Dear Jamie Oliver,
You want to put pressure on world leaders to take action against obesity and undernourishment the world over. And you are absolutely right to highlight these problems to David Cameron ahead of your forthcoming appearance at the World Health Assembly. You are also spot on in your appeal to link obesity with malnutrition and to point out the obvious and worrying contradiction that these two problems can go hand-in-hand. It is also fantastic that someone so high profile and energetic has got behind a cause that many of us have been worrying about for so long. But it is no longer enough to just point out the problem. Now is also the time for solutions. And, for obesity, these are frustratingly very hard to find.
Target the individual
The first and most common solution is to target the individual. This is the domain of psychologists, nutritionists and dietitians and has been the mainstay of dietary management for decades. Interventions have been developed using state of the art techniques including nutritional education, cognitive behavioural therapy (CBT), mindfulness, relapse prevention, goal setting, imagery, aversion therapy, self monitoring, persuasion, and motivational interviewing which are delivered by teachers, public sector health professionals, private weight management groups, self-help books and, more recently, apps and the internet.
Whether it’s for prevention or treatment, the aim is ultimately to get people to eat less and do more. Although we know the theories and have the research, though, not much weight is lost and most of what is lost is regained quite quickly. We live in an obesogenic world and even with the best will in the world people make bad choices when the world around them makes it easier for them to eat more and do less. So targeting the individual doesn’t seem to work.
How about the environment?
The next obvious target is the environment. Poor town planning, lack of pavements, no street lighting, poor public transport, lifts, escalators, moving walkways, narrow cycle lanes, expensive gyms, no showers at work, parking in towns all make us more sedentary and less active. While cheap fast-foods, expensive vegetables, ready meals, staff-canteen stodge, takeaways, poor cooking facilities and cake trolleys at work make us eat more than we need. The environment needs to change. But I’m a psychologist and you’re a celebrity chef so we need those in charge of the environment to make these changes. Yet apart from some changes to school lunches and the hint of a sugar tax, those in charge seem reluctant to bite the bullet and do what is needed.
The power to persuade
So what is left? We know that beliefs predict behaviour and that beliefs can be changed through all of our state of the art techniques. And we are good at persuasion. But maybe now is no longer the time to use our powers of persuasion on the person who is already obese or overweight. Or even on the person who might become so, given the world we live in. So maybe now is the time to change our target to those people – the town planners, the food industry, marketing experts, advertising agents, policy makers and politicians (with their own beliefs and behaviours) – who have the power to change the world we live in.
So Jamie. When you speak to the World Health Assembly, please do emphasise the problems of obesity and malnutrition, but please also offer some solutions. And when considering your solutions, don’t only target the individual or the environment, but target those people in charge of the environment using every state-of-the-art trick that we can offer you. That way you can change what the people in power think and do so as to ultimately change the thinking and doing of everyone else. Persuasion is a powerful thing. You’ve already excelled at this with your push on school lunches and the sugar tax. This is now an even greater chance to persuade those in power.