South Auckland deserves more than a ‘short-sighted, short-term fix’

Te Whatu Ora Counties Manukau recently announced it was running a new obesity clinic in South Auckland.

According to the health agency, it’s for “people and whānau preparing for bariatric surgery, and as an alternative pathway for those not considering surgery”.

The clinic, due to open next month, has been labelled a disgrace by Buttabean Motivation founder Dave Letele.

He says it’s a short-term, quick-fix being targeted at Pacific and Māori really struggling in South Auckland. Worse, it doesn’t get close to fixing the real issues

Here he is talking to Teuila Fuatai.

 

I was so pissed when I saw Te Whatu Ora Counties Manukau had a new clinical programme focused on quick weight-loss.

It’s targeted so specifically at us — at Pacific and Māori living in South Auckland, who really need help with health and weight. I know exactly who the people are that  they’re targeting because I used to be one of them.

In February 2014, I was 210kg. I’d lost my kids, I was broke, really depressed and hated my life. I needed to start moving again and a friend suggested I train to be a boxer. In total, I’ve dropped more than 100kg, and it’s all been through training and being consistent with my food.

Since then, I’ve made it my mission to help people on their own journey — people who were just like me. It’s why we have From the Couch. The 12-week programme is for people who have literally gotten off the couch to start their health journey.

It’s also the same group of people being targeted by Te Whatu Ora’s new programme, Te Mana Ki Tua — even though we’ve already been doing the work for about seven years.

Our programme is based on a model I developed after I helped a guy called Phil Tele’a, whose weight was threatening his life. Phil was nearly 300kg when he messaged me in 2016 saying he wanted to lead a healthier lifestyle. He’d been in hospital and the doctors had told him he was unlikely to reach 30 if he didn’t change something.

I told Phil to come to one of our bootcamps at Māngere Bridge. I would train him and check in with him all the time. How are you going? How’s your eating going?

We didn’t have any facilities back then. We just trained outdoors and at community centres. We’d go to different parks and maunga around Tāmaki. I learned early on that it was the connection between us and the personal support which made all the difference to him.

We took that approach and scaled it up to what’s now become our From the Couch programme. We take groups of 30 at a time. And Phil’s one of the trainers. Like all BBM staff, Phil’s been through the bootcamps. He was 295 kgs when we started working with him and he’s now lost 150 kgs altogether, 70 kgs of that in his first year with us.  Phil is from our community, he’s got lived experience, and he knows the challenges that face our people.

In 2021, my company got $400,000 from Te Whatu Ora to run From the Couch for two years. Alongside that, Te Whatu Ora also put $100,000 to cover medical support from the primary healthcare organisation Total Healthcare, and research into our programme by Massey University.

The money’s really meant we’ve been able to make From the Couch more formal.

It means doctors and nurses from Total Healthcare come to all the sessions and work with our participants along the way. It also means we’re getting research to back us up — and even the head researcher from Massey University can’t believe how good our results are.

Early evaluation results show the average weight loss over 12 weeks is 10 kgs. We also know participants have made major gains with decreases in blood pressure, better diabetic control and lower cholesterol levels. For me though, the mental health improvements are the big thing. So many of our people are feeling down and hopeless, and we’re changing that.

The first interim research report, published in October, focused on mental health. It showed more than half of the participants they’d evaluated were experiencing severe depressive symptoms at the start of their From the Couch programme. At the end, of those who finished, less than seven percent were still experiencing symptoms.

In October last year, Te Whatu Ora asked me for my thoughts on their new obesity programme. Back then, they said they were still designing it. They described a heavy reliance on Optifast meal replacements for people for 12 weeks, then providing food packages for people if they wanted as they went back to eating normal food. Their intention was to support the current bariatric programme at Counties Manukau, and I think that’s really about helping people to lose weight fast — so they qualify for the surgery, or other weight-loss medications.

I didn’t want anything to do with it. It’s a short-sighted, short-term fix.

Optifast is a low-calorie meal replacement drink — you survive on 500 to 700 calories a day. You get quick results. Massive weight loss. The operation also gives you massive weight loss fast. And sure, bariatric surgery has its place, but Counties Manukau already has a programme for that.

They went ahead anyway and announced the programme. They’ve set aside $1.4 million for the clinic’s first year, and they expect 120 people to come through. They’ve also budgeted $2.9 million following that.

Meanwhile, we’re sitting here trying to stretch our $200,000 a year as far as it will go and take through as many groups of 30 as possible.

Since being funded, we’ve taken three groups through our programme in Manukau. We’ve got two running at the moment, and we’re aiming to do another three across West and South Auckland before funding runs out in September.

Honestly, the clinic’s a slap in the face. It’s a disgrace. It makes no sense to pour millions more taxpayer dollars into that type of clinical setup because it just won’t solve the problem for families.

You only need to look around us. Our people are surrounded by bad choices. Everything bad for us is at arm’s length. Not just bad food, but alcohol, addictions like pokies, the TAB. Everything bad is right here. And our people are up against it.

I have parents working two to three jobs, and they’re exhausted. Making healthy meals, even getting the right groceries, is the last thing on the list. Or not even on the list. And that affects the diet and health of the whole whānau.

It’s why we need a holistic approach. Our whānau need navigators, and people who’ve lived through their experiences. Our people don’t come through our door alone, they come in with their kids, nieces, nephews, aunties and uncles. If we want to break the cycles, we’ve got to also educate the children, and the children have to see their parents working hard to achieve their results.

Te Whatu Ora should be working with community groups like us who are already doing this. All of us say the same thing when we see these kinds of initiatives. Stop trying to reinvent the wheel. Why not get rid of all the takeaway outlets around us if you really want to help? Because what happens once they take those meal replacement drinks away from people?

Last month, we started our first ever From the Couch programme in West Auckland —  it was amazing to see because they’ve been crying out for it for so long.

At the first session, one of the GPs who works with us, Richard Hulme, diagnosed four type-two diabetics. We made them aware that they have diabetes and that they need to manage it, and we’ve connected them to the health system. Imagine if we’re able to turn them around from being type-two altogether — because that’s certainly something we’ve achieved many times before. Just think of the taxpayer savings in that.

And the mahi, the community, doesn’t stop there.

Once our people have finished From the Couch, they go through to Heavyweight Champs, which is a bit tougher, and then they move into our general population of boot camps. One of our trainers James McDiarmid started out on From the Couch this time last year. He was nearly 300kgs, and since then he’s lost 115kgs. He’s now a full-time employee and runs the programme in West Auckland.

A lot of the participants end up becoming mentors, who are all volunteer leaders, and then we take as many as we can as full-time employees too. Because we need people who’ve lived it, who’ve been through it, who know what it takes to work with us.

All of our pathways into those different classes are free. You don’t have to start paying for membership, because that’s a barrier to people, and their whānau getting healthier.

If we, and other organisations like us, had more resources, then we could work with far greater numbers. Imagine what we could do with the millions going into this new Te Whatu Ora programme in South Auckland.

The system just needs to stop with the same old shit and actually empower us. We’re already doing the mahi in our communities. We just need more funding and resources.

 

Dave Letele is of Ngāti Maniapoto and Sāmoan descent. He is the founder of Buttabean Motivation, which delivers free health, nutrition, fitness and youth employment programmes. He and his team also run BBM Foodshare — a foodbank service which began during the first Covid lockdown. Dave’s own health journey led to BBM, which began as free group-training sessions at different parks in South Auckland in 2014. He’s also been a heavyweight boxer and played professional rugby league. Dave lives in Tāmaki Makaurau with his wife Koreen and their children.

As told to Teuila Fuatai. Made possible by the Public Interest Journalism Fund.

© E-Tangata, 2023