Government obesity strategy 'dangerous' and BMI measure should be scrapped - report

A group of MPs is calling for the use of Body Mass Index (BMI) in determining if an individual’s weight is healthy to be scrapped - branding the government's obesity strategy "dangerous".

The Women and Equalities Committee warned the impact of the pandemic, both on eating disorder sufferers and those at a high risk of developing one, has been “devastating”.

Earlier this month, ITV News told the story of eight-year-old Heidi. She has an eating disorder and her mum says the Covid pandemic has made her daughter’s situation “a million times worse”.

Heidi's eating disorder makes her so exhausted, she often struggles to concentrate. This means she only goes to school for half a day

The MPs' report warns that BMI, used as a health risk indicator in individual patients who are then put on weight loss or weight gain programmes prompted by their score, contributes to issues such as eating disorders and poor mental health.

The committee also branded the government’s obesity strategy as “dangerous” for those with negative body image - potentially triggering eating disorders in the people it is designed to help.

“We have been hugely saddened to hear of the number of people who have faced appearance and weight-based discrimination when accessing NHS services,” the report said.

“The use of BMI inspires weight stigma, contributes to eating disorders, and disrupts people’s body image and mental health.”

The Covid pandemic is thought to have worsened the situation for those with eating disorders, or at risk of one.

It recommended that Public Health England stops using BMI as a measure of individual health and instead focuses on a “Health at Every Size” approach.

Such a system would honour differences in factors such as age, ethnicity and gender, and prioritises healthy lifestyle choices over correcting weight, according to the report.

On the obesity strategy, the committee said that it was “at best ineffective and at worst perpetuating unhealthy behaviours” and called for the government to commission an independent review into the evidence base for its policies.

What is the government being urged to do?

  • Replace BMI measures with a focus instead on 'Health at Every Size'

  • Immediately scrap plans for calorie labels on food in restaurants, cafes and takeaways - with concerns it will contribute to growth in eating disorders and disordered eating.

  • Bring forward legislation restricting or banning the use of altered images in adverts, over concerns this is contributing to poor body image.

Chair of the committee Caroline Nokes said: “Over the past 10 years, there has been a wealth of research and recommendations on how to tackle negative body image but government action in this area is limited – we need to see urgent action.

“The pressure will intensify as gyms and beauty salons reopen on Monday,” the Conservative MP added.

“This may be exciting for some but it will be difficult for people who experience body image anxieties. It’s critical that government action works towards improving body image.”

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Tom Quinn, director of external affairs at the eating disorders charity Beat, said the group has seen first hand the impact of the pandemic.

"This past year has been particularly difficult for those affected by eating disorders, with Beat’s helpline alone delivering 100,000 support sessions and seeing a 302% increase in demand, and we believe further measures urgently need to be taken to protect those at risk."

He welcomed the committee's findings, adding: “BMI should never be used as the sole factor in diagnosing eating disorders, or for determining who is ‘unwell enough’ to access treatment.

“This can lead to potentially dangerous delays, and can drive people deeper into eating disorders in order to be taken seriously.

Dr Agnes Ayton, chair of the Faculty of Eating Disorders Psychiatry at the Royal College of Psychiatrists, said: “People with eating disorders should not be denied help based on their BMI. This could put them in a life-threatening position to reduce more weight in order to meet the threshold to access services.

“We urgently need resources and more funding for research if we’re to deal with the hidden epidemic of eating disorders this pandemic has brought on.

“At the same time, public health messaging on weight management must take into account sensitivities around body image and the complexities of this mental illness.

"That’s why it’s vital that patients with eating disorders and the mental health professionals who support them are part of the conversation shaping the anti-obesity strategy.”

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A Department of Health and Social Care spokesperson said: “We know poor body image can be a factor in disordered eating for both men and women and we are committed to improving outcomes for those with eating disorders and related mental health issues – with record funding to expand dedicated services in the community.

“Early intervention services are being launched for young people with eating disorders which could see them begin treatment within two weeks.

“With over six in 10 adults overweight or living with obesity it is important that we take action to help people live healthier lives, and our approach is guided by the latest research and emerging evidence. NHS England has been clear it does not support the use of BMI thresholds.”

If you or someone you know is affected by any of the issues raised in this report, help is available.

Beat offers a support service you can reach on 0808 801 0677.

Their Helplines are open 365 days a year from 9am–8pm during the week, and 4pm–8pm on weekends and bank holidays.