Royal Colleges call for “duty” on sugary drinks in action plan against obesity

BMJ 2013; 346 doi: (Published 19 February 2013) Cite this as: BMJ 2013;346:f1146
  1. Matthew Limb
  1. 1London

Obesity programmes in the United Kingdom have failed and an urgent, society wide campaign is needed to fight the epidemic, says the Academy of Medical Royal Colleges.

The academy issued a 10 point action plan in a report1 on 18 February, following a year long inquiry by its obesity steering group.

Its recommendations include piloting a 20% levy on the price of sugary soft drinks; mandatory, food based standards in UK hospitals within 18 months; and reducing fast food outlets near schools.

It says that health professionals should be better trained to provide more help for patients with weight problems, acknowledging that some clinicians are “insensitive, ineffective, and lack confidence.”

Part of the problem, says the academy, is that doctors lack the services available to refer people to and the report demands a big expansion in funding for weight management services.

Academy chairman Terence Stephenson said that the UK was facing its biggest public health crisis, with obesity related illness causing many needless deaths from avoidable diseases and costing the NHS an estimated £5.1bn a year.

He said a new campaign was needed to overcome vested interests and urged everyone to take collective responsibility—government, health professionals, food companies, educators, and individuals.

“It’s now time to stop making excuses and instead begin forging alliances, trying new innovations to see what works and acting quickly to tackle obesity head on—otherwise the majority of this country’s health budget could be consumed by an entirely avoidable condition,” Stephenson said.

The academy says some positive anti-obesity measures have been taken by the current and previous governments, including aspects of the “responsibility deal,” the “five a day” nutritional scheme, and progress on “traffic light” food labelling. But overall it says that the programme to tackle obesity has been “largely piecemeal and disappointingly ineffective.”

The academy’s recommendations include measures to improve food quality in schools and hospitals and tackle the UK’s “obesogenic environment.” It says that the existing mandatory food and nutrient based standards in England should be applied to all schools, including free schools and academies. Planning authorities should do more to promote active travel and increase green spaces. There should be a ban on television advertising of foods high in saturated fats, sugar, and salt before the 9 pm watershed, and an agreement from commercial broadcasters that they will not allow these foods to be advertised on internet “on demand” services, says the report.

All UK departments of health in the four nations should together invest at least £100m in each of the next three financial years to extend and increase provision of weight management services. The royal colleges, faculties, and other professional clinical bodies should promote “targeted” education and training programmes within the next two years, says the report. Healthcare professionals in both primary and secondary care could then ensure that “making every contact count” becomes a reality, “particularly for those who have most influence on patient behaviour.”

Stephenson said, “The healthcare profession has taken the step of uniting to take action—and we’re calling on others to step up and take responsibility too.”

Lindsey Davies, president of the Faculty of Public Health, which is a member of the academy, said: “If tackling obesity were as simple as telling people they should eat less and move more, we would not have a problem now. The reality is that obesity is a complex issue.”

She said that piloting a duty on sugar was a “very sensible” way of establishing how successful such a levy would be.


Cite this as: BMJ 2013;346:f1146