Obesity—a vital issue that’s being overlooked in the UK elections

The adult population in the UK is among the most obese in Europe and the UK came top among 18 European countries in an assessment of household availability of ultra-processed food.12 A recent report found that obesity among 10-11 year olds has increased by 30% since 2006 and type 2 diabetes among the under 25s has increased by 22% in the past five years in the UK. Obesity has a cost.3 In 2020 obesity related costs were estimated at £58 billion annually in the UK, with projections that this could rise to £162 billion by 2060 if unchecked—about 2.5% of GDP.45

This is not inevitable. The UK National Food Strategy has identified measures that would make a difference, including restrictions on promotion of junk food, forcing large food companies to report annually what they produce or sell, expanded eligibility for free school meals, subsidies for healthy foods, and including health considerations in government procurement.6 The World Health Organisation (WHO) offers several “Best Buys,” to tackle obesity, including elimination of trans-fats and front-of-pack labelling.7 To this list the World Obesity Federation adds tackling weight bias and stigma, which exacerbate the obesity epidemic.8

Given that we know what to do, what do Britain’s political parties propose in their 2024 election manifestos? Not much.

The Conservative and Unionist Party only mention obesity once in their 76-page manifesto, saying that “We will continue to tackle childhood and adult obesity and will legislate to restrict the advertising of products high in fat, salt, and sugar. We will gather new evidence on the impact of ultra-processed food to support people to make healthier choices.”9

Nor is there much in the Labour Party’s 136-page manifesto, which also includes only one mention, saying that: “We face a childhood obesity crisis. So, Labour is committed to banning advertising junk food to children.”10 It also commits to “introducing free breakfast clubs in every primary school” but does not elaborate on other anti-obesity measures.

The Liberal Democratic Party manifesto does not mention obesity, but acknowledges that, “Too many families simply can’t afford enough healthy, nutritious food. Ultra-processed foods, high in saturated fat, sugar, and salt, are usually much cheaper than healthier foods—contributing to serious health problems, especially among poorer households.”11 It does, however, promise several measures that would help, including: “protecting children from exposure to junk food by supporting local authorities that restrict outdoor advertising, postponing TV advertising to after the 9 pm ‘watershed,’ and extending the soft drinks levy to juice and milk-based drinks high in added sugar.” They also promise “free school meals for all children in poverty” and aim to “ensure everyone can get affordable, healthy and nutritious food, produced to high welfare and environmental standards.” They will use “public procurement policy to support the consumption of food produced to high standards of environmental and social sustainability, and which is nutritious, healthy…” and commit to “Introducing robust and clear-to-understand food labelling.”

While the Green Party manifesto also mentions obesity once, it does devote substantial attention to food environments.12 It commits to a series of goals that include: “All children to have a daily free school meal, made from nutritious ingredients, and based on local and organic or sustainable produce and free breakfast clubs for children to Year 6. Everyone to have sufficient income to make healthy sustainable food choices. Schools to involve children in growing, preparing and cooking food, as part of the core curriculum, so that they recognise and understand how to use basic fresh produce.” The manifesto pledges to “transform our food and farming system so it produces healthy, nutritious food” and commits to “improved food labelling” but does not mention taxes on junk foods, reformulation to reduce sugar, salt, and trans-fats, or curbs on marketing to children.

The newly established Reform UK Party, running mainly on an anti-immigrant platform, has published a 32-page draft “compact with the people” that does not mention obesity.13 Nor does it refer to any of the obesity-related measures in the UK National Food Strategy or WHO’s “Best Buys.” It’s one reference to labelling calls for British consumers to know whether their food is British or imported (seemingly unaware that many processed foods will include both).

While manifestos are an unreliable prediction of what political parties will, or even can do once in power, they indicate a direction of travel. The political parties seem sanguine about the costs—human and financial—of the growing obesity crisis. Their health related pledges focus almost exclusively on fixing the NHS. While the NHS certainly needs fixing, it will always struggle if the population becomes steadily less healthy.

In many respects, this election can appear as a competition to see how many vital issues each party can ignore. The lack of ambition on obesity is one among many. Those few journalists who try to point this out are usually told that “that’s not what my constituents are saying on the doorsteps.” As they knock on our doors over the next few weeks, we in the health community have a rare opportunity to change this.