Ending the obesity epidemic
Today, the Health and Social Care Committee published its final report of the food and weight management inquiry. In it, the committee calls on the Prime Minister to follow through on the promise to “launch a moonshot to end the obesity epidemic” by making tackling obesity a priority – with targets and milestones towards reducing rates – across all departments.
In their evidence, our Vice President, Alice Wiseman MBE, Director of Public Health for Newcastle and Gateshead, and Helen Gollins, Director of Public Health for Trafford, stressed the importance of this multi-faceted approach, explaining that there was no single solution and that agencies must work together.
I was particularly pleased to see the report’s emphasis on prevention and needing regulatory changes to the food environment. As Alice said in her evidence:
“It is not possible for a whole generation of people to lose willpower all at the same time, and actually, what we need to start thinking about is the population measures that we can take to address this as an issue rather than always thinking about individual interventions.”
Recently, I spoke at an international conference on childhood nutrition, organised by the Sabri Űlker Foundation and The Nutrition Society. Sadly, I didn’t get to go to Istanbul, but, through the magic of technology, was able to take part in the panel on public health approaches where I talked about just this issue.
While living with obesity carries significant risks for people of all ages, it is especially important to address obesity among children and young people. In the UK, more than one in five children leaving primary school are living with obesity, with one in three classed as above a healthy weight. This is a marked increase from obesity levels in the 1990’s and, as Alice said, has not happened by chance – over the years, food high in fat, sugar and salt has been made more attractive, available, and affordable.
In short – our food environment has changed dramatically, with dire consequences; ultra-processed food is one of just four products (along with tobacco, alcohol and fossil fuels) that are responsible for 19 million deaths worldwide every year.
What our children are eating is particularly important because our lifelong food habits are formed in childhood – that means we not only need to get it right for their health as children, but for their ongoing health and wellbeing. And it isn’t just about their physical health and wellbeing needs – it is about their engagement and achievement at school, which can impact subsequent ability to contribute to the economy, and the cost any ill-health has to our health and social care services.
No-one is arguing there isn’t a problem, but one reason the problem is growing is because there is argument about who is to blame and what the solution is.
For me, the answer is obvious. Obesity is not the result of individual behaviour, personal responsibility or “lifestyle choice”. Healthy food is expensive and not seen as particularly desirable, particularly for children. By contrast, unhealthy food is cheap and highly attractive because manufacturers of unhealthy food products spend millions on advertising and marketing. They wouldn’t do that if it didn’t result in sales and high returns.
There are a host of other factors too, like access to open green spaces and opportunities to exercise in a safe environment but, put simply, obesity and food-related ill health are the natural consequence of living in an increasingly unhealthy environment, shaped by commercial, economic, political and social forces.
Therefore, investing in weight management services and weight-loss drugs, while helpful to treat the problem, and definitely needed to support individuals living with obesity right now, is not a viable, long-term solution. Instead, to prevent people from becoming overweight, we need to stop relying on medicalised solutions and develop policies that are designed to provide children with the healthiest start possible. When it comes to food, that means improving access to healthier food and restricting the influence of unhealthy products.
The challenge isn’t identifying what works – that bit is simple and we’ve seen how an upstream approach can work with tobacco control. Apply the same principles to food to improve our nutritional intake and we need legislation free from industry influence, taxation, subsidies, mandatory reformulation, licensing powers, advertising controls, ethical investment and local food-system leadership.
Importantly, resistance to these changes isn’t coming from the public. Polling carried out last year found that 74% of people want the Government to prioritise the public’s health over business growth, while 81% believe companies put profit ahead of public health.
The difficulty with bringing these policy changes about comes down to developing the power, confidence, and political will to act independently from the drive for profit. It is happening at a local level, as highlighted to the HSCC in our evidence, and we have seen some ambition and commitment at a national level, like for example the updated School Food Standards and upcoming ban on the sale of energy drinks to children under 16.
However, what is needed now to really shift the dial is sustained action across the policy ecosystem that is implemented no matter who is in power so that we can properly protect our children from being exploited for profit and start giving them and their families the freedom and opportunity to lay the foundations for a long, healthy, happy life.