The Government is now investing in an array of apps to tackle the obesity crisis, with some success. Etan Smallman finds out how much an app can really do
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We make a dizzying average of 200 decisions every day about what we eat. Could apps help us to make better ones? It is a question posed by a new two-part Channel 4 series, Michael Mosley: Who Made Britain Fat?, in which the medical journalist and former doctor examines government policies to tackle obesity.
It is 30 years since the first official strategy to address the problem, during which time rates have quadrupled. A 2020 paper found that there have been almost 700 failed policies in England since 1992.
The Government is now investing in an array of apps to tackle the crisis, with some success. Downloads of Public Health England’s Couch to 5K app reached five million in July last year. But software that helps us to regulate our intake of unhealthy food has been slower to take off.
A study last year by researchers at the Nuffield Department of Primary Care Health Sciences at Oxford University found that participants in three online weight-loss programmes – including the NHS Weight Loss Plan –
lost an average of just over three pounds in 12 weeks. This was not significantly different from members of the control group, who were asked to do absolutely nothing at all. (The study does not relate to the current, upgraded iteration of the NHS Weight Loss Plan app.)
A spokesman for the Department of Health and Social Care (DHSC) says: “The new NHS weight loss app has so far shown very promising results, with the latest evaluation showing an average weight loss of 5.6kg over the course of the 12-week programme. We are committed to helping people live longer, healthier and happier lives, which is why we launched the Office for Health Improvement and Disparities, which will focus on levelling up the health of the nation.”
Dr Claire Madigan, of Loughborough University’s School of Sport, Exercise and Health Sciences, is concerned that a focus on digital over in-person support could be leaving out parts of society. She says: “There is some evidence that they create inequality. Some people might need more support than just an app.”
Another study last year, by researchers at the universities of Bath, Bristol, Cardiff and Exeter, found digital interventions aimed at boosting exercise levels to be effective for better-off members of the community. But it concluded that “for people of low socioeconomic status, there is no evidence that digital physical activity interventions are effective, irrespective of the behaviour change techniques used”.
Dr Madigan believes that the self-monitoring and goal-setting aspects of apps are helpful. She recommends the popular and free My Fitness Pal, which has a 14-million item food database available to help you accurately log everything you eat. But, she says: “Face-to-face programmes tend to work because there is a sense of accountability, where people get weighed in front of the group leader. People want to show others that they are still losing weight.”
She adds that research has found short-term very low-calorie diets (about 800 calories a day, until a healthy weight is achieved, or for up to 12 weeks) are also effective, as well as regular weighing in front of the mirror. “We know through the Weight Control Registry in the US, which is a large study of people who have been really successful at losing a lot of weight and keeping it off, that they do weigh themselves regularly,” Madigan says. “It does keep people on track, and is much better than judging by clothes. People say: ‘Oh I’ll just wait till my clothes are tight’, but you don’t tend to realise they’re tighter, or by the time they are, it might be too late.”
Finally, she says there is no one-size-fits-all solution, adding: “The best thing for weight management is up to the individual. It’s finding something that works for that person so that they are able to stick to it.”
In the first episode of the Channel 4 series, Mosley (inset) meets Amy Whitter, a 31-year-old fitness instructor from Wolverhampton, where more than two-thirds of adults are overweight or obese. The mother of two eagerly signed up to Better Health Rewards, a £6m scheme inspired by a successful programme in Singapore that uses an app and activity tracker to reward you for healthy eating and exercise. Despite a supposed January launch, Ms Whitter is still waiting for it to start.
In the meantime, she tried out the NHS Food Scanner app, which allows you to zap the barcode of a product to be recommended “healthier swaps for next time you shop” (and was relaunched this year by former Girls Aloud singer Nadine Coyle).
Ms Whitter was unpersuaded to incorporate the app into her daily routine. “There were a lot of products that weren’t found,” she says. “Or quite strange products that were coming up as the kind of better option, and you wouldn’t get them in the regular shops. I hadn’t heard of a lot of the things that it was suggesting I change things to.”
When she scanned in a packet of Oreo cookies, the app recommend she instead opt for organic soya chunks. (The DHSC says: “We are working very closely with data partners to expand upon the database of food and drink products and welcome further conversations with retailers, manufacturers and data providers to help fill these gaps, as well as feedback from families.”) Overall, Ms Whitter says: “It’s not really something that I would do in a shop – get your phone out and scan everything, with two children with me.”
Mosley thinks apps have their limits. “Of course governments need to try new things – and we cannot expect them all to work. Technology is transforming healthcare. But my beef with apps on our phones is that they put all the responsibility on us.
“We make on average 200 decisions a day about what to eat, while being bombarded by advertising for cheap, unhealthy food. So that’s a lot to ask. Instead, our governments need to improve the things we’re choosing from.”
- Michael Mosley: Who Made Britain Fat?’ starts tomorrow at 9pm on Channel 4