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The problem is we live in a world where bad habits are made to look attractive and are easy to indulge and satisfy, says Peter Kelly…

The Telegraph recently reported on a healthy living trial by the NHS in Wolverhampton. It said that in 2023, there was a five-month trial where patients were encouraged to download the Better Health app and engage in healthy behaviours in exchange for financial rewards.

Participants were rewarded with gym passes, supermarket coupons, high street gift vouchers and cinema tickets for engaging with the app. This is slightly similar to schemes private health insurers use.

Private health insurers will reward you with discounts and cinema tickets if you log healthy living indicators on their apps. For example, if you use an exercise tracking devices, go to affiliated gyms or volunteer at a park run, Vitality private health will give you points that you can then use for claiming rewards.

Obesity is said to cost the NHS more than £6 billion a year

In the NHS scheme, the Government gave away £500,000 and concluded the trial produced trivial results. In one sense, that’s a lot of money but on the other hand, obesity is said to cost the NHS more than £6 billion a year, so the money was a drop in the ocean really.

The average payout on the scheme was £72 – not exactly life-changing money. The general consensus in the comments section of the article was that this trial was a tremendous waste of money.

The pinned comment under the article was from a lady who stated she was “fed up by the tax-payer having to expend large amounts of money on people who will not help themselves and ignore all medical advice. They have chosen this route!”

Another gentleman commented that “people are generally lazy and just want a quick fix or to make it someone else’s problem”. There are a lot of comments along the lines of ‘Government finds new ways to waste my money’.

Personally, I would like to see more reporting on trials like this. I think it would be very beneficial to have the architects of such trials explain what prompted them and why they think they may work.

This trial has been completely trashed by The Telegraph and plenty more armchair critics. Is the criticism fair? Three months is not a long time for a trial. Who helped design the trial?

In the international bestselling book Atomic Habits, James Clear outlines a practical guide on how to change your habits and get one per cent better every day. He talks about how small changes can have a big effect over time.

The Telegraph did report that the participants who were paid out the most on the scheme made the best improvements. The study found that exercise increased by around one minute a day and that fruit and veg intake increased by two portions extra a week.

But there was no improvements in the amount of saturated fats and sugars consumed. These results were seen as not statistically significant.

In Atomic Habits, Clear states that small habits make a big difference and he tell us to forget about setting goals and instead focus on our system instead. He says you do not rise to the level of your goals, you fall to level of your systems. In this trial, were new systems discussed and implemented? Another big lesson of Atomic Habits is that habits are very identity-based.

And the key to building good habits and overcoming bad habits is focusing on creating a new identity first which is in line with practicing good habits. Was this idea discussed and encouraged on the trial?

To change your beliefs, Clear suggests you first decide what person you want to be and then prove it to yourself with small wins. Easy, right? He talks about the four steps of building good habits and breaking bad habits. Cue, Craving, Response and Reward. 

How to create a good habit:

Cue: Make it obvious.

Craving: Make it attractive.

Response: Make it easy.

Reward: Make it satisfying. 

How to break a bad habit:

Cue: Make it invisible.

Craving: Make it unattractive.

Response: Make it difficult.

Reward: Make it unsatisfying.

The problem for us and the people of Wolverhampton who took part in the trial is we all live in a world where bad habits are made to look attractive and are easy to indulge and satisfy. We are constantly bombarded by highly sophisticated and expensive advertising telling us how attractive bad habits are, such as eating fast food, drinking alcohol and gambling.

Ad campaigns for bad habits hire celebrities and use the top advertising agencies in the world. Campaigns for good habits print some flyers and posters and stick them up in pharmacies – no celebrities, no blockbuster Hollywood movie affiliate campaigns, no multi-million pound budgets.

Is it really a lack of personal responsibility that people are overweight? Or is it because our smartest and brightest are telling them what to do if they want some satisfaction?

Peter Kelly is a pharmacist based in London and a stand-up comedian.