Turning the Tide: A 10-year Healthy Weight Strategy

A new ten-year report from a coalition of health organisations and experts 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.1

Worldwide levels of obesity have nearly tripled since 1975.2 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 1993.3 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.4

The Obesity Health Alliance (OHA), a coalition including the British Heart Foundation, Cancer Research UK, Diabetes UK 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.

The OHA 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 reformulation levy on the food industry to incentivise the production of healthier food and drink. The OHA 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. 

Professor Dame Anne Johnson, chair of the expert working group advising the OHA said: “The majority of people in the UK have a weight classed as overweight or obese and this will continue without ongoing and comprehensive action from Government. We reviewed the evidence across the multiple factors that influence healthy weight, and if the Government commits to bold new policies, we can turn the tide, reducing obesity and greatly improve our nation’s health.” 

John Maingay, director of policy and influencing at the British Heart Foundation said: “Evidence shows that introducing bold policies to create a healthier environment for everyone is the route to improving our nation’s health. After years of focusing on education and awareness measures, the UK Government has started to move in the right direction with an obesity strategy which focuses on making the healthy option the easy option. We must now build on this with forward-thinking policies, such as placing a levy on companies to encourage them to produce healthier food. This will set in train the positive change we need to reduce the devastating impact obesity has in the UK today.” 

Professor Linda Bauld OBE, academic lead for the project said: “Turning the tide on obesity is achievable. Over the same three decades in which obesity has continued to rise, UK smoking rates have been halved - achieved through a series of comprehensive government strategies. ‘Turning the Tide’ sets out a clear evidence-based agenda for policies and interventions to bring about similar success and reduce the impact of excess weight on a range of diseases.” 

The report also highlights the pervasiveness and damage caused by weight related stigma and calls on the Government, the NHS, the media and employers to play their part in eradicating weight stigma across all settings.

Angela Chesworth, an obesity patient advocate, said: “People living with obesity deserve to be treated with dignity and respect. We all deserve access to treatments that will improve our health. We also need to stand up to weight stigma and bias which is proven to be detrimental to psychological and physical health. It’s time to eradicate obesity stigma for good and focus on the policies that will actually improve health.”

Obesity increases the risk of developing a range of chronic conditions, including type-2 diabetes, heart disease, liver disease and cancer. 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. 

1 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
2 WHO 2021 Overweight and Obesity factsheet. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
3 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
4 D. Theis and M. White 2021 ‘Is obesity policy in England fit for purpose? Analysis of government strategies and policies, 1992–2020’ Milbank Quarterly 99(1): 126–70 https://doi.org/10.1111/1468-0009.12498
5 Mohammad S et al. Obesity and COVID-19: what makes obese host so vulnerable?. Immun Ageing. 2021; 18: 1 
Target Audience
Commissioners of care and other obesity interested organisation representatives
Healthcare professionals
Movement and Exercise professionals