Why NICE should not recommend WEIGHT WATCHERS

So here we are, almost half way through 2014 and I am frustrated and irritated by the plethora of pointless reportage and misinformation both in newspapers and in broadcasting on the (yawn yawn) epidemic of ‘diabesity’ (diabetes/obesity) so far this year.   I say ‘pointless’ because what IS the point of talking the talk and generating data if the Government and NHS continue to implement ineffective measures to reduce said statistics?  I am referring here to last week’s reportage that NICE are recommending that GP’s fund patients who need to lose weight, to a 12-week course at Weight Watchers, Slimming World or Rosemary Connelly, which could cost over £100 per patient,

http://www.thetimes.co.uk/tto/health/news/article4101688.ece) .

Indeed the NHS is in a critical state, what with all the challenges faced by the new Commissioning, budget cuts, closure of some GP surgeries and numerous other issues. But what is glaringly obvious is its inability to acknowledge that NHS budgets which are already stretched to their limits because of the ever escalating costs to treat the health risks of diabesity, (£7.7 billion currently, rising to £13.5 billion by 2035/36, treating kidney failure, stroke, nerve damage, & blindness), (1) , are about to be wasted on a scheme that frankly pays lip service to the public and will, at best, only be successful for a very small minority of people who learn to avoid processed foodstuffs in order to break the refined sugar cycle, (which is no different from an addictive drug), and which would ultimately enable them to take responsibility for their own health.

Research has shown that reversing the diabesity trend has been, and will continue to be, an impossible feat if tackled with education alone – it needs political and environmental  intervention to reduce its availability otherwise biochemical drive will eventually overcome any cognitive attempt to control sugar intake, as is the nature of an addiction, (2, 3, 4). Why therefore, I ask, are GP’s prepared to go along with this insanity and allow slimming companies such as Weight Watchers, make healthy profits from this new national guidance? (http://www.thetimes.co.uk/tto/health/news/article4102857.ece).

Surely it would be more practical, cheaper and more effective for the NHS to employ all the highly trained and qualified, yet underused nutritional therapists, (5) into primary care, where they can interact with the patients (individually or in groups) and guide them to make healthy choices from natural foods which are economical, have not been chemically interfered with, nor are creatively marketed by food manufacturers branding for the slimming companies, some of which contain more sugar than non-slimming products, (6). Nutritional therapists have the expertise and knowledge to inform and facilitate dietary retraining to change eating habits in order to prevent the sugar habit perpetuated by eating processed foods and drinks.  People need educating by qualified experts who can translate scientific evidence into practical, user-friendly advice that is appropriate for people from every socio-economic group.

Did NICE ever think to read the ingredients on Weight Watchers desserts or savoury snacks?  Did they ever consider that by reducing or removing fat from a product would require the food manufactures to add hidden sugars to make it appealing to the customer……thus keeping said unsuspecting customer forever hooked on sugar?  Did NICE ever consider that by encouraging people to choose their food by its ‘point count’ rather than its nutrient value to health, misleads the uninformed person as to what foods constitute a healthy diet?  Its a bit like funding a heroin addict for 3-months in rehab, but allowing them to continue to consume products which contain heroin, albeit in smaller quantities, but still enough to keep them hooked.  What happens to these people after 3-months?  Apart from the minority, I propose that schemes such as this will make minimal positive impact to the NHS budget.

Here are some facts that NICE might like to consider before rolling out this ill thought out scheme.

• Anyone can become a weight loss coach or run a slimming club.  Slimming clubs have their own protocol to follow.  They do not require coaches to have a degree in diatetics, health sciences or nutrition.

• Becoming a slimming group coach is advertised as a great way to earn up to £400 per week and only requires a 6-day training course, (7).  Unbelievable!  Qualified nutritionists train solidly for 3-4 years at degree level, yet GP’s would rather spend vital resources on their patients being facilitated on a diet for 3-months by unqualified slimming club coaches.

• Weight Watchers’ products are made by food manufacturer Heinz – one of several companies that produces some of the products that hook people with hidden sugars in their ready meals – the very foodstuffs that make it difficult to control how much sugar a person eats, such as 6 teaspoons sugar in a can of tomato soup and Farleys Rusks for babies and tots, a staggering 29g per 100g.  Should NICE really be backing these food giants via the backdoor?

• If slimming club coaches had scientific knowledge, training and qualifications in relevant biological and physiological subjects that gave them the knowledge and experience to advise their members, they would NOT recommend their members to rate food by its point count rather than its nutrient value to health; they would NOT recommend they bought ‘slimming products’ which contain more sugar than some non-slimming natural foods/products, and they most certainly would NOT recommend that NICE funds food manufacturers which have driven the trend for diabesity over the past 30 years and led us into this hideous epidemic and NHS crisis.

• Has NICE or GP’s considered that it may take longer than 3 months to retrain a person’s eating habits in order to kick the sugar habit?  If patients are drip-fed hidden sugars and not given the best information during this 3 months, they are very likely going to resort to their original eating habits as soon as they finish the course.  Statistics reveal that a staggering 97% of dieters regain the weight, and more during the following 5 year period.  After all, isn’t that how these slimming clubs have become such successful businesses over the years? If I had a penny for every time I heard a person exclaim that they had lost weight whilst they were on a ‘proper’ slimming club diet, but promptly put it all back on, plus some, after they ‘came off the diet’, or were rejoining Weight Watchers/Slimming World again, I would indeed be very wealthy!

• Do NICE and GP’s, in their infinite wisdom really believe that short term diets actually work and will reverse the trend of diabesity?  Surely not – there is far far too much scientific, evidence-based research that informs us otherwise.

I could go on, but I hope you can see where I am coming from and going with this?  I recognise that people from different cultures and socio-economic situations have different starting points with their diets and that sometimes it isn’t practical or even possible for some people to cook fresh ingredients on a regular basis.  But what I do know is that nutritional therapists are highly trained professionals who keep up to date with medical research and therefore are much better placed to provide a holistic and multidisciplinary approach, including educating them nutritionally with truthful,  practical information and advice. Such intervention can clinically confer relevant improvements in physiological measures, (blood pressure, blood lipids), health behaviours (eating and activity habits, dietary quality), and psychosocial outcomes (such as self-esteem and body image), (8).  Such approaches confer far more self-perpetuating positive health attitudes, the outcome of which would deal with the numerous and destructive health risks of being both malnourished but overweight or obese.

References

(1)    http://www.diabetes.co.uk/cost-of-diabetes.html

(2)    Lustig RH. 2013. Fat Chance. The Bitter Truth about Sugar. Fourth Estate. London.

(3)    N. D. Volkow, G.-J. Wang, D. Tomasi,and R. D. Baler: Obesity and addiction:  neurobiological overlaps.  Obesity Reviews. Vol. 14. Issue 1. Jan. 2013.

(4)    Davey RC.  The obesity epidemic: too much food for thought? Sports Med 2004;38:360-36 .

(5)    BANT.org.uk

(6)    http://www.telegraph.co.uk/health/healthnews/10862272/Weightwatchers-foods-higher-in- calories-than-standard-ones.html

(7)  http://www.slimmingworld.com/information/become-a-consultant.aspx

(8)  Bacon L & Aphramor L. (2011). Evaluating the Evidence for a Paradigm Shift. Nutrition Journal 10:9.