New Times,
New Thinking.

Why we need a new way of thinking about obesity

The former health minister and chair of Business for Health on why intervention is needed in a broken junk food market.

By James Bethell

Boris Johnson perhaps gave the most emotionally intelligent speech of his life when he tearfully explained how obesity nearly killed him when he was hospitalised with Covid

“When I went into intensive care,” he said, “when I was really ill, I was way overweight … and, you know, I was too fat,” he explained in a Twitter video. “I’ve always wanted to lose weight for ages and ages and like many people I struggle with my weight, I go up and down. But since I recovered from coronavirus, I have been steadily building up my fitness.”

For a moment, it seemed like we might have a serious government obesity strategy backed by a prime minister with the right personal story to change the national mood. But, as was often the way, someone changed his mind, and the Obesity Strategy was shelved. A bitter rearguard was fought through parliament, but ultimately the PM’s original good intentions were binned. 

Two years later, we have gone full circle. A quarter of the nation has a chronic disease, many related to them being overweight. As a consequence, the flow of sick people into the NHS, and soaring obesity-related deaths, have created a crisis. Britain’s resilience is suffering as a result. Yvonne Doyle, the former medical director of Public Health England, has said very clearly that “unhealthy societies are more vulnerable to future pandemics”.

The true cost of obesity to both individual health and the economy is increasingly clear. The ONS calculates more than 15 million people in England are obese, amounting to more than a quarter of the adult population, with a further 37.9 per cent classified as overweight. While the individual health risks associated with obesity are well documented, the UK’s problems deeply impact the economy, the NHS, and wider society. 

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Recent analysis has highlighted that obesity continues to spiral, costing individuals a collective £63.1bn a year, the NHS £19.2bn a year and wider society £15.6bn as a result of loss of productivity from people being too sick to work. 

Solving the obesity crisis does not lie in expanding treatment centres and bariatric surgery provision. Of course, we need to support those living with obesity, but the treatments are extortionate and rarely prove effective. The chance of an obese person attaining normal body weight stands at an annual probability of 1 in 210 for men and 1 in 124 for women. Nor is it enough to rely on tempting sentiments about “industry collaboration” and “individual responsibility”. These have proved to be dangerous distractions promoted by vested interests that delay real action.

I strongly support the message to eat healthy and exercise regularly. Those are my values. But history shows these aspirations have not beaten the lure of a longstanding junk food addiction, sold to the public with punchy advertising amplified by modern algorithms. And the junk food industry has made it very clear that its fiduciary duty to shareholders trumps its corporate social responsibility. It would be folly to wait for the laws of economics to rewrite themselves. This approach has failed us as a nation.

The answer is a more assertive stance against the causes of obesity. Free markets work. They drive prosperity, entrepreneurialism and innovation. Competition promotes consumer choice and efficiencies. But addictive products have created a failed marketplace, killing consumers at huge cost to the national wealth and individual prosperity. We need governments to protect consumers, create guardrails against excess, and empower communities to create healthy food environments. 

Whereas once we prioritised food labelling and informative campaigns aimed at encouraging lifestyle changes, nowadays we realise the importance of restricting access to and promotion of these addictive foods. We realise the importance of positive interventions such as free school meals and ultra-processed food taxes that incentivise eating healthier. We realise why we must lean in with a sugar tax, bans on television adverts for unhealthy food before nine o’clock, and on online adverts.  

These are the interventions necessary to break the so-called junk food cycle, as described by Henry Dimbleby, the food campaigner. Nothing short of that will make an impression. 

Weight loss drugs could be a game-changer, and we should determine their role in our battle against the bulge. But optimistic ministers tempted by a magic solution to this knotty problem should know that it’s unlikely to get rid of the issue altogether. We need to decipher how appetite suppressants fit into a broader national effort. 

Winning the battle against obesity will give our economy a massive supply-side boost. Our workforce will be more productive. The strain of welfare and disability payments will ease pressure on the Treasury. The NHS will have some breathing space as the flow of illness relents. The social care industry and the huge army of unpaid carers will have more time for themselves. 

This is a battle worth fighting. Voters are broadly on our side. It’s time to raise the standard and get stuck in.

[See also: Punitive welfare reforms won’t help sick Britain]

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