Let’s talk about obesity and missed policy opportunities in the UK

World Obesity Day image

We should all be concerned about the health crisis of obesity in the UK. But despite some action, responsibility is still placed on individuals in making healthier choices, rather than changing the food environment in which we all live.

World Obesity Day (WOD) takes place each year on 4 March. This is a united day of action to strengthen efforts to prevent and reduce obesity, and advocate for those living with obesity.

Global estimates of those living with obesity in 2020 were 0.81 billion. In two short years, this has risen to over 1 billion people. It’s projected that by 2035 there will be over 1.53bn adults living with obesity globally, showing that global rates are growing faster than initially projected.

If inaction continues, global prevalence will continue to grow, with dire consequences, knowing that obesity is a risk factor for up to 18 different types of cancers and other non-communicable diseases (NCDs), such as type 2 diabetes and cardiovascular disease.

This year’s theme is “Let’s talk about obesity &…” and, at World Cancer Research Fund, we want to highlight the missed policy opportunities that could have helped to curb the obesity crisis in the UK.

Between 2021–22, 26% of adults were living with obesity in England. What’s worrying is that these numbers increased from 2020. An analysis in England suggests that many proposed obesity policies are not fit for implementation, some have not been evaluated and others have weak policy design.

The policy opportunities

In 2020, we saw the introduction of a UK obesity strategy in light of the COVID-19 pandemic, shining a light on the relationship between COVID and excess weight. The strategy set out specific policy calls to action to tackle obesity and reduce the burden on an NHS already under severe pressure.

What were these policy options and where are we now?

Restricting volume price and location promotions

The Government committed to removing promotional offers on foods high in fat, salt and sugar (HFSS) through legislating to restrict volume promotions such as  and the promotion of such foods online and in store.

Multi-buys drive behaviour change, encouraging consumers to buy more or buy products they may not have intended to. Despite the regulations being proposed in December 2021, with partial implementation due in October 2022, restrictions on the promotion of HFSS products by volume were delayed initially to October 2023, and have now been further postponed until October 2025.

Such marketing techniques give the impression of saving consumers money, when in fact it’s the opposite. The goal of multi-buys is to increase the volume of food purchased so consumers spend more, not less, and research has confirmed this. Multi-buy offers on fruit and vegetables are rare; more often multi-buys are found on aggressively promoted HFSS foods, which contribute to ill health.

Key findings from this report suggest that while there was good awareness and adherence to the legislation online and in stores, exemptions included in the regulations mean HFSS products could still be seen at key locations without stores breaking the new rules

Katharine Jenner, Director of Obesity Health Alliance said:

“What we eat is determined by the food that is available to us, and that food is often high in salt, saturated fats, sugars, is low in nutrients and is often heavily processed.  Our UK policymakers should, with a sense of urgency, help shift the nation towards nutritious food that supports our health, not harms it.  This should include implementing planned measures such restrictions on unhealthy food and drink promotional offers, such as buy 2 get 1 free in supermarkets, which will start to tackle this key driver of poor health”

Advertising restrictions

The 2020 strategy also committed to further restrictions on unhealthy food advertising on TV and online. Following a consultation banning on HFSS advertising on TV before 9pm and online was due to come into force in January 2023.

Subsequent governments have repeatedly delayed this policy, claiming industry ‘needs more time to prepare.’ The new restrictions are now due to come into force in Oct 2025.

Similar to the volume price policies, this policy could be expected to reduce the number of children living with obesity by around 20,000 and have a significant positive impact on child health.

A recent report published by BiteBack 2030 found that food manufacturers spent £55 million on online adverts for biscuits, chocolate, crisps and ice cream in 2022 with ‘“7 of the top 10 food businesses behind £50 million (91%) of this spend, resulting in 6.5 billion advertising exposures’”.

The 2021 Health and Care bill highlighted a similar rationale that protection from such adverts (for UK children aged 4-15) “could remove up to 7.2 billion calories from children’s diets per year in the UK”. Further technical evidence on these restrictions was called for in a consultation published in late 2023.

The restrictions have been subjected to harsh pushback from the food and beverage industry which is an unsurprising tactic used to undermine the policy. We wait with anticipation to hear of the outcome of this consultation.

Caroline Cerny, Director of Policy at Bite Back said:

“Advertising is an extremely effective way to sell food. That’s why food businesses spend millions on it every year. And research is clear that it drives food preferences, purchases and consumption. Our young Bite Back activists are bombarded with junk food ads – on their social media feeds, on their laptops, on their journeys to and from school and even by direct message to their phones. Switching this off by bringing in the new regulations without further delay and extending to close loopholes would be the sign of a government that is genuinely committed to improving public health.”

A mother and son looking at food labels in a supermarket

Image courtesy of World Obesity Federation

Calorie labelling

Displaying calorie information is one of the few policies from the 2020 obesity strategy to be implemented. Displaying calorie information on non-prepacked food and soft drinks is now a legal requirement for businesses with more than 250 employees. This includes delivery platforms, online menus and third-party apps.

The food industry was also set a target of voluntarily reducing calories by 20% in products that contribute a significant amount of children’s calorie intake. The Office for Health Improvements and Disparities (OHID) recently published progress made between 2017–21 on this regulation in England. Limited progress has been made on meeting the 20% calorie reduction, with total volume and calorie sales increasing in a variety of food categories.

However, as policy experts, we at World Cancer Research Fund know this policy cannot work in isolation and should work in tandem, as intended, with the delayed restrictions on marketing unhealthy food, volume price promotions and in-store display location.

It’s time to stop focusing on individual behaviour and recognise the need to change the food environment. If policies such as the 20% reduction target can’t be met voluntarily by the food industry, other avenues should be explored.

Our hopes

With a UK general election this year, what do we hope for to help reduce obesity in the UK through policy?

  • A tax on junk food to incentivise the food industry to reformulate and sell healthier food and drink options.
  • Invest revenue raised from fiscal measures into improving children’s health, particularly measures that target lower socio-economic communities and seek to reduce health inequalities.
  • For existing policy commitments on TV and online junk food advertising –already delayed for many years – to actually be implemented.
  • A reinvigorated commitment to halve childhood obesity by 2030.

Our analysis comparing the status of nutrition policies in 30 European countries, including the UK shows that governments, including the UK government, rely too heavily on public information campaigns on healthy eating, which are unlikely to make an impact unless they are accompanied by improvements to the food environment. We need policies that focus on the environment around us to create greater impact.

The UK government recognises obesity as a major public health issue and has proposed policies to combat obesity, but they are only partially implemented. Proposals are commendable but they need to be well-designed, with appropriate monitoring of implementation. And these policies do not go far enough.

We need to focus on the multitude of factors that influence obesity, implement policies that work together in a multi-pronged approach, and shift the responsibility narrative away from the individual to the wider food system.

> Read the nutrition policy snapshots from across Europe

> Big gaps across nutrition and physical activity policies across Europe