort-eat as a way to make themselves feel better. Genetic factors have also been named as a possible reason for obesity with more than 400 genes being involved in making people obese and overweight.

Many environmental interventions will help people struggling with these problems by forcing them to take a healthier look at life compared to individual interventions where they would have to make the decisions for themselves but environmental interventions cannot completely eradicate obesity, and people who are struggling with depression, economically or genetically will still need help to prevent or tackle obesity completely. Some environmental interventions that are put into place will still need cooperation by individuals to fully take effect, people may decide not to use a bike even with the increased number of cycle lanes or not go into shops without lifts, to make sure that environmental interventions are properly taken advantage of policies need to be put into place to help the most vulnerable. Governments are recognizing that to tackle obesity it will require more than individual or environmental interventions and that “obesity is the result of a large number of factors, activities, and determinants”.

It is important to tackle obesity as soon as possible, as children are becoming increasingly more obese, with 9.6% of children in reception classes obese in 2016-2017, whilst in 2015 it was 9.3%. 13 Children from a lower socioeconomic background in more deprived areas are twice as obese as children in more affluent areas. The local government association and the association of directors of public health have a partnership with Leeds Beckett university to design whole systems approaches to prevent obesity, which shows that the government are beginning to understand how complicated the prevention of obesity is. Preventing obesity needs to be a collaborative effort not just with the government but many different companies. Coca-Cola have been known to fund research that claims bad diets don’t cause obesity 14 and whilst adverts for smoking have been banned due to how unhealthy it is,15 we still continue to have a large number of fast-food adverts on our TV daily which target families or individuals who are not as active and spend more time at the TV. Individual interventions are a positive way and cheaper way to prevent obesity but unfortunately is not able to target the most vulnerable of people.

Whilst environmental interventions require a lot more effort from the government and cost a lot more money to implement they are more likely to target the most vulnerable of people whilst also targeting the whole population and increasing how healthy our society is as a whole. Environmental interventions need to be implemented into society but a whole systems approach needs to be made alongside it with the collaboration of the fast-food industry and the government. It is a common stereotype that obese people have no self-control and just overeat, but there are many different reasons for obesity that go beyond what a person can control themselves, and for the benefit of the NHS and the future of our society it needs to be addressed even if individuals who do not suffer from obesity have to make lifestyle changes too as cutting out sugar in a diet or exercising more will also improve general health, not just obesity.

Obesity being passed down from parents to their children through bad habits needs to be put to a stop as it is a long cycle. Even if the initial money and effort we put into this environmental intervention is much bigger than if it were individual, the overall effects on society will be great, with not just obese people benefiting but also people who are considered healthy. Environmental interventions need to be a collaborative effort by many different companies to create policies that will benefit everyone, not only the most vulnerable to create a healthy society which can advocate health to everyone.

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