How Much?

(This was originally published 18 months ago)

The NHS South West Essex and Basildon council are due to start piloting a project paying severely overweight patients to lose weight from September. The scheme, Pound-for-Pound, is using Asda shopping vouchers as an incentive to lose weight.

One hundred volunteers will be selected from both sexes to participate in the trails. If it is proven to  be successful, the NHS hope to use it in the rest of the UK and save money in the long term.

Although there is no definitive weight requirements or set targets, the body mass index (BMI) of patients must indicate they are severely overweight. The BMI is calculated from their height, weight and gender. A BMI measurement of over 30 is considered obese. Nearly two thirds of adults within the UK are overweight or clinically obese and significantly more children are becoming classified as obese.

There are also no set targets, so the patients must agree to set their own goals. They will be educated about healthy long term weight loss through wholesome eating and exercise. The volunteers must agree to a weigh in after three months, when a photograph will also be taken to compare to their original.

Experts, such as Jo Grayley of Weight Watchers, have warned it is irresponsible  to reward weight loss financially and could encourage crash dieting. 'Without support over a three-month period, there will be weeks where motivation levels will drop. You would also get people who might do  silly things to lose a lot of weight for the reward. It can be dangerous to lose a lot of weight in a short amount of time. Losing weight should be its own incentive. I don't think attaching a monetary  reward to it is necessarily a good idea'.

It has certainly got many people debating the benefits of healthy long term eating. Katie Bolton of LeedsGrub (an on-line Leeds based food review blog) advised 'We need to eat to survive, but why not enjoy something we have to do by necessity.  I get far more pleasure from eating nice food than I do from looking  thin'.
Although she also stated, 'Healthy food is perceived as expensive, so giving people money to spend on better food could help them'.
She believes 'it is much more important to re-educate people in nutrition, budgeting for shopping and how to cook proper meals, this will help people to eat tasty enjoyable, nutritionally sound meals on a budget'.

Many of the commercially available diet plans (Weight Watchers, Slimfast, Jenny Craig) have websites where you can get hints and tips from professionals and forums where you can get support from other dieters. There are a number of diets available on the market, so is the reward of good health no longer enough?

Last year a government report recommended using a series of measures, including compulsory cooking lessons in schools and possible financial incentives. Although there were no proposals at the time, Department of Health sources indicated healthy eating vouchers were an idea.

The project, funded by Basildon Council who have set aside £1,000 for the scheme, believe it provides better value for money than previous schemes it has introduced, notably a £75 per month gym memberships scheme, which was rarely used.

A Basildon Council spokesman said: 'We don't want to encourage people to excessive weight  loss. It's a small push in the right direction.'

Obesity causes a host of health problems including diabetes, heart disease, infertility and some cancers. It is already costing the NHS hundreds of millions of pounds each year.

Although there are no targets for patients as yet, it remains to be seen whether the NHS will set targets for the doctors and nurses involved in the trial.

Questions have being raised around how the vouchers can be spent, Asda has confirmed it will only allow the vouchers to be  spent on healthy foods, such  as fruit and vegetables.