BRITAIN has one of the highest rates of obesity in Europe, according to a May report from the World Health Organisation. As the research noted, obesity is associated with many diseases, including musculoskeletal complications, Type 2 diabetes, heart disease and at least 13 types of cancer.

In 2017 Public Health England estimate the overall cost of obesity to wider society at £27 billion per year.

Tam Fry, the chairman of the National Obesity Forum and an expert advisory team member at action on sugar, tells Ian Sinclair what he thinks about the Truss government’s plans on obesity and what policies might actually work to address the deep-rooted problem.

According to the British Health Security Agency, in 1980 six per cent of men in England were obese (those with a Body Mass Index over 30). By 1993 it had more than doubled to 13 per cent and by 2019 it had doubled again to 27 per cent. Why have obesity rates increased so quickly in England and the rest of Britain?

Obesity rates in Britain have risen so quickly because no government in the last 30 years has succeeded in formulating a strategy that has any chance of stemming the epidemic. A review paper from Cambridge University published in January last year, Is Obesity Policy in England fit for Purpose, in the Millbank Quarterly, concluded that every attempt to come up with a workable set of measures was doomed to fail.

And there is nothing coming out of new Health Secretary Therese Coffey that gives any hope for success in the future. Ironically her mantra “ABCD” is the US obesity specialists’ description of the condition — Adipose-Based Chronic Disease!

No government, of whatever hue, has addressed the principal cause for the nation’s overweight: without serious curbs being slapped on a food industry that persists in lacing its products with excessive levels of fat, salt and sugar — three of the principal drivers of obesity — and continues to market the worst products at attractively low prices, levels will not fall significantly.

How do you respond to the common argument obesity is a failure of individual willpower?

The common argument that obesity is a failure of individual willpower was all the rage in the early years of this century and it was a very easy way for government to escape taking any blame. But all that went out of the window in 2007 when the Foresight Report was published.

The report was the result of two years’ intensive work into obesity commissioned by the Labour government and it clearly established that the obesogenic environment in which we all live was the main cause of the problem.

It recognised that few individuals would be able to withstand the incessant advertising and marketing of food and, the lower down the social scale they were, the more difficult it would be to resist the onslaught.

The incoming 2010 Conservative government then turned to a new strategy: promoting behaviour change. This was the great white hope for a few years. That ran out of steam quite quickly, however, when it became obvious that waiting for the population to change ingrained habits was akin to watching paint dry.

A special office was even set up in Downing Street to oversee the process but it had little effect. The office will probably be best remembered as the “nudge unit” but nudging was never likely to be the answer.

Running parallel with nudging, the Conservatives also mistakenly decided that it would appeal to the better nature of the food barons and came up with a “responsibility deal.”

The premise was that with their promise not to legislate food production, the barons would pledge voluntarily to reformulate their products into being “healthy” items.

In the expectation that industry would keep to its pledges, the government even invited senior industrialists to co-chair the committees which would implement the “deal.” It would be a vain hope. Pledges fell by the wayside and the deal was dead.

Last month the Guardian reported the new Truss government is considering scrapping a range of anti-obesity policies, including bans on “buy one get one free” offers, displays of sweet treats at supermarket checkouts, TV adverts for junk food before the 9pm watershed and possibly the sugar tax. You commented “Once again the interests of big business have dangerously overridden the interests of the man in the street.” How does big business influence government policy?

Essentially business influences government policy by pleading dire consequences for the country if Downing Street takes any measures that might affect its profits.

In a 2010 Guardian article entitled Andrew Lansley’s Department of Big Macs, Philip James, one of Britain’s top nutritionists involved in setting up the Foods Standards Agency at the turn of the century, gave two examples of the food industry at work.

In the first he described how it became clear to him that ministers were under intense pressure from industry to see that the agency excluded nutrition from its portfolio and should focus solely on food safety.

His second example illustrated how a report authored by him, outlining a strategy that had the potential of nipping childhood obesity in the bud, was never published at the express request of industry leaders because it suggested that advertising and marketing might influence children’s behaviour.

They seemed to have “persuaded” the then minister for public health, Tessa Jowell, that the report was “extraordinarily radical” and that they would like to speak to James.

Within days he was invited to a private chat over dinner with the industry chiefs “who considered it entirely reasonable to market products directly to children.” The report was quickly buried in some Whitehall graveyard — and there has never been anything similarly “radical” since.

Depressingly, many experts describe the current British anti-obesity strategy — which the Tory government is looking at ditching — as inadequate. What policies would work?

The greatest hope that something radical might be done to stem obesity came when then-PM Boris Johnson exited St Thomas’ Hospital having been treated for Covid-19. Realising that his own weight was identified as a contributing factor to catching the virus, he declared that he would launch a war on obesity.

In July 2020 he published the measures that he was sure would start to see it off. Public health specialists were jubilant that finally some of the draconian proposals that they had been advocating for years might be about to be implemented.

It was a false dawn. The majority of the proposals that Johnson hoped would empower adults and children to live healthier lives have now been kicked into touch by Liz Truss and Coffey and the single proposal that remains and which has just come into force, has served only to confuse — the idea that supermarket layouts be reconfigured so that sugary items in particular be furthest from the check-out has essentially infuriated customers who are baffled as to the aisles in which they will find their desired purchases.

The only initiative to combat obesity that might, over time, have some effect in significantly reducing it is the Soft Drinks Industry Levy (SDIL). It came into effect in 2018, after Chancellor George Osborne fought lengthy battles for it within Downing Street.

The SDIL knocked everyone out with its success and its continuing benefit has sparked clamours that it be extended to food items. Its success lies in the fact that it is not a tax on the drinks’ purchaser but a levy on the company bottling it.

Indeed, it allowed companies to escape the levy altogether if they radically reduced the sugar content in their sodas and they embraced the idea. There are now many zero sugar or low sugar versions of drinks on sale and, would you believe, companies are profiting from it.

Indeed, so immediate was the levy’s success that in 2019 Dame Sally Davies, who was England’s chief medical officer at the time, made an extension of the levy her first proposal to tackle child obesity.

She singled out milk-based drinks (presumably milkshakes and high street coffee shop drinks) as prime targets but, inevitably, any food product unreasonably high in sugar content could follow. Stripping sugar out of breakfast cereals, cakes and biscuits is also on the cards but more time is needed for reformulation to be achieved.