Like most places in the world, Scotland is experiencing an obesity epidemic and has the highest obesity levels in what is globally classified as OECD countries; Mexico and the USA are the only two countries in the world that have higher levels in comparison. Research shows that 26.8% of the adult population and 15.1% of children were classified as obese in Scotland in 2008. Moreover, 65.1% of adults and 31.7% of children were clinically classified as being overweight in the same year. Obesity and overweight pose a real threat to the health of Scotland’s population as well as the country’s ability to flourish socio economically.
It has been argued that obesity cannot just be seen as a health problem, neither can it be resolved simply by relying on behaviour change from individuals. A better approach requires cross sector and cross-portfolio collaboration as well as investment to ensure deep, maintainable adaptations to peoples living environments to change. This means promoting healthy weight and choices for everyone instead of the current view point of acceptance. The Scottish government is truly committed to taking proper action right away to stop the obesity risk from turning into a reality. The Government and COSLA have developed a joint plan - Route Map, which delivers longer term solutions to the problem that not only involves health care professionals, but local businesses, too.
The obesity challenge happens when energy consumption from any food and drink, to include alcohol, is more than the amount of energy the body needs to metabolise over lengthy periods, which results in excess fat being accumulated. Obesity and being overweight increases the chances of developing various diseases, like heart disease, hypertension, type 2 diabetes, certain cancers and early death. These risks start to increase with higher weight levels and are paramount amongst very obese individuals.
Obesity is associated with just as much poor health as problematic drinking, excessive smoking, and poverty. The total cost to society related to obesity was more than £457 million in 2007/08 and this figure is possibly underestimated. Most of this expense can be avoided! Adult obesity could rise to more than 40% by 2030, consequently further increase social health inequalities. It is estimated that obesity costs will double in Scotland by 2030, and range from £0.9 billion to £3 billion.
The government’s Route Map clearly sets some short and medium term goals to prevent the above from happening. The aim is to get most peoples' weight down to a healthy level in Scotland, hence, it will have a positive impact on life expectancy and several other outcomes, to include:
- » Children in Scotland will have a great start and be prepared to succeed
- » People will live longer and healthier lives
- » Inequalities will be tackled in society in Scotland
- » Improved health for every family member at risk. This is a longer term goal and will take a lot of years to achieve.
The government invested around £200 million between 2008 and 2011 to tackle the obesity epidemic in Scotland with a £56 million investment coming from health resources. Plus, more localised authorities are addressing obesity directly and indirectly by making a contribution to the national health goals and localised priorities in their own Single Outcome Agreements (SOAs). There is a considerable amount of investment and effort being made and it has encouraged a wide range of health initiatives and policies across different portfolios and sectors to tackle healthy weight goals. However, there are areas that need more attention and there is also a need to level out the overall balance between joint initiatives so that more is spent on prevention, which will mean less will need to be spent on treatment in the long term.
What the Scottish Government will do
Scotland has to be prepared for radical action and will do the following to begin the journey:
- » Energy consumption – control the amount of exposure to excessive food consumption of highly calorific food and beverages.
- » Energy expenditure – increase opportunities to take up cycling, walking, as well as other daily physical activities to minimise sedentary lifestyles
- » Early years – establish good life skills and encourage positive habits at a young age via early interventions
- » Working lives – increase the level of health responsibility on organisations outside of health services. Delivering policy responses goes far beyond individual initiatives. This requires extensive and systemic change in environment, culture, infrastructure, and what is deemed as socially acceptable.
The Route Map sets out various actions that are believed necessary. Each action mentioned below is targeted at a population level. The aim of executing the Route Map is to have a wider impact on all of society and remain more vigilant on disadvantaged groups.
What Happens Next
The government will establish a joint government leadership group to include COSLA leaders, Ministers, and other key stakeholders such as public health experts and the NHS, to make sure the Route Map is implemented correctly and decision-makers are held accountable. The group will:
- » Supervise the progress and identify important milestones in order to facilitate the delivery
- » Regularly, evaluate progress against essential milestones and outcomes and think about whether the decisions being made are adequate enough to make progress.
- » Provide authority to the combined research policy to make sure that any developing evidence and outside developments (like European or food pricing policies) are included into all the reviews
- » Manage and publicise a progress report of all the actions taken, find a national event to be arranged by the Scottish Public Health Network to give all stakeholders from various sectors the chance to get involved in helping to shape any action that derives from the policies found in the Route Map.