A government proposal that singles out people affected by weight or addiction problems creates easy scapegoats when effective health support is needed
We are living in a country being run by a pack of playground bullies. If anyone still had any doubts about this, government announcements of the last few weeks must surely have removed them. The systematic targeting of the vulnerable in the form of benefit sanctions (while protecting the interests of the powerful) panders to the lowest instincts of the crowd.
And nowhere is this more blatant than in the government's recent proposals to cut the benefits of people unable to work because of weight or addiction problems if they refuse to "engage with treatment". It is hard to conceive a more obvious target than the image of someone so fat they can't work, parked on a giant reinforced sofa, in a flat you are paying for, stuffing down food (paid for by your hard-earned taxes), getting fatter and fatter, whilst flatly refusing to engage with help that could transform them into a productive (tax-paying) member of society. Unless, of course, it's the image of someone tanked up on Tennent's Extra ... (you can fill in the rest).
Never mind that these are stereotypes, and grossly simplistic ones at that. Bullies don't do complexity, they thrive on first impressions.
Never mind that according to figures obtained from the Department for Work and Pensions, out of a total of 2.5 million people receiving incapacity benefit/severe disablement allowance or employment and support allowance, which is replacing them, just 1,780 do so as a result of obesity. We are talking peanuts (carrot sticks?) in terms of financial saving; but this is not about money.
Never mind that those who work with the target groups have already expressed concern about the effectiveness, practicality and ethics of such measures. When Westminster council suggested doing something similar, Dr Lawrence Buckman, the British Medical Association GP committee chairman, dismissed their proposals as "some of the silliest things I've heard in a long time", claiming that when he'd first heard about them he'd assumed it must be a joke.
Never mind that it's surely obvious to anyone with even a cursory knowledge of human psychology that attempting to change self-destructive behaviour by means of bullying and threats is not only unhelpful but likely to prove decidedly counterproductive. This is not about helping people; this is all about winning votes.
If the government actually wanted to help people struggling with severe obesity and addiction problems then it might start by addressing the gross imbalance which sees mental-health services receive only 13% of the NHS budget, despite accounting for 23% of the total impact of ill health in the UK. It might start to listen to the chorus of voices from patient groups to professional bodies, carers and mental health charities all saying unequivocally that mental-health services are in crisis, "a car crash", according to Professor Sue Bailey, the former president of the Royal College of Psychiatrists.
Because, believe it or not, overeating to such an extent that one is unable to go out to work is suggestive of underlying psychological issues. And though it might not suit the government's "self-infliction" rhetoric, there is a strong correlation between adverse childhood experiences, such as sexual, physical or emotional abuse, and adult drug and alcohol problems. In the field of severe obesity more research is needed, but anecdotal evidence from bariatric specialists suggests somewhere in the region of 50% of patients report histories of sexual and/or physical abuse.
These proposals will do nothing whatever to help such individuals. Indeed, in corrupting and undermining relationships between service users and professionals they can only make recovery harder. But the damage goes further than that. If we don't stand up to the bullies, we risk becoming like them. We lose our compassion and decency. In pandering to our lowest instincts, the bullies demean us too.
Eating disorders that lead to obesity and addiction can be linked to mental health issues, yet treatment is curtailed by underfunding. Photograph: Kevin Britland/Alamy
