DR MAX PEMBERTON: Sorry, but vouchers that bribe people to lose weight won't work

Asia's Tech News Daily

Obesity epidemic costs every person in the UK an extra £409 in taxes annuallyA new scheme is being trialed in Wolverhampton for making healthy choices Dr Max says people must recognise long-term health benefits for lasting change 

As a nation, we really are nowhere near as healthy as we could be. The UK is the second fattest country in Europe, after Malta. And one study estimated that the obesity epidemic costs every person in the UK an extra £409 in taxes annually. That’s unacceptable — something simply has to be done.

But what? Despite millions of pounds being spent on public health campaigns, we still seem to be stuck on the couch, shovelling fast food into our mouths without an apparent care in the world.

We clearly need a different approach. Enter a new scheme being trialled in Wolverhampton whereby residents are given incentives, such as free cinema tickets, shopping vouchers and theme park entry, for making healthy living choices.

The coupons — which some have termed ‘sloucher vouchers’ — will be given out to lazy locals who boost their exercise levels and improve their diet.

A new scheme being trialled in Wolverhampton involves residents being given incentives, such as free cinema tickets, shopping vouchers and theme park entry for making healthy living choices (file image)

A new scheme being trialled in Wolverhampton involves residents being given incentives, such as free cinema tickets, shopping vouchers and theme park entry for making healthy living choices (file image)

They’ll be given a fitness tracker linked to an app that will monitor things like step count and the amount of fruit and vegetables they consume.

The £3 million trial is part of a £100 million package of government measures to tackle obesity which, with related diseases, is estimated to cost the NHS an enormous £6 billion a year.

It’s going to run for six months and then may be rolled out across the country.

I’m going to admit to feeling rather conflicted by this. On the one hand I understand that the ‘nudge’ approach of gently encouraging people to make lifestyle changes by offering incentives often, in the long run, saves money.

The improvements made can mean money is saved on costly treatments linked to an unhealthy way of living — prevention being better (and cheaper) than cure.

The idea of incentivising people in this way isn’t actually new. I remember once, when working in a drug rehabilitation clinic, being involved in a study looking at infections in drug users.

It was an uphill struggle because no one volunteered.

After several months of trying and failing to recruit patients to assist, the study suddenly became a success. This was down to one simple thing: money.

Given the importance of the research, it had finally been decided that a financial incentive of a few pounds should be offered to encourage people to participate. Once this had been introduced, the uptake of testing shot up from only a handful of volunteers to nearly every patient I saw.

Dr Max Pemberton (pictured) says for lasting change people must themselves recognise the long-term benefits to their health, rather than be doing it for a night at the cinema courtesy of the taxpayer

Dr Max Pemberton (pictured) says for lasting change people must themselves recognise the long-term benefits to their health, rather than be doing it for a night at the cinema courtesy of the taxpayer

At first I felt uneasy about this as it seemed like bribery. But I came to appreciate that it was a case of weighing up the ethics of financial coercion with the benefits to the greater good the research produced.

Ethically it was complex, but in practical terms the strategy worked, and for the initial investment of a few pounds per recruit, it provided a better understanding of where to direct resources and thus reduce waste.

But offering a benefit like cash to participate in a study is different to bribing people to live healthier lives.

For one, there’s evidence that suggests that, while people are initially keen, in the long term they soon get bored. In particular, those most at risk due to obesity or poor lifestyles are the ones most likely to resort back to their old ways.

Older drivers could avoid prosecution for careless driving under a scheme being considered across the UK. Over-70s who had been tested would avoid a fine and penalty points for offences like driving too slowly or jumping a light. This is a great idea. Older drivers tend to be incredibly safe. From working in A&E, the people I worry about getting behind the wheel are young men. 

The bribes seem less exciting, lose their novelty and appeal, and the effort that is required to get them soon tips the scales the other way.

For lasting change, people have to really want to change. They themselves must recognise the long-term benefits to their health, rather than be doing it for a night at the cinema courtesy of the taxpayer.

And this is another issue I have with schemes like this.

As a taxpayer, I rather resent my money being spent on things like shopping vouchers for other people to get them to do the things — like going to the gym or eating healthily — that I do anyway. It just seems inherently unfair.

Yes, I understand that in a socialised medical model like the NHS we all have to carry the burden of other people’s choices and therefore it’s in all our benefits to do what we can to get them to improve things.

But still, while it’s probably the right thing to at least try, the scheme rather sticks in the craw doesn’t it?


Therapy beats a boob job, Shirley

Dr Max said rarely do cosmetic procedures improve body confidence in the long term and certainly don’t fix the underlying problems in any relationship. Pictured: Shirley Ballas who had breast augmentation and liposuction in a bid to improve her self-esteem
Pictured: Shirley on the cover of Prima magazine

Dr Max said rarely do cosmetic procedures improve body confidence in the long term and certainly don’t fix the underlying problems in any relationship. Pictured: Shirley Ballas who had breast augmentation and liposuction in a bid to improve her self-esteem 

Strictly Come Dancing head judge Shirley Ballas has spoken candidly about the lengths she went to to save her marriage before realising she was ‘doing it for the wrong reasons’. As well as breast augmentation, she had liposuction to her arms and legs in a bid to improve her self-esteem. I feel for Shirley — I’ve seen so many women who have undergone similar invasive procedures under the misguided belief that it will help their relationship. The truth is these procedures rarely improve body confidence in the long term and certainly don’t fix the underlying problems in any relationship. When people ask my advice about cosmetic procedures, I always say the same thing: have psychotherapy for two years (which will cost far less) and work on your self-esteem. If after this you still want it done, do it with my blessing. So far, not a single person who has gone through the therapy has had surgery, but they have all felt much better about themselves — and their bodies.


Dr Max admits that he doesn't buy that a third of us are walking around with a mental illness once the dark nights set in. Pictured: Mick Jagger wearing 'sad  glasses'

Dr Max admits that he doesn’t buy that a third of us are walking around with a mental illness once the dark nights set in. Pictured: Mick Jagger wearing ‘sad  glasses’ 

  • Mick Jagger has been photographed wearing ‘sad glasses’. No, not glasses that are uncool — these are the latest fad for treating seasonal affective disorder (SAD), where the symptoms of depression are triggered by the onset of winter. While I’ve seen a few patients over the years who seem to have a seasonal variation to their depression, studies suggest one in three people suffer. Really? A third of us are walking around with a mental illness once the dark nights set in? I just don’t buy it. Feeling a bit down or miserable because it’s cold outside is not the same as being clinically depressed.

Dr Max prescribes…

Qigong for endometriosis

Often referred to as Chinese yoga, Qigong aims to help sleep, stress and energy levels. Research has shown that it can also relieve chronic pain from conditions including endometriosis — a common and painful condition where the lining of the womb grows outside the uterus. If you’re unfortunate enough to suffer from this, there’s an online two-hour Qigong session on wellbeing website kaylolife.com — part of the site’s ‘endo week’.

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