Comment on NIHR research: ‘How can local authorities reduce obesity’

Greg Fell, Vice President, Association of Directors of Public Health (UK) 

We very much welcome the publication of today's review of research into obesity put together by the NIHR - the review offers a helpful summary of some of the critical pieces of evidence published by the NIHR over recent years and serves as a useful guide for local authorities. 

With over 25% of adults and 35% of children leaving primary school living with the condition, obesity and overweight has already overtaken smoking as the leading cause of morbidity in this country according to the global burden of disease survey. It will soon overtake smoking as our leading cause of death.  

These stark figures will have a significant impact on demand for social care and the NHS. They also have important knock-on economic effects as many of the people affected are of working age.  

The consequences of obesity will, therefore, be felt in all parts of local government and this guide helpfully focuses our attention on the evidence base for interventions and what might work in moving away from the obesogenic environment. 

It is impossible to ignore commercial influences on our choices, choices which can often be to the detriment of our weight. Disappointingly, the Government’s decision to delay imposing restrictions on advertising and multibuy deals for high sugar, fat and salt foods will continue to mean that while there is plenty of evidence documenting the tactics of industry to shift our choices, there is less evidence of the impact of this type of nationwide intervention.  

It is important therefore to develop our evidence base of investigating the impact of local level interventions that countermand the commercial influence on health.  

The next stage in this development of robust evidence will be the inclusion of information about the costs and benefits of interventions linked to the social, economic and environmental causes of obesity. Prevention interventions require investment. We will therefore need to capture and evaluate the level of return on that investment and how it impacts the whole of society.  

These are only parts of the jigsaw however - getting the framing right for obesity, as with all public health issues, is vital. Obesity is not an issue we can treat our way out of and requires a whole system approach by a range of partners to build a culture where healthy weight is the default.