Don’t write your congressman. It’s the British government that’s being asked to pay for Weight Watchers. It may seem absurd for any government to fund Weight Watchers but that's what our cousins in the UK are discussing.

There’s ample reason for them to be concerned about obesity. During a layover at London's Heathrow airport I picked up a copy of The Daily Telegraph, one of the less sensational English newspapers. An article reported that British girls are the fattest in Europe. Almost 30 percent of girls under the age of 20 are overweight or obese. Previous research showed about a quarter of Britain’s adults to be obese, surpassed in Europe only by Malta and Iceland. The number of Brits with diabetes has more than doubled since 1996 so there’s ample reason for concern.

In the same paper there was an article reporting that the National Health Service (NHS) in the UK was spending 5.1 billion pounds ($8.7 billion) on treating overweight patients. The Weight Watchers proposal would have the NHS pay 100 pounds ($171) for a 12-week program (Weight Watchers or other “slimming club”) when the physician refers an obese individual. It is suggested that even if only a small number of patients lost weight the NHS would still save considerable sums of money by reducing the number of cases of diabetes and heart disease needing treatment.

Opponents of this proposal object to the state (the NHS is a government agency) interfering with peoples’ lifestyle choices. Funding is also an issue since many local health authorities are struggling to keep facilities open to care for people who are seriously ill. The money needed to send people to Weight Watchers would have to come from other programs.

Then, there’s the question of the effectiveness of referring obese folks to Weight Watchers or similar programs. A recent New York Times article on the obesity epidemic in the UK quotes Dr. Tony Goldstone, a skeptical endocrinologist at London’s Hammersmith Hospital. He suggests that telling a fat person to get thin through dieting is like “telling an asthmatic to breathe more.” He points out that our biology has trained us to get food when it is available (foods high in fat and calories helped our ancestors survive) but our environment has changed so that food is plentiful, not scarce. Even though starvation is unlikely in the US or UK, we’re still hard wired to prefer foods that high in fat and sugar.

While I don’t doubt that many people benefit from Weight Watchers I think government intervention should approach the obesity epidemic as a public health problem rather than trying to treat people who are overweight. In the US we could change our food environment without targeting individuals. A good start would be to increase taxes on sugary beverages that are the single greatest contributor to juvenile obesity. Richmond, California and a few other cities tried to do this but the beverage industry spent big bucks to defeat this proposal. Paradoxically, they claimed taxing sodas would penalize minority groups but this is the segment of our population that has the highest prevalence of juvenile obesity and would benefit from a reduction in consumption of sodas. A similar measure will be on the ballot in San Francisco in November. 

It will be interesting to see the outcome if the Brits do adopt government funding for Weight Watchers. Regardless of their results, we need to develop public health interventions that would decrease the prevalence of obesity without targeting or stigmatizing individuals.

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