Ministers have been warned that their efforts to tackle Britain’s obesity crisis are likely to fail because the public are constantly “bombarded” by unhealthy food options.
Britain has one of the highest obesity rates in Europe, with two in three adults overweight or obese and the NHS spending £6bn a year treating obesity-related ill-health, a figure that is forecast to rise to £10bn a year by 2050. The government has announced plans to introduce a 9pm watershed on TV and a ban on paid-for advertising online for unhealthy food and drink, plus new restrictions on the promotion of unhealthy food and drink in retail outlets and online.
However, a damning 28-page report, commissioned by the government’s own obesity research unit and seen by the Guardian, warns that these efforts will fail unless much wider action is urgently taken to transform the entire food environment.
The review, by the Centre for Food Policy at London’s City University, found that easy access to and availability of unhealthy food 24 hours a day across the UK makes losing weight “difficult” for millions of people who are trying. “People engaging in weight management reported eating more, simply because food was always easily available and this close and constant exposure triggered them to want food more often,” the review found.
“People also reported that being met everywhere with promotions made it very difficult not to think about food or make unplanned purchases of HFSS [high in fat, salt or sugar] food.”
Even Britons who are “trying really hard” to lose weight are being “thwarted in their efforts” because of the amount of unhealthy food they encounter each day. City University’s experts undertook the review for the National Institute for Health Research (NIHR) obesity policy research unit, which commissions independent research to inform ministers.
The review concludes that even well-designed weight management services will only have a “limited impact” on Britain’s long-term efforts to promote and maintain weight loss if ministers fail to improve the food environment at the same time.
Kimberley Neve, the lead author of the review, said: “This review highlights not only how difficult it is to lose weight in Britain, and keep it off, but also that it’s not just about willpower or self-control: even people trying really hard are thwarted in their efforts by unhealthy food options that are everywhere – they’re easy to find, cheap to buy, quick and appealing.”
The review found that the relatively lower cost of unhealthy food options made weight management “particularly difficult” for people on a low income, with unhealthy food more likely to be promoted and on offer in shops and supermarkets.
“With Christmas treats in abundance in the supermarkets, and new year resolutions around the corner, the narrative needs to shift so that instead of going on the usual January diet, people ask for a food environment that supports them to be healthy,” said Neve, a research assistant for the food systems and policy analysis workstream of the NIHR Obesity Policy Research Unit at City University’s Centre for Food Policy. “For that, you need policy to level the playing field for industry to start making changes.”
Experts not involved with the review said its findings were incredibly stark.
Jane DeVille-Almond, the chair of the British Obesity Society, said: “Pretty much every activity we encounter, outside our homes today, involves our senses being bombarded with food aromas. The sad fact is many of these foods are considered bad food choices, especially if we are trying to lose weight or eat more healthily.”
Britain must “steer changes” in the food environment if it is to become healthier, she said. “Cinemas, leisure and activity centres, hospitals, work spaces, supermarkets and food outlets all need to work on offering and promoting tasty healthier choices.”
Caroline Cerny, the alliance lead at the Obesity Health Alliance (OHA), said the review showed Britain’s obesity crisis was “far less a problem of individual behaviour and lack of willpower” and “far more about the environments around us”. She added: “The UK’s health problems reflect an environment that is flooded with unhealthy food and drinks.”
A separate report by the OHA published earlier this year said Britons are exposed to an “obesogenic environment” from birth, “one in which calorie-dense, nutrient-poor food is accessible, abundant, affordable and normalised and where physical activity opportunities are not built into everyday life.”
The new review found that people often come up with diet plans, but shops, supermarkets, advertising on public transport and workplaces can make it almost impossible for them to stick to their routine.
“The ubiquity and appeal of unhealthy foods means that people actively trying to lose weight or keep it off must avoid parts of the food environment – a certain aisle in the supermarket, the work canteen or a friend’s party – to be able to adhere to healthy eating plans,” it said.
“Government attempts to address this with new restrictions on junk food marketing in 2022 are a positive first step,” said Cerny. “But we need much more, including levies on the food industry to incentivise them to produce healthier products.”
Ministers are being urged to accept seven policy recommendations. These include shifting the balance in the UK food environment so there are more discounts on healthier foods such as fruit and vegetables. Businesses should also be helped “to provide healthier options in the workplace” for employees, and fast food outlets should be incentivised to sell healthy options, the review urges.
Tam Fry, the chair of the National Obesity Forum, said similar measures were urged a decade ago, but ministers failed to act. “The government’s responsibility deal launched in 2011 was an attempt to tackle all the issues around HFSS food and was accepted by food companies as long as it was free from regulation. The government declined to legislate and the deal unravelled. The researchers’ demands must now be mandated – no ifs and no buts.”
A Department of Health and Social Care spokesperson said: “As part of our obesity strategy to get the nation fit and healthy, we are introducing mandatory calorie labelling in large restaurants, cafes and takeaways, restricting advertising of foods high in fat, salt and sugar being shown on TV before 9pm and in paid-for advertising online, as well as restricting less healthy food promotions in stores and online.
“Additionally we have invested £70m into adult weight management services made available through the NHS and councils, so that people living with obesity have access to support that can help them to lose weight.
“The Office for Health Improvement and Disparities will build on our national efforts to tackle obesity, improve mental health and promote physical activity.”