Focus: Obesity in the UK - whose problem is it?
By Hannah Abdulla | 14 February 2014
The blame game continues to escalate as to who is responsible for the obesity crisis in the UK. While some point the finger at the Government for not being convicted enough in its approach to tackle the problem, the finger is often pointed back at the food industry for failing to co-operate. Hannah Abdulla explores the complex issue.
At present, one in three children were leaving primary school in the UK is either overweight or obese. The financial burden of obesity weighs heavily on the NHS in the shape of a bill of around GBP10bn a year.
So said UK shadow minister for public health Luciana Berger at a conference on the issue this week in London, the latest to be held on the issue and one of most significant events since the purported link between sugar and obesity hit the headlines at the start of the year.
However, while the issue of obesity has returned to the headlines, and industry and government insist they are working on soultion, the problem is, according to some, not treated as a priority.
Professor Paul Gately, founder of More Life, a company providing weight management services, claimed the cost of obesity to the UK "dwarfed" the cost of any other health category such as substance misuse or sexual health. However, he said the amount being spent to prevent the problem was much lower than what was spent to tackle other health issues.
"Obesity is talked of as a priority. But it is not acted on as a priority," he told the Westminster Food & Nutrition Forum.
In 2011 the UK government launched the Responsibility Health Deal with a series of voluntary pledges by the food industry designed, they claimed, to deal with the problem.
Thirty-eight 38 food and beverage companies have signed up, for example, to a calorie reduction pledge, advised the Department of Health's obesity and food policy branch's deputy director, Richard Cienciala.
The civil servant was speaking at the WFNF event and gave the example of Burton's Biscuit Co., which, he said, through brand reformulation, reduced the amount of calories consumed via their products by by 700,000 in 2013.
Firms including McCain Foods have also agreed to work with the DoH in implementing consistent front-of-pack labelling to, the signatories say, better inform customers of what they are consuming.
Nevertheless, despite such initiatives, some campaigners believe more needs to be done. "As a voluntary deal, it won't go far enough," Malcolm Clark, coordinator of the Children's Food Campaign, tells just-food.
"The Responsibility Deal is similar to other pledges," he says, where companies can choose what they want to sign up to, if they want to. There is, Clark argues, "no numerical or quantifiable measurement" to hold them to account.
Clarke points out there are "too many companies that haven't signed up, and for those that have - they're on fairly easy commitments."
Terry Jones, director of communications for industry association The Food and Drink Federation, which worked with the DoH on the development of the pledges, admits that, while the deal has made significant progress since its launch moving "further and faster" than similar pledges, there is still further to go.
"A lot of the same companies have been asked to do more, there's been a [focus on] a deepening of commitment rather than a broadening of membership," Jones says.
However, Jones acknowledges the pledges could benefit from companies signing up; there are at least 6,500 F&B manufacturers in the UK. "That's the big prize; how you get more people rather than the familiar names."
Clark, meanwhile, claims there was a lack of a "joined-up approach" at government level. While the DoH was making efforts to solve the problem, until very recently the Department of Education had, he says, not played such a significant role. Only now, with the launch of the School Food Plan is the DoE starting to connect with the DoH on the issues.
However, that has highlighted another problem, Clark says - the Department for Culture, Media and Sport where, the campaigner claims, "we get absolutely no joy. They're just not interested in this type of issue".
He added that the government had to respond by "connecting it up" so it wasn't just the DoH and Public Health England dealing with it but in fact the whole body.
However, as Clark and other industry watchers argue, the food industry should take some responsibility for the way they promote their products.
Speaking at the WFNF event, Dr Roberta Re, nutrition research manager, Leatherhead Food Research, said: "Food may be a core within the obesity problem. The industry plays a role and can manipulate very well our choices," she said.
Her comments were supported by alarming statistics presented by Kantar Worldpanel that showed, while the volume of food being taken home in the last seven years had increased by 5%, the calories being taken home were up by 11%, sugar by 10% and saturates by 12%.
Of those, 37% of saturated fats and 32% of sugars had been sold in products involved in some form of a promotion.
Clark says, with the "millions the F&B industry has to spend on marketing" the Government was stuck in an "unfair fight" with a minimal budget to spend on tackling obesity.
"Even when supermarkets carryout health promotions such as the Change for Life campaign, they're usually far outweighed by the promotions on junk," he adds.
While some supermarkets have, for instance, removed confectionery from checkouts (as most recently exampled by Lidl), there is "far more to be done", says Clark.
The need for immediate action was put forward at the WFNF event by Dr Andrew Coward of the Birmingham South Central Clinical Commissioning Group. "We believe children of this generation will have shorter lifespans than their parents," he said.
His comments were supported by Dr Jude Oben, consultant gastroentologist and hepatologist at Guy's and St Thomas' NHS Foundation Trust, who said obesity was one of the key causes of liver disease. Dr Oben said he treated a 16-year-olds who is likely to have cirrhosis as a result of liver disease caused by obesity by the time they are 30.
"As liver specialists, we won't be able to cope with the onslaught of the disease," Dr Oben said.
But at what point does the consumer himself start taking responsibility for what he's eating?
Dr Oben demonstrated a case study of a liver transplant patient who he treated for cirhossis in 2009. In 2013 the patient returned again with the same problem. Each liver transplant costs the UK GBP85,000.
Is the problem truly a lack of information? Or is it easy availability of well-marketed bad food?
"Yes people need to make better choices," Clark acknowledges. "But they also need less of the nudging in the wrong direction."
Clark has carried out a recent survey on Asda's products sold for under GBP1. He found over 200 products part of the promotion. More than 150 were food items - but only one of those was a fruit or vegetable. Asda had not returned a request for comment at the time of writing.
"It's not just the supermarkets," Clark says. "It's your [manufacturers'] responsibility to your customers also. The Government may not have the scope or the money to deal with it."
There have been a number of suggestions to impose levies on food manufacturers which financially penalises them for excessive amounts of calories. In Mexico, the country's government has looked to impose a tax on products with at least 275 kilocalories per 100 grams in a bid to cut obesity rates.
Without such measures, the UK government is, Clark argues, "fighting with one hand behind its back".
However, Jones is not so sure taxing companies would be the right way forward.
"Additional taxation will hit poorer families hardest; it will also be an inappropriate public policy in tackling obesity - there just isn't the eveidence to show it works," he says. "And on the economic side of it - F&B is one of the largest manufacturing sectors which can deliver sustainable growth - the additional tax would jeoperdise this. If you look at the Danish example [a tax on fat] where they had DK100 per kg, the Danish Agriculture and Food Council said it was going to cost 2,400 jobs. There are far better ways that you can encourage consumers to eat better. Things to do with labelling, portion size reformulation and education.
For Jones and the FDF, there is not one party responsible for obesity and there was not one party that could resolve it. His thoughts were echoed by Cienciala at the DoH. "There is no silver bullet to the obesity problem; we all have a part to play."
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