Recent research(1) revealed one in eight people will have Type 2 diabetes by 2045 if obesity continues to increase at its current rate. Last year, at the European Congress on Obesity in Vienna, it was estimated that 14% of the global population are obese and 9% have Type 2 diabetes. By 2045, obesity levels are expected to rise to 22% and 14% are predicted to suffer from Type 2 diabetes. In the UK, obesity levels are at 32% and diabetes rates are predicted to rise by over a quarter, from 10.2% to 12.6%.
These figures cannot be ignored and the global fight against diabetes needs to be accelerated. Type 2 diabetes is a growing health crisis and it also has huge cost implications. According to Diabetes UK, the NHS spends almost £12 billion a year on treating people with Type 2 diabetes(2). Those with the disease need to monitor their blood sugar levels, potentially take medication and can be subject to a number of complications, including blindness, kidney failure and amputations.
In order to truly tackle Type 2 diabetes, we must tackle the root cause – obesity. According to the pharmaceutical company, Novo Nordisk, globally obesity levels must come down by 25% to prevent Type 2 diabetes rates increasing above 10%. In the UK, to stabilise diabetes rates at 10%, the rate of obesity must decrease from 32% to 24%1.
That is no easy task. Health services have, for a long time, relied on traditional, medicine based treatments. However, medicine does not tackle the root cause of obesity. Recently, health services have started to see the potential and the power of lifestyle interventions to tackle obesity and, in turn, Type 2 diabetes. Lifestyle interventions, which involve having a healthy diet and regular exercise, have been found to help patients not only manage Type 2 diabetes but reverse the condition completely.
Digital interventions have been helping to facilitate this. The NHS last year launched the Healthier You: NHS Diabetes Prevention Programme digital stream, of which Liva is a part of. For this, we provide patients at risk of developing Type 2 diabetes with an app that connects them to a personal health coach. The patient, with guidance and support from their health coach, sets personalised health and lifestyle goals which they can then track and monitor through the app. The patient can have regular video or text consultations with their coach and access an online support community of other patients, as well as educational information to help them improve their lifestyle. Patients can track information relating to, for example, their sleep, nutrition, exercise levels, blood sugar levels and water intake. The results have been promising with some patients losing up to two stone in their first two months.
More needs to be done however to help individuals tackle unhealthy lifestyles to reverse the obesity trend. The focus shouldn’t just be on adults, but children too. Recent research has revealed a concerning relationship between Type 2 diabetes and childhood obesity. Research from King’s College London revealed that childhood obesity can increase the risk of Type 2 diabetes four-fold by the age of 25 compared to children with a normal BMI(3). This demonstrates the need to prevent obesity from early life and for the government to invest more in engaging the public in obesity prevention efforts.
Whilst in many places childhood obesity rates are rising, one city where they are falling is Amsterdam(4). The city has set up a healthy-weight programme which has seen a 12% drop in overweight and obese children. The programme costs around £5.3 million a year and relies on working with existing professionals such as teachers, doctors, nurses and social workers to enforce a consistent, healthy lifestyle message. Children are taught how to eat healthily, are not allowed sugary snacks or fizzy drinks in school and are encouraged to be active. For those that need a little extra help, fitness classes are offered. The city has also started initiatives, such as banning fast food adverts on the subway. With such impressive and impactful results, it is logical for other cities to follow suit.
The good news is that along with initiatives such as the Healthier You: NHS Diabetes Prevention Programme, initiatives are being set up and put forward to tackle the growing problem of obesity in the UK. The London Mayor, Sadiq Khan, has announced a ban on junk food adverts on London tubes and buses in an attempt to curb the epidemic of childhood obesity. This will mean any adverts that promote foods and drinks that are high in salt, fat and sugar will no longer be displayed on London transport. In other areas, obesity drives have been less successful, however. A national proposal to prevent junk food adverts during prime-time TV was prevented.
In addition, at the time of writing, the UK government is considering implementing bans on junk food deals which would be a welcome initiative. Strategies like this are needed in order to create long-term behavioural change in those who opt for convenience and instead, encourage them to choose healthier, fresh foods. As such, although a ban on deals is helpful, it’s unlikely to be effective alone. It needs to be supplemented with promotions to encourage parents to buy more nutritious food and also education for children on the importance of making healthy lifestyle choices. Just how they have done so in Amsterdam.
The figures are clear; inaction against obesity has severe consequences. Without initiatives to tackle obesity, diseases like Type 2 diabetes will continue to rise. This will cause a huge medical challenge in the UK, as well as significant cost challenges. Policies need to be implemented to help individuals make behavioural changes to live healthier lifestyles and take people away from relying on medication to mask their diseases. The NHS Healthier You: Diabetes Prevention Programme is one example where lifestyle changes are being implemented. However, efforts need to be made to tackle obesity on a wider scale to prevent individuals from even becoming pre-diabetic. What is more, we need to start helping children. Amsterdam has shown the power of junk food bans alongside education on how to eat healthier food. Let’s hope the UK will follow suit to help bring down obesity rates and, in turn, stabilise and begin reversing Type 2 diabetes rates.