Winning the battle but losing the war

Well the National Obesity Forum (NOF) dropped a bombshell into the world of public health this week, for sure. But although they got some startling initial headlines, I’m not sure from a PR perspective they ended the week on the winning side. As I say in my book, I am not a scientist – but I am a media professional and I can spot a badly managed campaign at 1,000 paces!

The report can be found here, although this isn’t a link to the NOF website, but a separate organisation, Public Health Collaboration, which claims that NOF have authored the report. I’ve just spent five minutes on the NOF website and couldn’t find a link to the report anywhere, yet in all of the media the NOF were inextricably linked to the report itself. It might be there somewhere on the NOF website – but you’d expect an organisation which grabbed front page headlines in both the Sun and Mirror to have the report (or at least a link to it) which produced those headlines front and centre of their website for quite some time. The website was also still hosting advice which directly contradicted the findings of the report well into Monday (and might still be doing so for all I know), as many of those opposed to the findings were only too happy to point out across social media. Confusion is never a good start.

The report was widely covered. I myself caught this early Guardian article and tweeted that I thought, on the basis of the article, that they were more right than wrong, and that some experts were still in denial. I still think that, but am amazed at how some good, sensible suggestions can end up being messed up by poor delivery and bad planning.

Just to be clear, my own view, based on both a thorough reading of all the research I could find, backed up by my own experience and expressed at length in The Life of Riley, is that eating real food is the answer if you want to reduce your weight and live more healthily. That means more meat, fish, vegetables, nuts, wholegrains, fruit, and less refined and starchy carbs (and less food that comes in boxes, cartons or from the take-away). But I’m a realist – and therefore appreciate we all like carbs from time to time, an occasional take-away is not going to eternally damn you, and that even though refined, added sugars have no nutritional value, many of us like a pudding once in a while. So these things will remain part of my life, but in moderation.

And I think the “reduce your carbs” argument is starting to seep into the general public consciousness. As this extract from a letter from a consultant surgeon in Thursday’s Times shows “…Three years ago I adopted a “low carb” diet as my waistline was approaching 40 inches — a loose definition of obesity — and was able to shed the excess weight with almost no self-pity. So far this diet has been sustainable (morale being maintained by lashings of nuts and dark chocolate). Occasional carb treats do not seem to cause a problem. Many family members have had the same positive experience with low carbs….” Even Christopher Snowden, who was withering about the report in general, grudgingly acknowledged as much in the Spectator, saying “There is no doubt that some people lose weight on the low-carb diet, but the empirical evidence in support of LCHF as opposed to a low-fat or other low-calorie diet is far from compelling.” I think Snowden is wrong on how compelling the evidence is, as this Lancet article shows, but my argument would simply be that currently any approaches which suggest moderating carbohydrate intake seem to be demonised by the public health establishment, and that doesn’t seem sensible. And if that’s what the report set out to achieve – to put low-carb approaches back into the mainstream, I’m not sure it succeeded.

Essentially the report was attempting to say “eat real foods, don’t worry if they contain some fat, as it’s OK, and reduce those starchy carbs if you want to lose weight”. Except it attempted to do way more than that, and was also busy launching hand grenades at all & sundry.

For example, the argument that the good natural fats found in real foods (saturated as well as unsaturated) have been unfairly demonised would, you’d have thought, been an easy sell in. But if you give quotes like Dr Aseem Malhotra’s “Eat fat to get slim. Don’t fear fat. Fat is your friend. It’s now truly time to bring back the fat” you shouldn’t be surprised if mischievous newspaper sub-editors spin that into headlines which look rather dodgy, and which cause reasonable people to question the validity of your argument.

And the headline focus on fats meant the other principal thrust of the argument, about limiting carbs, got lost – and all the sound and fury generated by this report didn’t get the ‘reduce your carbs’ message out as clearly as it should have done.

I also felt the report took on too many targets, with too scatter-gun of an approach. Sun Tzu would never recommend that an insurgent campaign (which is what this is) fight on ten fronts at once – but that’s what this report attempted.

I was particularly annoyed that exercise was rather dismissed by the report as being of no use in weight-loss, under the heading “you cannot out-run a bad diet”. There was virtually no positive reference to becoming and staying physically active, and there is some evidence that moderate physical activity (such as regular walking, as recommended in The Life of Riley) can help increase the effectiveness of a sensible eating regime designed to lose weight (even if only marginally). In fact, the Public Health Collaboration recently published a separate healthy eating report, which encouraged exactly this sort of physical activity every day. You can’t have it both ways, and being dismissive of people who are physically active but might eat badly is not good PR. Even if exercise doesn’t help weight loss, so what? It’s one of the best things you can do to live a longer, healthier life, and I just couldn’t see why it needed to be referenced in this negative way

I also felt labelling sugar as “decadent” was hardly likely to cheer up those of us who are attempting to fight a sweet tooth. It made it sound as though we needed to go for “re-education”.

Dr Malhotra, who is from the PHC not NOF, seemed to end up as the main spokesman for the report, and on 5Live on Monday (2h 07m 45s in) seemed to end up blaming George Bush and the World Health Organisation for the fact I was still overweight a couple of years ago! At least that’s what I thought he was saying, but the ad hominem attacks and conspiracy theories again don’t help ordinary folk warm to your message – no matter how much you believe them. There is evidence this low-fat vs low-carb row has become a bit of a dirty fight, but from the perspective of the general public, they simply want to be told what is good and bad to eat and how they can most easily lose weight if that is what they want to do.

And that’s the most depressing part, because if the insurgents do lose their war against the public health establishment then we might never move on. The public health establishment, after all, really do have their hands on the levers of power, patronage and publicity. And they are the ones really failing people. 40% of us are overweight. A further 25% are obese, and yet public health officials wring their hands and say ‘it’s not our fault, only 5% of the public follow our guidelines!”. Well I hate to break it to you guys, but if 95% of us are ignoring what you say, perhaps you need to say something else.


Maybe I’m wrong though. Reading Thursday’s Times this morning (it’s been a busy week) I see Carol Midgley in her diary column quote the report almost verbatim, without giving the establishment view even a by-your-leave. So maybe the tide is turning.