Last week, bronchitic, I went to my doctor. He also weighed and measured me, discussed my diet, alcohol intake and lifestyle. Impressive. All was entered into the database. The next day, the government announced that the UK's obesity rates are the worst in Europe. No connection, I promise.
Obesity and overweight are now normal. Two thirds of men and almost 60% of women are overweight. We are on course to have a third of boys and girls aged under 11 overweight or obese by 2010, missing the target to halt the annual rise by then. Most analysts think the target lost, barring a fuel crisis, banning cars from streets, preventing parents worrying kids will be murdered if they venture outside, destruction of soft drink factories, etc.
Commenting on the bad figures, the Minister for Public Health spoke of the need to "think of 21st century solutions", which makes me a bit twitchy. This could go diverse Orwellian routes. Mass surgery? Reliance on functional foods? Do I see a chance for consumer correction in Lord Layard's £600m proposal for mass cognitive behavioural therapy (CBT)? I see current obesity policy as at phoney war stage. There's a stand-off, some mutual recrimination, not much happening overtly but defensive positions being prepared. Meanwhile, crisis looms.
Most policy being planned is soft. Nothing draconian, except possibly on adverts. Much advice and encouragement. Government-sponsored social marketing, all framed around personalisation of health choice. The EU is promoting voluntary action through its obesity round table. Next month, in Istanbul, all European health ministers meet to enshrine WHO policy.
There is a creeping acceptance that not much actually will be done about obesity, although everyone wants to be seen to be doing something. It is being normalised. We have UK targets for children but adults are encouraged, in Caroline Flint's words, to "want to change their lifestyles and take responsibility for their health". This could mean either governmental washing of hands or mass CBT.
Waiting in governmental wings is an interventionist model mooted by Sir Derek Wanless's Treasury reviews of national healthcare funding and of public health. His 'fully engaged' scenario is currently parked, on obesity at least, but most know that it can be brought out. The questions are: when and on what terms?