Lessons from around the globe in the fight against obesity

Health literacy

OBESITY IS NOT a uniquely American problem. Since 1975, obesity worldwide has tripled, and in 2016 more than 1.9 billion adults aged 18 years and older were overweight. Of these, 650 million were classified as obese. Meanwhile there were 41 million children under the age of five who were overweight or obese as of 2016. It’s clear that obesity is a global issue.

Different countries are exploring different ways to fight obesity. In Amsterdam, a healthy-weight program has led to a 12% drop in the number of overweight and obese children. The program involves regularly weighing children at school and testing them for agility and balance. Those children that are overweight are referred to a child health nurse, who offers families a free package including dietary advice, gym classes and a volunteer who makes home visits to check on the child.

‘The most important thing is not to communicate in a standard way, because everybody already knows eating sugar and eating fast food is unhealthy,’ Kristel de Lijster, a child health nurse, told the BBC. ‘You really want to communicate the message on the level the parent and the child understands.’

A program exactly like this may not be desirable in the United States and may not work as well. It means intervention from local or regional government in an individual’s private life and it means telling parents how to raise their children. But that doesn’t mean we can’t learn from this example, and what it shows very clearly is the importance of education and action on a level that the patient understands and will therefore be receptive to.

In the vast majority of cases, obesity––and the conditions it leads to, like diabetes––is the result of making poor lifestyle choices. With education and sustainable action, individuals can change their lifestyles and start to restore their health. I’ve written before about how patients are too often given clinical answers to clinical questions, when what they need is effective communication, told simply and memorably, so that they retain it for good. That’s why Advanced Tissue uses video tutorials––because they engage, persuade and inform. A list of bullet points is unlikely to turn around the life of someone with reversible prediabetes. A story that warns and inspires might.

In the present day, 90% of the 84 million Americans who are prediabetic do not know they are prediabetic, and so many Americans fail to realise the poor state of their health that they’re in that when they seek out treatment it comes at a far higher cost. Those in Amsterdam are clearly having some success, but in the long term, no school, government or external body can be there at every hour of the day to tell individuals if they’re unhealthy and to ensure they eat good food and exercise regularly. That means that individuals need to learn about health and nutrition in a way that will allow them to identify their health status and take action themselves. As a culture, we also need to encourage accountability so that individuals understand that they are the ones responsible for their health.

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