Bold new policies – such as a levy on the food industry and phasing out all forms of junk food marketing – are needed to improve the health of the population.
A new ten-year report from a coalition of health organisations and experts, including the British Liver Trust, has called on the Government to take action to reverse the persistently high levels of excess weight in the population.
No country in the world has managed this across the population to date[i]. Worldwide levels of obesity have nearly tripled since 1975[ii]. Currently in England, 64% of adults have a weight classed as either overweight or obese with 28% of them living with obesity. This compares to 53% and 15% respectively in 1993[iii].
Obesity is a risk factor for non-alcohol related fatty liver disease (NAFLD), a condition which, if left untreated, can lead to cirrhosis, liver cancer or liver failure. Experts predict that over the next decade, NAFLD will become the leading cause of endstage liver disease and liver transplantation.
In the last 30 years there have been 14 government health strategies that have set targets for obesity reduction, containing 689 policy recommendations – yet many of these were not fully implemented or evaluated and focused on relying on individuals to change their behaviour, rather than addressing the wider structural drivers of obesity.
Vanessa Hebditch, Director of Policy and Communications at the British Liver Trust, says: “The causes of excess weight are complex but its effects put a huge strain on our healthcare system. Being overweight is a risk factor for non-alcohol related fatty liver disease – and the increases in the numbers of people affected is one of the main reasons we are facing a liver disease crisis in the UK.
“We know that the numbers of people classed as overweight or obese will continue to rise unless the Government takes action to create a healthier environment for everyone. The healthiest option should always be the easiest option. We need forward-thinking policies to make this happen and to avoid more and more people being diagnosed with liver disease in the future.”
Turning the tide
The Obesity Health Alliance, a coalition including the British Liver Trust, health charities and medical royal colleges, brought together a group of leading clinicians, academic and policy specialists to assess the evidence related to the multiple factors that influence healthy weight.
Their report, ‘Turning the Tide: A 10-year Healthy Weight Strategy’ emphasises that change is possible, with a system-wide approach that includes multiple policies that work together to both change the environment and provide support to individuals. The report sets out a long-term agenda for action with 30 policy recommendations.
What we’re calling for
The Obesity Health Alliance is calling on the Government first to ensure the full implementation of long-awaited new policies included in the Health and Care Bill, such as the 9pm watershed on junk food adverts on TV (initially committed to by the Government in 2018) and removing paid-for adverts online. These should be implemented in full and without any further delays or watering down.
As a next step the Government should use their forthcoming Food White Paper to address other drivers of poor diet such as bringing in a levy on the food industry to incentivise the production of healthier food and drink. The Obesity Health Alliance also recommends that the Government builds on existing policy approaches by phasing out other forms of influential junk food marketing including child-friendly packaging and sports sponsorship.
Further action is also needed to support people living with obesity, such as mandating weight management services in every area of the country and ensuring psychological services are available.
The COVID-19 pandemic has brought the health risks of obesity sharply into focus with clear evidence that people with obesity have an increased risk of severe disease, hospitalisation, and death from COVID-19.5 But this health burden is not equal. Obesity prevalence is higher among disadvantaged groups locking in poor health across the generations.
[i] NCD Risk Factor Collaboration (NCD-RisC) 2017. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet, 390:2627–2642
[ii] WHO 2021 Overweight and Obesity factsheet. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
[iii] NHS Digital 2020. Health Survey for England 2019. https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2019/health-survey-for-england-2019-data-tables