A golden opportunity to tackle obesity through food and drink policy

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We need policy to tackle what has become a public health emergency – obesity.

Obesity and diet-related disease are some of the nation’s biggest health threats, with estimates in 2022 to 2023 showing that in England, as many as 22 percent of children aged four to five were overweight or obese. For adults, that number increased to 64 percent, with those aged 55-64 more likely (72.8 percent) to be classed as overweight or obese.

For context, obesity rates in Japan are 5.5 percent and looking back to 1990, only 12 percent of the UK’s population was obese. The rise is staggering and the rates continue to increase each year. 

Now the UK Government has been urged by the House of Lords Food, Diet and Obesity Committee to develop a long-term strategy to fix England’s “broken food system”. The Committee described the government’s recent efforts to tackle obesity as “an utter failure” in its recent report, and the data reflects that. But after as many as 700 wide-ranging policy proposals between 1992 and 2020, where do we go next?

The proposals, previously discussed, set out seven key recommendations to drive change in a society where two-thirds of adults are overweight and just under a third (29 percent) live with obesity. These include a salt and sugar reformulation tax on food manufacturers, a ban on all advertising of unhealthy food across all media by the end of this Parliament, new reporting requirements on the healthiness of food sales for some businesses, and giving the Food Standards Agency (FSA) independent oversight of the food system.

Highlighting the costs

So why is there such an appetite to tackle obesity at a national level? The answer is simple: cost and our health.  

The government estimates that obesity costs the NHS around £6.5 billion a year. The House of Lords Committee report suggests that the current cost of obesity is at least 1-2 percent of UK GDP.

Without action, this cost will only rise. Insights from the think tank Future Health show that obesity is forecast to cost the UK 3 percent of GDP by 2050. This factors in the wider economic impact of obesity and associated medical conditions; for example, among men who have suffered a stroke, the chance of being employed in the following year reduces by 20 percent.

But it isn’t just about the cost; it is also about our health. Needless to say, most of us want a healthy fit nation. We probably all also desire our children to be healthy and grow to become healthy adults. However, given that obesity prevalence also disproportionately affects children in lower-income households, that means it is far more likely that underprivileged children will suffer the most if nothing is done. Change is needed.

Implementing change

Policies and regulations can and do work. Six years ago, almost one in five five-year-olds in the Finnish city of Seinäjoki was overweight or obese. The municipality’s health department improved nutrition education adjusted physical activity requirements in schools and improved school meal nutrition. That approach halved the rates of obesity/overweight children.

The Conservative Government introduced several initiatives to tackle the overconsumption of calories, including the Soft Drink Levy in 2018, calorie labelling, and the introduction of regulations restricting the placement, promotion and advertising of foods with high fat salt and sugar (the HFSS Regs). However, these did not go far enough.  

What about UPFs?

One of the main topics of debate has been the impact of ultra-processed foods (UPFs) on health and investigations have been undertaken to determine whether the level of processing has a negative impact on food and subsequently our health. Indeed, this is one of the points addressed in the Committee’s report, which calls for further research on any potential link.  

While people’s definitions of UPFs will differ, it is generally considered to be a UPF if it includes ingredients you wouldn’t ordinarily find in your home kitchen, alongside multiple additives, such as preservatives, emulsifiers, sweeteners and/or artificial colours and flavours.

In the UK, around two thirds of calories consumed by teenagers and half of the intake for toddlers come from UPFs. Research undertaken by Harvard University over a 34-year period, following 114,000 people, suggested regular consumers of ultra processed meat have a 13 percent higher chance of premature death.

Commentators, and probably those who don’t want a UPF tax, suggest that such a tax will have unwanted side effects. They claim there is no clear consensus on what UPF is, such food taxes would impact low-income families disproportionately, and industry would resist.

Much like the push back on the HFSS regs, this seems like nonsense to me. For starters, there are already recognised categorisation systems for food to determine if the food is UPF. While such systems may not be perfect, they provide a readily available way for any legislation to classify food. So, you either list the foods caught by the tax, or implement a system for determining if a food is UPF.

As for food taxes disproportionately impacting low-income households, I see the argument but again I do not share the view. Much like the Soft Drink Levy, new taxes are designed to encourage food producers to reformulate their products to avoid or reduce tax burdens.

As much as 45,000 tonnes of sugar has been removed from soft drinks since the levy was introduced, despite sales volumes of such drinks rising. The HFSS regs have encouraged the reformulation of biscuits, cereals, cakes, puddings, yoghurts, ice cream and other products caught by the regulations. That is also likely to happen if a UPF tax were introduced.

You must also remember when thinking about financial considerations that money generated from a tax could be used to aid lower income households. Furthermore, if the tax works, the £27 billion cost of treating obesity-related disease should reduce, again freeing up more cash to support lower income households. 

That brings me to industry resisting. Newsflash on this: industry always resists new regulations which could affect the bottom line. It isn’t a reason not to do it.

Further action on advertising bans

Another suggestion from the report is to ban all advertising of unhealthy food across all media by the end of this Parliament. This follows the ban on online adverts for junk food and on TV adverts before 9pm, which will come into force in October 2025.

The imminent changes were a Conservative Government policy that followed consultations in 2019 and 2020 aimed at tackling childhood obesity. We’ve been waiting for the ban to kick in for a long time. It was initially scheduled for 2023 following delays in May 2022, along with ‘buy one get one free’ restrictions, in light of the cost-of-living crisis.

Labour’s mantra of “prevention is better than a cure” means the ban was inevitable. The Government’s impact assessment suggested that the ban would reduce children’s calorie consumption, thereby increasing lifespan, reducing obesity-related disease and saving the public purse around £1.2 billion. Based on that assessment, it is a no brainer.

Research has shown that there is a significant shift in consumer behaviour following legislation tackling junk food promotional activities. In the immediate aftermath of the HFSS in-store product placement regulations, insights company Kantar noticed an £82 million drop in sales of HFSS products. This includes £32.4 million in sales of healthier, non-HFSS alternatives with consumers embracing more savoury choices.

This is strong evidence that legislative action is having a positive impact, and brands, alongside the wider food, drink and retail sector, will take action on calories if they are forced to do so.

What are the next steps?

Ultimately, if the Labour Government wants to lean into more progressive steps, it needs to go beyond how products are marketed. The House of Lords Committee has made recommendations that tackle the food itself, the governance of our food industry and accountability, in addition to how it is promoted. This all-encompassing approach is vital if we are to make positive change and address the ticking time bomb of obesity.

Change will not happen overnight, but Labour has a chance in its first year of government to support initiatives that could see obesity rates fall by the end of this parliament. Depressingly, however, I do not see any clear indications from government that it is planning to make the sweeping changes we need.

The House of Lords has thrown down the gauntlet. Hopefully Labour will accept the challenge.