London, 27th July 2020
- OPEN UK, a group of UK obesity experts, welcome government’s focus on obesity, but warn it will not offer effective weight management support for those people living with severe obesity
- Support the new measures on food advertising, but there is a need to ensure that this doesn’t promote unhealthy relationships with food or worsen health inequalities
- Urgent need to address weight stigma and discrimination, however, focus on individual behaviour change, rather than system wide actions, and the wider determinants of obesity, has the potential to fuel existing UK weight stigma and discrimination
- Group calls for further action which takes a whole systems approach and reflects the complex, chronic, multifaceted nature of obesity
We welcome the Government’s renewed focus on obesity, with the actions suggested and the new ‘Better Health’ campaign reflecting population-level, preventative measures. For some of the population these measures may improve health related decisions, but for many people (especially those living with severe obesity), this strategy will not offer effective weight management support. Hence, we look forward to learning more about the Government’s proposed improvements to NHS weight management services.
We are supportive of the ban on TV and online adverts for food high in salt, sugar and fat before the 9pm watershed, as well as ending ‘buy one, get one free’ deals on these foods. At a population level these may prove effective measures and help support the health of people regardless of bodyweight and health status. Similarly, the inclusion of calories on menus and alcoholic beverage labelling may also prove useful in helping people make healthier food and drink decisions. There is, however, also a need to ensure that this doesn’t have unintended consequences for people with eating disorders and promote unhealthy relationships with food. Indeed, given the association between obesity and inequalities, it is imperative that new actions do not worsen health inequalities.
OPEN is committed to improving public awareness of obesity and supporting aligned actions reflecting the complex, chronic, multifaceted nature of obesity as highlighted 13 years ago in the UK Government’s Foresight Report. The Foresight Report highlighted that there are over 100 factors that contribute to weight gain that are, for instance, biological, genetic, social, and psychological. As such, while the changes referred to by the Prime Minister to ban advertisements and deals for foods high in salt, sugar and fat are important population health interventions, further decisions to implement a whole system approach to obesity are needed.
We believe that a more effective strategy would be to take a whole systems approach to obesity and providing greater access to weight management services across all Tiers, rather than focusing solely on individuals making changes. Counterintuitively, in 2019, Public Health England, the Association of the Directors of Public Health and the Local Government Association commissioned a whole systems approach to obesity programme. This programme concluded that a long term, system-wide approach to obesity, which is tailored to local needs and works across the life course are needed.
Obesity is defined and should be recognised as a chronic health condition. For some people living with obesity, lifelong support and treatment may be needed, which may vary over time depending on individual needs. Any support for people living with obesity must also have long term considerations and treated with equal opportunities to access support or appropriate treatment as any other health condition such as cardiovascular disease or Type 2 diabetes. Short term solutions for a long-term health conditions do not make sense and is likely to influence inaccurate and often stigmatising perceptions and unrealistic expectations. It is therefore key that the Government consider how the 12-week initiative will be enhanced after conclusion to ensure long-term weight loss maintenance.
OPEN UK has concerns that the focus on individual behaviour change rather than system wide actions is likely to fuel weight stigma and discrimination that is already pervasive in the UK. Focusing solely on individual changes not only overlooks the wider determinants of obesity but leads to beliefs that obesity is solely within an individual’s control. This is likely to lead to blame, perceptions that obesity is the result of a lack of willpower, and negative attitudes and behaviours towards people living with obesity.
There is an urgent need to end weight stigma and discrimination, across all settings including in healthcare settings and in media portrayal. Yet, there is also a need to address weight stigma in obesity related policies. In 2018, the All-Party Parliamentary Group on Obesity reported that weight stigma and discrimination was widespread in the UK and that experiences of stigmatising and inappropriate care leave people less likely to seek the healthcare.
We look forward to opportunities for transdisciplinary collaboration with the Government in developing longer-term, structural solutions. With this in mind, we call for the Government to reconsider the current obesity strategy and in doing so:
- Develop actions to improve public awareness of the complex, chronic, multifaceted nature of obesity
- Address the wider determinants of obesity
- Address pervasive weight stigma and discrimination
- Reconsider the focus on short term, 12-week interventions
- Consider effective treatment options for those with severe and complex obesity
About OPEN UK
The Obesity Policy Engagement Network (OPEN) UK is a partnership programme, bringing together different expertise across obesity to improve obesity care in the UK. Novo Nordisk has fully funded the secretariat of OPEN UK, but has no influence over the group’s activities. Novo Nordisk has had no influence over the content of this statement.
OPEN is a partnership programme and sustained global initiative initiated and supported by Novo Nordisk to improve obesity care internationally. It is a network for national coalitions of public health, policy, patient representatives and other thought leaders in the field of obesity with representation in over 15 countries including the UK, Italy, Germany and Spain.
OPEN seeks to provide national policy advocates with the opportunity to share diverse perspectives on a common challenge, identify solutions and collaborate to address the current barriers and challenges to effective obesity care.
Through the global network, members obtain insights and tangible tools on how to put in place effective national obesity strategies which deliver workable, effective solutions that successfully address the obesity challenge