UK government disbands advisory group on obesity

The UK government has quietly disbanded its expert advisory group on obesity in a move seen by some as a way to silence independent critical voices.

The expert group was set up by the previous Labour government to advise on the evidence that emerged from the “Tackling Obesities: Future Choices” project of Foresight, part of the Department for Business, Innovation and Skills. The expert group then went on to support the development and delivery of the “Healthy weight, healthy lives” strategy and public health programmes such as Change4Life, which aimed, with support from the Department of Health for England, to encourage people to lead healthier lives.

Members of the group were unpaid. The closure has happened quietly and with no publicity.

Geof Rayner, a member of the advisory group and honorary research fellow at the Centre for Food Policy at City University, London, told the BMJ that he believes that ministers don’t want advisers whose ideas do not fit theirs. He said, “They don’t want to hear critical independent advice. They only want advisers who agree with their way of thinking.”

Dr Rayner said he believed that the Department of Health had been upset about an article he had written in the BMJ in April that criticised the government’s endorsement of “nudge” thinking as a strategy to tackle obesity (BMJ 2011;342:d2177, doi:10.1136/bmj.d2177). The head to head article, written with a fellow advisory group member, Tim Lang, professor of food policy at City University, said that “nudge is a smokescreen for, at best, inaction and, at worse, publicly endorsed marketing.”

A letter from the health department to Dr Rayner dated 27 October says that closing the advisory group was discussed in June and that it was agreed that the time was right for change. Dr Rayner was not present at this meeting and questions how many members of the advisory group were actually there at the time.

The letter goes on to say that ministers are putting in place new arrangements that best meet future needs, including supporting the new National Ambition Review Group with appropriate input from experts. It also adds that it will ensure that there is appropriate expert input to local decision making through the new Public Health England organisation.

The government’s plan for reducing obesity in England, its “Call to Action on Obesity in England,” has come under attack from many experts in public health and obesity because it focuses only on individual responsibility and fails to tackle the influence of the food and drink industry (BMJ 2011;343:d6688, doi:10.1136/bmj.d6688).

Dr Rayner said he is surprised the coalition government didn’t disband the group as soon as it came to power. “I think it was a fig leaf for their very ideological approach to obesity. They believe that the obesity crisis can be solved through personal responsibility. There is no scientific basis to this approach.”

He added, “The approach will fail because ministers place so much faith in industry action—not only the food industry but the drinks industry, including soft drinks. If ministers feel that self regulation will fix things, they are sadly mistaken. In January 2006 David Cameron protested about the half price chocolate oranges at the retail chain WH Smiths. They are still there.”

Professor Lang said, “The closure of the expert advisory group is bad news all round: bad politics, bad policy, and bad science. It shuts the door on an important attempt by the state to recognise the systemic nature of what drives obesity. With the Foresight report came the beginnings of an effort to address that systemic nature. We members had no illusions that a radical transformation was happening, but at least there was a recognition that the complexity driving obesity could be mapped and broken into policy elements which could be displayed.”

He added, “It’s plain as a pikestaff that obesity requires systems change, not a tweak here and there, yet that is what is being offered by the [government’s] responsibility deals. By adopting the responsibility deals as its policy framework I believe that the government is entering dangerous policy territory . . . Its approach puts the onus on industry to do what it wants. This is a policy ‘lite’ framework, which I think is actually dangerous for industry. If it fails, which it is likely to, the onus and responsibility will be firmly on industry. That’s why some companies are nervous—and rightly so. They know it won’t work, and they’ll be blamed when it doesn’t.”

Another group member, Ken Fox, emeritus professor of exercise and health sciences at Bristol University, said, “What has actually been achieved has been disappointing, particularly as the Foresight report gave a brilliant framework to work from. I have been hugely disappointed for some time at the lack of priority given to physical activity and health. The current government’s efforts seem to have shifted pretty exclusively to food intake and the new responsibility deal, with particular emphasis on chasing the big food and drink companies. In my view this is a very restricted vision of the causes of obesity and has probably actually worked against physical activity in the broader context of health by diverting attention away from it.”

But the advisory group’s chairwoman, Susan Jebb, head of diet and population health at the Medical Research Council’s human nutrition research unit in Cambridge, said, “The ending of the group was not unexpected. In policy terms it was a relatively informal group set up by the previous government for a particular purpose: to provide a channel for ongoing scientific evidence into the obesity policy team following on from the Foresight report.”

Dr Jebb, who also chairs the government’s food responsibility deal, said, “There is no shortage of independent critical voices. Just because there has been the closure of the expert group, it doesn’t mean the end to all scientific criticism.”

She added, “Given the new structures announced in the public health white paper and the Call to Action, together with the shift in emphasis from central to local action, I think it is reasonable to suggest that the role of the expert group will now be taken on by others.”

Dr Jebb said that she would like to give the government the benefit of the doubt but that she would be watching closely. “I am absolutely convinced that scientific evidence and analysis are critical to informing and shaping the obesity strategy and that good evaluation of programmes is essential so we learn from everything we do.

“Public Health England has very clear responsibilities to do this, and I shall be watching closely to see how they discharge these. For obesity specifically, the role of the National Ambition Review Group will be crucial, and I hope it will not be too long before the membership of this group is announced . . . I would like to think it will include scientists with specific expertise in relation to obesity.”

A health department spokesperson said, “The government has made public health a priority and as such we are bringing in a new approach. In light of our new approach we are also bringing in new advisory arrangements for obesity.

“Dr Susan Jebb will continue as science adviser, and there will be a new National Ambition Review Group on obesity, which will bring together key partners and experts from the academic and scientific field. Public Health England will also play a crucial role in providing robust intelligence and evidence to local areas.

“We are grateful to previous advisory group members for their input and will continue to ensure that expert advice is at the heart of public health policy.”