What are we going to do about obesity?

The problem we have with obesity is well known. In the UK, around 63% of the adult population are above a healthy weight and for children the statistics are even more disturbing. One in three children leaving primary school in the UK are overweight according to government figures (HM Government 2020). The UK is not alone, and according to the World Health Organisation, in 2016, there were 1.9 billion adults aged 18 and over globally who were overweight. Obesity is now not an issue solely seen in high-income countries, but according to the World Health Organisation (WHO 2021), only sub-Saharan Africa and Asia have more people underweight than overweight or obese. The health consequences of being overweight and obese are also well known, including increased risk of cardiovascular disease, diabetes, musculoskeletal disease and some cancers. As has been seen during the current pandemic, we know that being overweight or obese also increases the risk of being seriously ill or dying from Coronavirus. The effects of obesity on individuals, groups and communities include increased hospital admissions, reduced ability to complete activities of daily living and impact on lifestyle. Poor diet and physical inactivity are major risks contributing to obesity (The Health Foundation 2022), and so the answers to prevent and reverse this trend are clear. Whichever way this is achieved, the answer lies in reducing calorie intake, especially from high fat, sugar and salt (HFSS) foods, and undertaking regular activity and exercise. WHO recommends 60 minutes of physical activity per day for children and 150 minutes per week for adults (WHO 2021). In the UK, government policy is focussing on support using evidence-based tools and apps to advise people on losing weight, including weight management programmes offered by the UK National Health Service (NHS). Supporting individual behaviour change can be useful. However, unless there is focussed and appropriate legislation, the problem will not be addressed.This was the experience prior to the smoking ban legislation agreed by many countries over two decades ago. The UK government is discussing banning television advertising of specific foods before the 9 pm watershed. They are also considering bringing in legislation that will place responsibility on food businesses to provide enhanced food labelling by identifying the number of calories in the foods they sell to customers and for retail outlets to restrict volume promotions of HFSS foods, e.g. the ‘buy one get one free’ schemes that some supermarkets offer. However, these proposals continue to focus on the behaviour change approach putting the emphasis on individual action. The UK government commissioned an independent report on food production and the National Food Strategy, Part Two, was published last year (Dimbleby 2021). This identified 14 recommendations that cover areas of food production and consumption, including agriculture, food manufacture, retail and trade, education, health, research and INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 2022, VOL. 60, NO. 2, 127–129 https://doi.org/10.1080/14635240.2022.2052539