Specialists condemn government’s obesity plan as too simplistic

Experts in public health and obesity have condemned the government’s plan for reducing obesity in England because it focuses only on individual responsibility and fails to tackle the influence of the food and drinks industry, they say.

The government’s new strategy document sets out measures for reducing obesity as the NHS moves towards a new public health system. Its main recommendation is to “empower” people to make healthy decisions by providing information and tailored support on weight management at a local level. Although it recognises that physical activity is important, the plan suggests that reducing energy intake is the key to weight loss.

“We will favour interventions towards the less intrusive end of the Nuffield ladder [which ranks public health measures from doing nothing to eliminating choice]—with a focus on equipping people to make the best possible choices,” it says.

The plan calls on partners, including the food and drink industry, to do their part in helping to reduce the country’s collective calorie count by 5 billion kilocalories a day. To achieve this, it suggests more calorie labelling, reformulation of processed foods and drinks to reduce energy content, and “changing the balance” of food promotion. But it sees the plan as part of the government’s “responsibility deal,” a voluntary public health initiative launched in March that encourages businesses and other organisations to make pledges to improve health through their influence.

“We are disappointed that the government has not yet stepped up to its responsibility to protect the public’s health by banning trans fats and introducing a minimum price for alcohol,” said Lindsey Davies, president of the Faculty of Public Health, the United Kingdom’s standard setting body for specialists in public health.

“The smoking ban has demonstrated how changing the law can improve health and save thousands of lives. The government must use the law as well as ‘nudge’ techniques to create a culture that makes it easy for people to make healthy choices and consume fewer calories,” she said.

Philip James, emeritus professor of human nutrition at the London School of Hygiene and Tropical Medicine, London, and president of the International Association for the Study of Obesity, said, “The plan is a completely inadequate response to the problem of obesity.

“It is not simply a question of personal responsibility. There is an environmental problem in terms of the food system we have.”

Professor James argued that legislation was needed to ban advertising of food products to children and to provide warnings about foods high in fat and sugar. “Price is also fundamental. The whole food pricing system is manipulated by government and the food and farming industries so that sugar and fat are cheap. We have to introduce measures to put the prices of these foods up.”

Announcing the plan, the health secretary, Andrew Lansley, argued, “We have already seen how we can move further, faster through the responsibility deal, and I am now challenging business to help us make even greater progress.”

He announced the plan at the publication of the latest report on energy requirements from the Scientific Advisory Committee on Nutrition. The report updates recommended daily energy intakes after a review of new evidence on energy expenditure. It recommends an average daily energy requirement of 2605 kilocalories (10.9 MJ) for men and 2079 (8.7 MJ) for women. This is based on the energy intake needed to achieve a healthy body weight range (body mass index 18.5 to 24.9 for adults) and best estimates of existing physical activity.

The energy requirements for adolescent boys and girls and adult women are higher than previous estimates. The committee says that this is not because these groups have increased their activity levels but because the figures represent a closer estimation of energy needs at current activity levels in the UK population.