Bill Nichols

10 December 2014

Bill Nichols

019 All Headlines and No Narrative: The Obesity ‘Epidemic’ (December 2014)

Obesity headlines? You may have seen the recent attention-grabbing – if depressing – fusillade.

Here’s a quick rehearsal.  Nearly 30% of the global population, or 2.1 billion individuals, is overweight or obese.  (UK = 37%).  Collectively they cost the world economy ~$2 trillion, or 2.8% lost output, annually.  That’s less only than smoking and armed conflict (McKinsey, November 14).

One third of Year 6 UK primary schoolchildren is already overweight or obese (Health and Social Care Information Centre). More than 70% will become obese adults (Association for the Study of Obesity).   And 70% of obese youth also have at least one risk factor for cardiovascular disease (CDC, US).

Enough, you cry!  Your point?

Answer: it’s partly a communications’ challenge.  (And one we’re exploring at the Bucks Centre for Health Communications and Research (CHCR)).  Specifically this week’s visit to govtoday’s excellent London conference, Obesity: A National Epidemic, convinced me.

Under a heavy collateral data bombardment, I learned quite simply: there is no single narrative.  And without one, this epidemic (or pandemic) will always slip quickly off the news-agenda.  Why?

Villains and Heroes

For speedy analysis, I like the ‘villain-hero-conflict-solution-outcome’ tool. Try it on Ebola and you’ll quickly see why it stays so successfully on the agenda.  Its narrative is clear and effective.  But obesity?

First up, find a villain or ‘dark lord’?  Mmm: spoilt for choice.   You could fairly audition food processors, fast-food outlets, regulators, lobbyists, poverty/deprivation, the tax-man and (in the UK) the NHS.  Or try money out of your pocket. Some suggest that obesity and its consequences cost the NHS £10 billion annually.  If so, then this villain ‘robs’ everyone of over £160 per year. As Public Health England points out, revert obesity to 1993 levels and it will save at least £1.2 billion per year. (George Osborne, please note).

Lost already?  What about a hero?   OK there’s ‘Sir Health Of Well-Being’.  He’s a lovely chap. Very well-intentioned.  But lacks charisma.  Too ‘nicey, nicey’.   And be honest, humankind tolerates only so much good behaviour.  An individual, or single front or campaigning body, is required to lead the charge.

Next it gets byzantine: the conflict. This battleground is more complex than the Syrian Civil War or 3D chess!  Obesity, say the experts, is a consequence of: a) genetics, b) environment (we live now in an ‘obesegenic’ world), c) psychology, d) behavioural factors and/or e) some combination of the above.   Try pitching all that in the ‘elevator’!  In the current state-of-knowledge, it’s not even clear which dimension has the strongest weighting!

Solution?   Seriously, who knows?  There are far too many variables in play and issues outstanding.

So outcome?  A super-healthy society would be nice.  And pigs are flying in massed formation over my office.

Sadly, depressingly, we all ‘get’ the question.  But without a narrative, this looks set to drift – and escalate.

So, all joking apart, before you settle down to that Christmas turkey, obesity narrative anyone?

And do please leave a reply below!