23. mayo 2023
Obesity has long been a pressing concern in the UK, holding one of the highest obesity rates globally. This issue not only contributes to significant burdens on the healthcare system but also exacerbates broader inequalities. As the UK government strives to address health disparities, tackling obesity has become a key priority. But what is the future of obesity policy in the UK and and what initiatives are aimed at prevention and intervention.
The Magnitude of the Problem
The prevalence of obesity has surged in recent decades due to changes in food systems, lifestyles, and work patterns. Disturbingly, the UK stands as the third-highest country in Europe with an obesity rate of 25.9%, affecting around two-thirds of adults and one-third of children who are overweight or obese. This epidemic places immense strain on the National Health Service (NHS), amplifying existing workloads and budgetary pressures. In 2018-19, 900,000 obesity-related hospital admissions were recorded costing an estimated £6.1 billion. If left unaddressed, these costs are projected to escalate to £9.7 billion by 2050, burdening future generations.
Shifting from Treatment to Prevention
In 2019, the UK outlined a transformative strategy centered on the prevention and early detection of diseases in the NHS Long Term Plan, recognising the urgency and need to address growing challenges such as obesity rates. With a focus on health inequalities, the plan introduced innovative NHS prevention programmes targeting conditions such as diabetes, cardiovascular disease, and cancer—where obesity serves as a significant risk factor.
Whilst groundbreaking treatments such as Semaglutide show promise for type-2 diabetes sufferers, their long-term safety and cost-effectiveness must be carefully evaluated. Most recently, this drug has achieved ‘celebrity status’, as it is increasingly being used by celebrities and alike for weight loss purposes, piling onto a toxic culture of social media weight loss promotion targeted at the young and vulnerable, and simultaneously making the drug less accessible to those who require it for treatment purposes.
Recent Initiatives and Challenges
Building upon the NHS Long Term Plan, the UK government launched an ambitious Obesity Strategy in 2020 in response to the escalating obesity crisis. Departing from previous approaches focused on individual behaviour change, the strategy aimed to transform the external food-shopping environment to promote healthier choices. Introducing measures to restrict online and TV advertising as well as volume- and location-based promotions for high-fat, sugar, and salt (HFSS) foods. These initiatives were widely supported by health experts, who had long advocated for such changes.
Additionally, in the following year, the government commissioned the National Food Strategy (2021), an independent review that shed light on the market incentives that drive the consumption of unhealthy foods. It recommended building on the success of the sugar tax, which was introduced in 2018 as part of the childhood obesity plan for action and prompted the reformulation of low-sugar recipes by the industry, resulting in a 35.4% reduction in total sugar sold in soft drinks between 2015 and 2019. The report proposed a similar tax on sugar and salt, with revenue allocated to helping low-income families afford fresh fruits and vegetables.
Barriers and Criticisms
Despite successive governments’ focus on obesity since 1992, policy implementation has consistently fallen short. High turnover of ministers and a lack of continuity in policies have undermined efforts to address long-term health implications. Additionally, concerns about appearing intrusive and favouring individual responsibility over systemic interventions have hindered progress. Market-based measures have faced opposition, as they are often seen as disproportionately affecting low-income individuals who rely on the cheapest and unhealthiest foods.
Following Boris Johnson’s departure, much of the 2020 strategy has been delayed or dropped. His successor Liz Truss announced a review of the key measures in response to the cost-of-living crisis, leading to a significant delay in the restriction of volume-based HFSS promotions. However, Truss also questioned the sugar tax and delayed the advertising ban on HFSS products to October 2025, leaving it up to the next government to implement – a move which William Hague, former Conservative Party leader, called “morally reprehensible”.
The delay and abandonment of key policies have been met with fierce criticism from stakeholders. Only some recommendations made in the National Food Strategy were implemented, leading Henry Dimbleby, charged with creating the 2021 National Food Strategy, to quit his position. The Obesity Health Alliance, a group of over 70 health charity leaders, medical organisations, and health professionals also sent an open letter to the Prime Minister expressing their concern, highlighting that measures have been dropped without parliamentary approval.
The Future of Obesity Policy
Looking at the government’s track record, we can acknowledge that there will be a future of obesity policy in the UK. However, it is unclear to what extent stakeholders and decision makers will work together to truly prioritise this challenge and shape our population health for the better. Tackling obesity has been a government target for decades. Strategies, reviews, reports, and legislation have been written and implemented, but often reworked, delayed, or dropped completely. Undoubtedly external factors have had a driving force, especially in recent years, given the slight distractions of Brexit, a pandemic, and with a cycle of political chaos that has frustrated effective cooperation.
We know that the UK government sees prevention as the key to dealing with increasing health pressures. On wider health policy, Health Secretary Steve Barclay pronounced technology as “crucial to a forward-looking, modern NHS”. A £20 million research boost was announced last year, which will make new medicines and digital technologies available to patients, including apps encouraging lifestyle changes.
Past approaches demonstrate that behavioural policies are ineffective in stabilising, let alone reversing, obesity trends. A wider health strategy centered around technological innovation will help, but the most effective measure is market intervention – which advocacy groups should continue to campaign for.
We can be idealistic and say that effective disease prevention is only possible through a long-term cross-party strategy; but we are fast approaching a general election with the Conservative Party desperately trying to hold onto power and the Labour Party more focused than ever on nabbing the top seat. How high will tackling obesity end up on each party’s manifestos?The RPP London team will continue to follow developments closely. If you have any questions on this topic, please don’t hesitate to contact us.