Sarah Harte: There isn’t a light touch solution to tackle weighty issue of obesity

There’s no soft-soaping the fact that Eurostat figures reveal that we are one of the most overweight countries in the EU for both men and women.

Weight is a sensitive topic. Opinions differ on whether we ought to use the term obese or whether it should even be classified as a disease with a lack of consensus among medics on the issue.

Green Party deputy leader Róisín Garvey recently said that Irish children were overweight because they were “being driven to school from across the road.” Exercise is a weight factor, but people are overweight for diverse reasons. As the European Central Statistics office put it in a report last week, we live “in an obesogenic environment”.

I know a GP involved in the field of public health who has very strong opinions on the overprescription of drugs by some of his colleagues. It’s hard to imagine he’s too popular at medics’ shindigs. He believes that obesity is a risk factor for other illnesses rather than a disease and that patients wouldn’t have to take so many drugs for things such as cholesterol and blood pressure if they could get their weight under control. He says doctors ought to be more forthright about patients being overweight instead of scribbling prescriptions.

The kind GP could clear a party faster than you could say ‘hors d’oeuvre’ when he gets onto health and nutrition. He told me that he’d rather live with HIV than Type 2 diabetes because in his view HIV is far more manageable. The health implications of Type 2 diabetes are potentially grim including limb amputation, kidney failure, stroke, heart attack and cancer.

But then I also know people happily taking weight loss drugs such as Ozempic and shrinking dramatically.  Donal O’Shea the HSE National Clinical lead for Obesity has spoken about the value of new medications in preventing and treating obesity underscoring the complexity of the issue.

There’s no soft-soaping the fact that the European Central Statistics figures reveal that we are one of the most overweight countries in the EU for both men and women. Also, the World Health Organisation has forecast that Irish men are set to be the most overweight out of 53 countries equalled only by Uzbekistan.

What is even more concerning is the latest research by the HSE which shows that one in five children is overweight or obese. Unsurprisingly, rates of obesity are higher in areas of disadvantage with one in four children in DEIS schools being overweight or obese. However, being overweight is not solely linked to disadvantage. In an average classroom of thirty, six will be overweight or obese and there is no difference between rural or urban schools.

Of course, there are public health initiatives such as Slaintecare Healthy Communities. In primary schools, children learn about food, nutrition and healthy eating as an obligatory part of the curriculum, but nutrition doesn’t occupy a discrete space and there are no practical food sessions presumably in part because of a lack of resources.

We might consider teaching children cooking at the primary level for three reasons. One is that children deserve to know how to cook cheap, simple but nutritious food. A recent European study suggested that being obese as a young child can potentially cut life expectancy by up to 50%

A more clinical reason is that as part of a suite of measures it could help save the state a fortune in the long term. One projection indicates that on present trends without policy interventions obesity will cost us €5.4 billion by 2030. Plus, the impact on the health service is huge.

Thirdly, children can influence their parents in what has been termed ‘bi-directional parenting’ with young people able to influence for example our recycling habits or what kind of language we use about issues such as racism or trans people. Hands up who hasn’t had a stiff lecture from the younger generation about pulling up their socks in one of these areas and promised to do better in terms of attitudes and personal behaviours while mounting a half-spirited defence doomed to fail about having grown up in a different time.

We could teach cooking skills, it’s not a Pollyanna idea. In 2009, Jamie Oliver, having found the British government’s provision of food education to be severely lacking, set up the Ministry of Food to give cooking lessons as well as lessons on nutrition and sustainability in places such as Newcastle, Bradford, and East London. 

Reading some of the testimonies from parents about how he had changed their lives was striking, they loved knowing how to feed their family well and had found that eating meals together was not just good for their gut but for family bonding

Naturally, Oliver came in for flack for being a poverty tourist. There’s no question this is a complicated issue, but Oliver had a point when he said, “The poorest families in [Britain] choose the most expensive way to hydrate and feed their families. The ready meals, the convenience foods.” Having access to good food involves an element of social justice.

Earlier this year The Big Issue had a highly supportive article on how his Ministry of Food was still going fifteen years after its inception and how across 74 sites Oliver’s recipes and nutritional tips are taught to children, parents and young people.

The key thing is that there is a difference between judging and educating. This is a whole of a population health issue rather than a cosmetic one. In my local Supervalu one thing that strikes me when I’m sticking my nose into people's baskets and trolleys is that often the older generation in rural Ireland knows how to feed themselves. You will often see an older man well into his seventies with brown bread, a turnip or two, a cut of meat and some cheese in his basket carefully considering his weekly shop. By contrast, younger, busy parents will often have a trolley jammed full of what is essentially processed sugar including sugary drinks, white processed bread, takeaway pizzas and so forth.

For the sake of transparency, I confess that I scuttle out of the shop on a Friday evening hoping nobody will see my shopping. I will die wrestling with a sweet tooth, but it doesn’t mean I can't acknowledge the public health issue around nutrition, or the link between diet and disease.

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With all that Apple tax money sloshing about you wonder if the time has come to introduce cooking into the curriculum. I’m sure some teachers reading this, will think, what now we have to teach them to cook on top of everything else, but obviously, it could be handled in different ways, with specific trained cooks teaching the subject.

Food literacy is not a magic bullet. Cooking skills and nutritional information alone won’t cut the mustard. But while weight loss drugs have a role to play in managing weight, the idea of increasing numbers of the population on drugs pushed by highly profitable pharmaceutical companies is warped.

We also need to have a hard look at unhealthy food marketing including in supermarkets and consider introducing some kind of sugar tax as well as subsidies for fruit and vegetables. It’s clear we urgently require robust new cross-departmental policies to tackle what has been described as an epidemic. We did it with tobacco, it’s time to do it with food.