New UK Obesity Initiative – Small Step, Right Direction
On 27 July, the Department of Health and Social Care announced the government’s obesity initiative, urging the nation to lose weight “to beat coronavirus” and “protect the NHS”. For the stated purpose, it’s probably too little too late. The initiative is backed up by a 67-page report that convincingly establishes the correlation between excess weight and your chance of getting the virus, spending time in an ICU and dying. That said, we have a fair shot at a vaccine in far less time than it will take a meaningful number of people to lose a meaningful amount of weight.
But, for public health in the longer term, it’s a small step in the right direction. Obesity is a significant risk factor for developing cardiovascular disease, type 2 diabetes, at least 12 types of cancer, liver and respiratory disease, and mental health problems. For that, we applaud the government’s initiative and hope there is more to come.
If you want to know how obesity is defined and how many of us are actually obese, see our recent blog post here.
So, what exactly does the government’s initiative involve? Broadly, three things.
1. Ban on Advertising and Promoting Junk Food
Yes, the government actually has a complex formula to determine if something is junk food, or “HFSS” as they call it (high fat, sugar and salt foods). A food is assigned “bad” points based on calories, saturated fat, sugar and salt per 100 grams. Then it gets “good” points for fruit and veg, fibre and protein content. If bad minus good exceeds a threshold, it’s junk food. It’s imperfect in many respects, but at least it’s objective and hard to manipulate.
So, in an effort to prevent our children from developing bad eating habits, the government is banning advertising junk food on TV and online before 9.00 pm. Currently, half of the ads for food on mainstream TV are for junk food.
The government is also banning “buy one get one free” promotions for junk food and any other promotion of junk food by volume. The idea is to shift price promotions to healthier foods.
2. More Calorie Labeling
We are well accustomed to seeing calorie and nutrition labels on most packaged food that we buy in shops. The new rules will extend labelling requirements to restaurants, cafes and takeaways that employ more than 250 employees and to alcoholic beverages. Studies show that people commonly underestimate the calorie content of these foods and beverages.
3. More NHS Support
At present, it’s not easy to get effective weight management on the NHS. From next year, obese people who are also type 2 diabetic or who have high blood pressure will have access to services. That’s not everyone who needs help, but it is a lot of people.
Are these steps in the right direction?
It’s hard to take issue with calorie labelling. Surely, the costs of labelling are modest and those costs are applied evenhandedly to all who meet the criteria. So, we can probably safely assume that the burden on producers and retailers, and on competition, is minimal.
The cynical among us might take issue with more NHS spending on health conditions that people can fix by themselves. After all, we all have the ability to lose weight on our own with a bit of knowledge and a lot of willpower. But the fact is it can be extremely difficult to succeed, particularly for obese people. I am in favour of spending taxpayer money on helping people lose weight because it’s a good investment. At present, treating health conditions caused by being overweight or obese costs the NHS £6.1 billion per year. Weight management counselling is far cheaper than bariatric surgery. The opportunity to save money and help more people is obvious.
I do struggle with the ban on junk food advertising and promotions. It reeks of the nanny state trying to interfere in adult choices. It’s also government taking over parental responsibility for raising and educating children. While I don’t approve of either in general, I think it’s the right step in this particular case.
The fact is many adults make bad choices all the time, and the taxpayer pays for them. Many adults do not teach their children to make good choices and instead fuel their children’s junk food habit. Again, the taxpayer pays. Sure, there are plenty of socio-economic reasons why adults make bad choices and fail their children. For me, it’s not about assigning blame. It’s about the appropriateness of the state stepping in when adult behaviour harms others. And it’s about protecting the public purse.
The jury is out on the question of whether bans on advertising and promotions will work. We know that bans on tobacco advertising had some positive effect, but we also assume that taxing tobacco to put it beyond the reach of most people had a much greater effect.
For so long as junk food is cheap and plentiful, these new measures will only nibble at the heel of the problem. I hope there is more to come.