Jonathon Holmes is a Policy Adviser with The King’s Fund.
Following decades of steady increases, the majority of adults in the UK are now overweight. Similarly, childhood obesity rates have been climbing for years, and most recent data shows a big increase during Covid-19.
Increasing rates of obesity are resulting in worse health, greater pressure on the NHS, and widening heath inequalities. Successive governments have failed to grasp the initiative on the growing obesity crisis. It was the Prime Minister’s near fatal brush with Covid-19 that reportedly made him resolve to tackle the issue and bring forward a flagship “Obesity Strategy” which included commitments to ban pre-watershed junk food advertisement and prevent retailers offering Buy One Get One Free deals (BOGOF) on unhealthy foods.
Despite the growing public health crisis, the government have now shelved these plans, citing the rising cost-of-living as justification to delay the policy.
Common sense might suggest that promotional deals like BOGOF will save consumers money and therefore ease the strain on household finances. However, the evidence shows the opposite to be true, BOGOF deals lead to increased consumption and increase overall spending by around 20 per cent. They do this by encouraging us to buy more than we initially intended.
What is more, the proposed ban on BOGOF deals was limited only to unhealthy foods with little nutritional value, like sweets, crisps or chocolate. These products are often positioned near supermarket check outs to maximise likelihood of impulse purchases and leverage so-called “pester-power” of young children.
This is not a fringe theory. Indeed, it was cited by the government as part of the rationale to introduce the policy. In 2020 the government described BOGOF deals as “not ‘good deals’ for our wallet or our health.”
Separately, it is very difficult to see how limiting pre-watershed junk food advertisement could contribute to the rising cost of living. This policy was aimed solely at limiting the promotion of unhealthy food to children. Dropping policies to tackle rising obesity rates is not an effective way of tackling the growing cost of living crisis. It will only be damaging to our health.
If ministers are serious about driving down obesity and tackling the cost of living crisis, they should consider some of the policies set out in the National Food Strategy. like expanding the Healthy Start Scheme which provides vouchers for low income families with young children and pregnant women to buy healthy food and vitamins. Commissioned from the co-founder of the Leon restaurant chain, Henry Dimbleby, the strategy includes a raft of proposals to encourage healthy eating and a more sustainable food system but is currently gathering dust on a shelf in Whitehall.
Moreover, obesity rates are significantly higher in more deprived areas. A range of factors are driving this but put simply, the cost of maintaining a healthy diet and the prevalence of cheap junk food, means that healthy choices are harder to make if you are on a low income.
Following the government own healthy eating guidance, Eatwell Guide, costs nearly three times as much as the average household spends on food and non-alcoholic drinks. More deprived areas have more junk food outlets, meaning that, for those living there, the unhealthy choice is usually the easier or more convenient choice.
This then creates persistent and unfair health inequalities: people from more deprived areas living shorter lives in worse health compared to those in more affluent areas. This disparity means, for example, that men in Blackpool have a life-expectancy of 74, while in East Dorset men can expect to live to 83. As Sajid Javid argued recently, raising up the health outcomes of the least healthy to those of the most healthy is exactly what levelling up should achieve.
The costs to the NHS are eye-watering. NHS expenditure on treating obesity was £6.1 billion in 2014 and given current trends in obesity prevalence, will only grow. The King’s Fund’s own analysis shows that in the year before the pandemic there were over one million obesity related hospital admissions in England, an increase of 17 per cent on the previous year. Rates of obesity related hospital admission in the most deprived areas were more than twice the rate as the wealthiest.
Faced with this level of unfairness and mounting pressure on the NHS, doing nothing cannot be an option. The case for government intervention is clear and compelling, yet this government has shied away from decisive action – like all its recent predecessors.
Effectively tackling the obesity crisis will require a cross-government effort to address the broad range of social and economic factors that sit behind our spiralling obesity rates. The NHS also has a vital role to play. For example, primary care services are starting to trial new weight management interventions, and are working toward offering obese people more guidance and support to make healthy choices.
As a first step, re-thinking this latest u-turn should be a priority. The current obesity crisis was years in the making. Reversing this will not be a quick or easy job, but the worthwhile ones never are.