Memorandum by The Obesity Awareness and
Solutions Trust (WP 17)
TOAST
The Obesity Awareness and Solutions Trust (TOAST)
is a national charity (Reg No 1088049), primarily a patient advocacy
group, committed to ensuring that people whose lives are directly
affected by obesity have a voice which enables them to have an
impact on policy, treatments and services. TOAST also aims to
expand and develop frontline action to prevent and solve the problem
of obesity.
TOAST works closely with academia, patient groups,
the medical profession, consumers, local government and a wide
range of industries, to raise awareness of and seek solutions
for the treatment and prevention of obesity. It also seeks to
share its experience and expertise in dialogue with policy makers
and regulators on a national level, decisively to confront the
obesity epidemic and to challenge discrimination and stigma.
SUMMARY
TOAST welcomes the general principles of the
government's public health white paper and believes that in part
the initiatives will influence the future health of the nation.
However, key to TOASTs concerns is the complex and multifaceted
nature of obesity, which has not been given strong enough recognition.
The initiatives and underpinning principles of the paper largely
concentrate on food and exercise, omitting issues relating to
why food behaviours and patterns develop in the first place; food
and the fat are still largely being treated as the problem, TOAST
would see them as being a symptom of a whole set of other factors
including: socioeconomic, psychosocial and psychological.
Will the proposals enable the Government to achieve
its public health goals?
With two thirds of the population of England
either overweight or obese and an increase of 400% over the last
25 years, obesity, under current trends will soon surpass smoking
as the greatest cause of premature loss of life. The government
will therefore have to be rigid in its implementation of the white
paper and also recognise the wider causes of obesity, which are
related to social circumstances, access to healthy food, local
referral services, availability of appropriate services, and personal
issues such as self-confidence and self esteem.
Are the proposals appropriate, effective and good
value for money?
The proposals are appropriate so far as they
cross a broad spectrum of issues and reflective initiatives which
begin to address the complexity of obesity; however the lack of
focus on drivers behind obesity has not been sufficiently addressed.
Obese people are a vulnerable group and should be recognised as
such, issues such as social stigma, and lack of access to treatment
need to be acknowledged and remedied.
TOAST welcome the review of treatments for obese
patients, however the effectiveness of this could well be undermined
as it is not due to be produced by the National Institute for
Clinical Excellence until 2007, and with the current morbidity
rate for obesity related diseases at 30,000 per year this seems
over due.
The real value of the public white paper will
be seen as the number of overweight and obese halt and then begin
to decrease. The reality that one in three children are now categorised
as overweight and one in nine obese must be addressed proactively,
and the delivery paper will hopefully demonstrate appropriately
an effective implementation to a problem which if trends continue
will cost the NHS a quarter of it's budget just to treat type
2 diabetes.
Do the necessary public health infrastructures
and mechanisms exist to ensure that proposals are implemented
and goals achieved?
The healthcare framework is in place however
the knowledge base of healthcare professionals needs to be assessed
in terms of identifying causes of obesity and recognising it is
often a symptom of an underlying problem, rather than just a problem
in itself. Continuing professional development courses on obesity
need to be developed and best practice disseminated around PCTs.
January 2005
| 
