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Clinicians underwhelmed by “watered down” childhood obesity strategy

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4576 (Published 22 August 2016) Cite this as: BMJ 2016;354:i4576
  1. Adrian O’Dowd
  1. London

The government’s long awaited childhood obesity plan for England has been roundly criticised as weak, disappointing, watered down, and underwhelming by doctors’ leaders, dentists, local government, national charities, and campaign groups.

The Department of Health described its strategy,1 published on 18 August, as a “far reaching” plan to curb childhood obesity by urging industry to cut the amount of sugar in food and drinks and investing millions of pounds in school sport.

Nearly a third of children aged 2 to 15 are considered to be overweight or obese, making them more likely to have health problems later in life.

The document said that the NHS in England spent around £5.1 billion (€5.9bn; $6.7bn) on overweight and obesity related ill health in 2014-15.

Under the obesity plan, the food and drinks industry will be encouraged to work towards a 20% reduction in the sugar used in products popular with children—including a 5% reduction in year one—achieved through cutting sugar levels, making portions smaller, or encouraging the uptake of lower sugar alternatives.

Progress made by the industry will be reviewed by Public Health England who will publish updates every six months.

There will also be a new soft drinks industry levy, described as a sugar reduction programme, which calls on companies to cut sugar in soft drinks. This is the “sugar tax” that the former chancellor, George Osborne, announced in March. Precise details of the levy are yet to be finalised. It will be the subject of a consultation and introduced in 2018.

Money raised from the forthcoming levy will be invested in programmes to reduce obesity and encourage physical activity and balanced diets for school children.

The government wants to double the time that children in primary schools spend being physically active to at least one hour per day and plans to put a further £10m a year into school breakfast clubs to give more children healthier food.2

However, two key recommendations made previously by Public Health England—to ban discount promotions of junk food in supermarkets and restrictions on the advertising of unhealthy food to children on television—were not contained in the government’s final plan, which has been delayed several times.

Primary schools will be monitored under a healthy rating scheme that will measure how they are supporting their pupils to eat healthily and be active.

The document also said that Health Education England had reviewed and updated existing e-learning materials about obesity and nutrition, and it was encouraging all those working in the NHS to take relevant training as part of their continuing professional development.

Financial secretary, Jane Ellison, said, “The soft drinks industry levy is an important step forward in the fight to halt our obesity crisis and create a Britain fit for the future.

“Obesity is a threat to both the health of children and to our economy, costing the NHS billions of pounds every year. The planned levy is already showing how it can be a powerful signal for change and I urge companies to reformulate their products before it starts in 2018.”

Duncan Selbie, chief executive of Public Health England, said, “This plan is the first step on the long road to tackling childhood obesity—one of the most important issues for the future of our children.”

BMA board of science chair, Parveen Kumar, was unimpressed by the government’s plan. “Given that the UK has the highest level of obesity in Western Europe—with one in three children overweight or obese by the time they leave primary school—the government should be doing everything in its power to tackle this problem,” he said.

“Instead it has rowed back on its promises by announcing a weak plan rather than the robust strategy it promised.

“Although the government proposes targets for food companies to reduce the level of sugar in their products, the fact that these are voluntary and not backed up by regulation, renders them pointless. It is incredibly disappointing that the government has failed to include any plans for tighter controls on marketing and promotion.”

The Obesity Health Alliance—a coalition of 33 national charities, medical royal colleges, and campaign groups—said that the soft drinks industry levy consultation was a bold and positive step forward, but said in a statement, “The government’s plan is underwhelming and a missed opportunity to tackle the obesity crisis and its devastating burden on the health of both society and the NHS. The government’s plan falls disappointingly short of what is needed.”

Neena Modi, president of the Royal College of Paediatrics and Child Health, said, “I am extremely disappointed that the long awaited strategy has been replaced by this weak ‘plan’ which provides no bold action, and instead relies on physical activity, personal responsibility, and voluntary product reformulation.”

Royal College of Physicians’ president, Jane Dacre, said, “I am disappointed that after such a long wait for the childhood obesity strategy, the government has published a downgraded plan that fails to address key issues such as marketing and promotion of sugar filled and unhealthy foods to children.”

Local Government Association portfolio holder for community wellbeing, Izzi Seccombe, said, “We have called for fundamental reforms, such as a mandatory reduction of sugar in soft drinks, better sugar labelling on food and drink products, calorie counts on menus in chain restaurants, and for councils to be given powers to ban junk food advertising near schools.

“We believe that these measures, which would help to promote greater individual responsibility, could help to significantly reduce childhood obesity. It is disappointing that a number of these key asks have not been included in the plan and we will continue to press government for them to be introduced.”

The British Dental Association’s chair, Mick Armstrong, said, “It will take more than half measures to deal with the sugar crisis. A sugar levy is one thing, but watering down action on junk food advertising and 2-for-1 deals sends entirely the wrong signal to business, parents, and health professionals.”

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