Intended for healthcare professionals


Clinicians underwhelmed by “watered down” childhood obesity strategy

BMJ 2016; 354 doi: (Published 22 August 2016) Cite this as: BMJ 2016;354:i4576

Re: Clinicians underwhelmed by “watered down” childhood obesity strategy


The new childhood obesity plan quite rightly highlights some of the important reasons why this issue should be seen as one of the greatest public health crises facing our country.(1) The fact that nearly a third of children are overweight or obese and that NHS in England spends over £5 billion each year on overweight and obesity-related ill-health should galvanise the Government into action. If the Government really does want to improve social mobility then obesity is certainly an area that needs to be tackled appropriately – as the burden is falling hardest on those children from low-income backgrounds.

The recent success at the Olympics has shown that: having a long term strategy; clear targets; resources including specified and appropriate funding; and high level support can bring its rewards. This type of approach is also needed to protect children and young people against obesity and a host of related disabling and some life-long non-communicable diseases. The health and wellbeing of today’s children and tomorrow’s adults deserves more significant and robust action.

It is good that the obesity plan “represents a start of a conversation, rather than the final word” as there is an urgent need for strong coordinated government-wide action.(1) As a next step, influential representatives from key Government departments including: Health; Education; Transport; and, Culture Media and Sport, should commit to jointly tackling this issue. Such endorsements will be critical for gaining and maintaining long-term momentum.

We have previously mentioned that a holistic approach is needed for this issue.(2-4) Different settings including the NHS and schools could play major roles. However, it is not enough to throw money at school sport, we need to provide enjoyable physical activities that encourage children and young people to participate and overcome the many barriers bought about by disability, gender, religion and culture.(5,6) Well-funded public health departments in local authorities are crucial to motivating and coordinating local efforts.

Although there is no magic bullet to tackle childhood obesity there are recommended interventions that can and should be implemented.(7-9) Besides providing individuals with information and skills, we also need to tackle obesogenic environments so that the social norm is no longer supporting unhealthy dietary behaviour.(9) Key environmental influences include the wide availability, promotion and affordability of unhealthy food and drink. Controlling TV advertising and better compulsory sugar labelling on food and drink products are just two areas that need to be urgently added to the development of this plan.

Funding is a critical area that also needs to be addressed. To win gold medals our country has had to spend substantial sums of money. It should be noted that effective public health interventions also cost. However, if we really want to tackle many of the chronic diseases that cause substantial suffering, ill health and premature death then proper funding is needed both at a local and national level.

After winning only one gold medal at Atlanta twenty years ago, the Government took appropriate action which resulted in 27 golds in Rio. The results speak for themselves!

1) Department of Health. Guidance: childhood obesity: a plan for action. 2016.

2) Watson M 2013 Consistent food labelling system is rolled out across UK. BMJ Rapid Response 23rd June 2013.

3) Watson M and Lloyd J, 2013 It’s time to ban junk food on hospital premises. BMJ Rapid Response 1st July 2013.

4) Watson M and Lloyd J, 2015. Taxing sugar should be just one element of a multifaceted campaign BMJ 2015;351:h4388

5) Lloyd J, 2015. Compassion through development of physical and mental health and well-being. In, Towards the Compassionate School. Ed. Maurice Irfan Coles. London: Trentham Books/IOE Press. 2015.

6) Watson M and Lloyd J, 2016. Re: Taxing sugar. British Medical Journal Rapid Response 21st March 2016.

7) Foresight. Tackling Obesities: Future Choices – Project Report. Government Office for Science: London. 2007

8) Academy of Medical Royal Colleges. Measuring Up: The Medical Profession’s Prescription for the Nations Obesity Crisis. London: Academy of Medical Royal Colleges 2013.

9) BMA Food for thought: promoting healthy diets among children and young people. London: BMA 2015.

Competing interests: No competing interests

23 August 2016
Michael Craig Watson
Associate Professor of Public Health.
Dr John Lloyd (Vice President Institute of Health Promotion and Education, Institute of Health Promotion and Education,
University of Nottingham, Faculty of Medicine and Health Sciences, Queen's Medical Centre, Nottingham. NG7 2HA