What can the UK do to tackle childhood obesity?

In our 2019 evidence to the House of Commons Health and Social Care Committee we identified the importance of:

• Action in the formative early years (including protecting babies from added sugar in infant formula).
• Combining top down approaches from government with bottom up approaches from local communities.
• Learning from successful initiatives in other countries, including how to successfully scale up local initiatives.
• The value of ‘whole system’ approaches and targetting those at greatest risk. 

You can see our evidence here.

Our earlier evidence to the Health and Social Care Committee

In our 2018 evidence to the Committee we identified:

• There are now at least three proven programmes known to reduce childhood obesity (in France, the Netherlands and Denmark).
• Each of these successful initiatives has adopted a sustained, systematic, joined up approach, rather than separate ad hoc initiatives (which has been the norm in the UK) 
• To tackle health inequalities action is needed upstream, to address the food industry related root causes of obesity. That’s because downstream initiatives, like health education and promotion, often increase health inequality rather than reduce it.
• The need for the government’s Industrial Strategy to therefore aim to enable the UK to achieve global market leadership in the production, marketing and sale of healthier food.

The Committee quoted some of our evidence in its report. Here’s our evidence on tackling childhood obesity.

Childhood Obesity Plan – Chapter 2

There was much disappointment with the government’s initial childhood obesity plan, published in 2016, as it appeared reluctant to seriously tackle the underlying causes of obesity. However, chapter 2 of the plan, published in 2018, goes further. It aims to halve childhood obesity by 2030.

When we reviewed the Plan we found:

• A range of positive proposals
• With positive progress on the Soft Drinks Industry Levy in particular
• But often little or no progress on implementing other proposals
• Missed opportunities (in particular in relation to the important first 1000 days of life)
• No recognition of the value of a whole systems approach (to push back against the many factors encouraging obesity in the modern world).

Here our verdict on the government’s Plan. 

International Childhood Obesity Plans

How do the plans the UK has made to tackle childhood obesity compare with plans in other countries around the world?

Our review found:

• At least 9 successful local/targeted initiatives in other countries (from Australia to Europe to the US).
• For the first time success in reducing childhood obesity within the UK (in Leeds).
• To have optimum effect, top down policies from governments need to combine with bottom up, community-based approaches.
• Examples of successfully scaling up effective local initiatives, both nationally and internationally (in particular through the EPODE programme in France).

Here’s our review of childhood obesity plans internationally.

Stopping Childhood Obesity – lessons from France and the Netherlands

In 2017 one of our team researched the value of a ‘whole systems’ approach to tackling obesity.

At the time she was living and working in the Netherlands so had good access to information about the successful JOGG programme there (Jongeren op Gezond Gewicht – Young people at a Healthy Weight), as well as being able to research the EPODE programme from France on which it was largely based.

She concluded:

• Politicians, both nationally and locally, need to realise just how serious a problem there is and put tackling childhood obesity much higher up their agenda.
• This means putting children’s health at the forefront - as a shared responsibility for all stakeholders (including local authorities, schools, healthcare providers, communities, businesses and families). 
• One off interventions in single settings aren't enough. We need to focus on the different causes of childhood obesity, understand how they interconnect and then take action to tackle them in a systematic, coordinated way i.e. a whole systems approach.
• Adopting this approach has already reduced levels of childhood obesity in a number of French towns and Dutch cities.

Obesity Q & A

In March 2019 our Director took part in Food Matters Live’s first podcast. Food Matters Live is a major food industry event which takes place in London each year and our Director was also a guest speaker at the event in November 2018 and November 2019.

In the podcast he answered a range of questions, including:

• Just how bad is the obesity problem in the UK?
• How can behaviour change contribute to reducing the epidemic?
• What do you see as the biggest cultural and social challenges to behavioural change?
• You have researched a number of international projects to tackle obesity. What do you consider the biggest determinants of success?

Here are his answers to these questions.

Can sports clubs help tackle male obesity?

Male obesity is a growing problem in the UK, with 67% of men in the UK overweight or obese, compared with 62% of women. However, commercial weight management programmes are mainly targeted at and taken up by women. Men are sometimes less likely to recognise their weight is an issue, more likely to view dieting as feminine, and less aware of the link between diet and ill-health.

Fortunately our research suggests that professional sports clubs may be able to help overweight men to lose weight and adopt healthier lifestyles. For example:

• Football Fans in Training (FFIT) is a weight management programme run by Scotland's top professional football clubs in collaboration with academics, for fans with a high BMI – providing participants with support from community coaches trained in diet, nutrition, physical activity and behaviour change techniques.
• In England, leading football and rugby clubs often have charitable community foundations, some of which now run weight loss programmes.
• West Ham Foundation is also working with its local Clinical Commissioning Group and Local Authority to reduce obesity related Type 2 Diabetes – and GPs across the borough are referring patients aged 18 and over who are at the risk of type 2 diabetes or heart diseases to the Foundation’s programme. 

Here’s more information about these programmes, including the results of a 12 month randomised controlled trial and feedback from participants.

Tackling Obesity

When we first started to research how best to tackle obesity there was a widespread belief that what was needed was a calories in, calories out approach i.e. eat less food and take more exercise. There was also a tendency to assume that obesity was the result of poor lifestyle choices (enabling government to take the view that it simply needed to provide health information and enabling food companies to stress the value of exercise, to distract attention from their own contribution to obesity).

We started by considering what had changed since the early 1980’s that might explain the rise in obesity (like the launch of 2 litre bottles of Coca Cola in 1978, the introduction of the microwave in 1984 and the expansion of takeaways and fast food outlets to create a market now worth £30 billion a year in the UK). We also checked what research had found. This led us to conclude that:

• Exercise is beneficial for health and helps with weight management.
• However, it is food (not only how much we eat but what kind of food) that has the biggest impact on weight.
• Food high in sugar, salt and fat increases the risk of obesity, while vegetables, fruit and wholegrains reduce the risk.
• A healthy diet is more effective than dieting.
• The first thousand days of life (from conception onwards) are particularly important in establishing food tastes, habits and preferences 

We’re pleased that some of these findings have now been widely accepted, although acting on them is sometimes taking longer and needs continuing pressure from ourselves and other health campaigners.

Here’s an overview of our initial findings.