Stricter laws on unhealthy food and drink should be put in place as a 10-year government programme to reduce obesity is having virtually no effect.
Relatively little progress in reducing ‘excess weight’ has been made during the seven years since plans to reduce levels of obesity in England were released. And self-regulation by the retail sector has failed because politicians are too worried about economic repercussions, according to a new report by health policy experts.
Instead, radical changes – that might reflect the approach used with the tobacco industry – need to be implemented to reduce the prevalence of overweight and obesity that contributes to almost three million deaths a year. A major concern raised is the relationships between governments and industry.
‘Government and industry partnerships have actually reduced the effectiveness of resultant policies,’ said Dr Stuart Flint, senior research fellow at the Carnegie School of Sport at Leeds Beckett University.
‘The food retail industry has no competence in public health and therefore no role in making public health policy. Industry involvement in public health policy making has led to weak action.
‘To enable meaningful change, the government should strengthen its approach and prioritise the known impact on population health of unhealthy foods and drinks over the hypothetical economic impacts of losing industry favour.
‘The responsibility lies with the government, and the food retail industry must be made to deal with the consequences.’
Dr Flint, alongside Dr Emily Oliver of Durham University, has outlined the errors in policy – and potential solutions – in a new paper published by Cambridge University Press.
At the heart of the problem, according to the paper, was a key government national policy: ‘Healthy Lives, Healthy People: A Call to Action on Obesity in England’.
Published in October 2011, the policy had bold and explicit aspirations to achieve both a sustained downward trend in the level of ‘excess weight’ in children and adults by 2020. The policy also aimed to work in partnership with businesses to address health issues.
Globally, obesity rates have tripled since 1975, with 41 million children under the age of five overweight or obese. In the UK, 63% of adults are overweight, according to the Organisation for Economic Cooperation and Development (OECD).
Dr Flint said the government faced several challenges in delivering on its health strategy, including how companies could collaborate without a conflict of interest. While aiming to meet their social responsibility agendas, businesses had tried to reduce the possibility of regulations for purely financial reasons.
‘There’s an issue about when goals are misaligned or directly conflicting and profit motives are obvious,’ he said.
‘For example, the government’s 2010 Public Health Responsibility Deal has been criticised heavily for allowing food and drink brands to have input during its development.’
Genuine legislative threat, external monitoring and sanctions had proved most effective in provoking change, with recent environmental laws a prime example. While some changes were already underway, including salt reduction and nutrition labelling, other areas such as food pricing strategies and marketing restrictions were lagging behind.
There was almost deliberate confusion caused by health claims, said Dr Flint, with the public told that unhealthy products can be consumed as part of a healthy lifestyle. The high-profile Soft Drinks Industry Levy – commonly known as the sugar tax – was also devised as a way of reducing current levels of childhood obesity.
But rather than reformulate their products with a lower proportion of sugar, the industry had instead focused on reducing the size of their products.
Some progress had been made, he said, regarding the marketing of unhealthy foods and drinks. However, the government had yet to adopt the All-Party Parliamentary Group on Obesity’s recommendations to ‘implement a 9pm watershed on advertisement of food and drink high in fat, sugar and salt’.
Dr Flint said: ‘Adopting softer approaches has enabled the government to maintain positive relationships with industry, but has undermined policy aims.
‘Even strong legislation or regulatory standards are not enough; we must also have a government willing and able to follow through with appropriate sanctions to drive compliance.’
However, the government faced a dilemma in introducing strong legislation: food and drink industry brands brought many benefits to the UK including contributions to gross domestic product, employment, and wider investment and sponsorship, such as major events.
‘The Government appears in a difficult negotiating position when trying to encourage or enforce obesity-related action,’ said Dr Flint.
‘Collaborative working and genuine “buy-in” from industry could accelerate the pace of public health improvement.
‘However, history tells us that – in relation to public health intervention – pursuing partnerships rather than adopting a stronger governance approach reduces effectiveness of policy strategies.
‘As a result, the government is currently failing in its responsibility to the public. It is prioritising protection against potential loss of economic or employment-related benefits from industry over actual and current damage that existing practice has on public health.
‘Legislation should be used more widely and effectively across a range of areas including food content, labelling and advertising, including imposing enforceable duties on bodies in a position to improve public health, and creating or expanding licensing, taxation and inspection powers.’