I welcome a new obesity strategy but its modest proposals kick in too late

The government’s new obesity strategy opens with the clear case for action, rightly describing it as one of this country’s greatest long-term health challenges. One in three children are leaving primary school overweight and one in five living with obesity. Young people in the most deprived parts of the country are more than twice as likely to be affected as those living in the richest areas, ingraining stark health inequality from early childhood. This gap has been steadily increasing for years, with no serious action beyond the Soft Drinks Industry Levy, SDIL, brought in under the coalition.

Many attribute the prime minister’s change of heart on the need to tackle the root causes of obesity to his own experience of Covid-19. It was impossible to ignore the overwhelming evidence that linked obesity to more serious complications including a higher risk of death from the virus.

Given the widespread concerns about a second wave of coronavirus infections this winter, time is however very short to make an impact on fitness and weight in order to reduce individual risk.

Many of the measures in the strategy, such as those tackling excess calories in the take-away sector, are not going to come on stream until late 2022. That is far too late, especially given that discussions have taken place for many years with all sections of the food and drink industry. The proposals are modest and do not include powers for local authorities to take meaningful action against those who compete by adding more salt, fat and junk calories to boost sales. Many of these businesses will be untouched by the requirements to set out calorie counts as they will not apply to those with fewer than 250 employees.

The strategy also completely ignores calls to expand the highly successful SDIL, which has painlessly resulted in a rapid reduction in the sugar content of fizzy drinks. In many ways it was the perfect tax, as the reformulation it drove resulted in very little needing to be collected. The obesity strategy is a missed opportunity to apply the same principle to other high-sugar coffee and smoothie drinks and some types of foods.

That said, there is plenty to welcome, especially proposals on a 9pm watershed for the advertising of junk foods high in fat, salt and sugar to reduce the harms to children from saturation marketing during popular family programmes.

The strategy also looks set to end price promotions such as Buy One Get One Free on junk food and drink. It will not mean that BOGOFs truly bog off, it just stipulates that supermarkets will only be able to offer them on healthier products. Given the clear evidence that these offers drive higher sales, it makes sense to incentivise better choices but this needs to happen quickly. Likewise, the proposed ban on lucrative end-of-isle and other prime placements for junk food and drink is sensible. Many parents will welcome not having to run the chicanes of sweets and crisps at the checkouts.

There is a clear recognition of the importance of calorie reduction in the strategy but it does not ignore wider lifestyle advice. Exercise matters and improves health whatever your weight. Successful programmes tackling childhood obesity in Amsterdam worked by taking a whole-system and locally-led approach that made it everyone’s business to improve the health of children.

More detail is promised on individual programmes to help those who are already struggling with their weight, but there is the inevitable app to get us started.

The new cycling strategy also announced this week is impressive in its scope and potential to transform the way we get around. It will require long-term stable funding for local authorities, rather than stop/start grants that mean many areas completely miss out on the chance to develop safe infrastructure or retain expertise. The proposals stretch a limited budget and no further funds have been announced beyond the commitments already made earlier this year. A transformation of infrastructure, and a Highway Code and supporting legislation that prioritises active travel and health, would be an opportunity to at least create one positive long-term legacy from the devastation wrought by the pandemic.