A couple of weeks ago I appeared in front of the Health & Social Care Committee to share evidence on food and obesity. These occasions set the pulse racing, and historically the politics of obesity have been fractious. But what struck me is the broad consensus that efforts to date have failed. We need solutions that actually work.
The numbers don’t lie. Obesity and excess weight cost the UK £126bn a year, with £31bn lost in economic output due to lower productivity. At the same time, two-thirds of people in the UK are living with excess weight and obesity, and our levels of childhood obesity are among the highest rates in Europe.
At the committee, I spoke about the need for the right policies. Big impact, strong participation from business with the right incentives, and a focus on where we get most of our food.
This year the UK government announced the healthy food standard, which would introduce mandatory data reporting and health targets across the food industry. We’ve analysed the impact of a wide range of obesity policies and this gets us the most bang for buck – around a 20% reduction in obesity while minimising cost to business and consumers.
This policy will require businesses to sell healthier food to improve their overall health score, integrating health into commercial decision-making. Crucially, businesses can improve their score by using already available tactics, such as promotion, advertising, placement, stocking and changing the recipes of products. It could mean they tweak their recipe for some sandwiches to contain less fat, or give less shelf space to sugary cereals.
Mandatory reporting is vital
To do this, we need good data. That’s why mandatory reporting is a prerequisite. We want businesses to better understand the healthiness of what is sold. We believe the Nutrient Profiling Model is the best way to measure this: it’s the metric currently used by the government, and the existing HFSS regulations are based on the NPM.
Of course businesses need time to prepare. The key is for the government to announce its plans early. Nesta’s original proposal modelled how the policy could work in the 11 largest UK supermarket and grocery retailers – the large, multibillion-pound companies that provide 80% of calories purchased by the public. With eight of these retailers already within a few points of the target we recommended, the policy would be a low-friction adjustment relative to more punitive forms of regulation.
We designed this policy based on the principle that targets should not drive down the total volume of products sold. We also proposed an outcomes-based policy that allows businesses to use all tools at their disposal to make decisions that work for their model. Rather than dictate business practice, it gives businesses maximum flexibility to meet the target. An independent economic assessment of the policy confirmed these improvements are possible without pushing up prices.
We want regulation to cover the whole food sector – including out-of-home businesses. The out-of-home sector has been subject to much less health-related regulation than grocery retail, creating an uneven regulatory playing field. Fairness is vital.
However, to maximise public health impact, the evidence points to implementing targets for supermarkets first. The impact is likely to be significantly higher than for out-of-home businesses, because sales from major supermarkets account for a much higher proportion of our diets (over 80%).
Still, action in the out-of-home sector should not lag behind supermarkets. Critical policy questions for out-of-home businesses remain unanswered, and solving them requires data from large food companies on the healthiness of their sales. The government should press ahead with data reporting to agree on a clear health metric and target for out of home.
There will be challenges as we design and deliver a world-first policy, but the prize is a big one: a healthier future for children and adults living with obesity and a more resilient economy. All of us are on board with this goal. Getting there requires real partnership and ambition across industry, the NHS and government.
Lauren Bowes Byatt is deputy director at Nesta
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