Should the Government be worried about opposition to the National Obesity Strategy?

By Imogen Shaw

Last week, the House of Commons debated the implementation of the Government’s National Obesity Strategy. The strategy, which has become a significantly larger presence in public debate following evidence of a link between obesity and adverse outcomes from contracting COVID-19, has met with staunch opposition from all quarters. This should be relatively unsurprising – public health measures inevitably attract controversy, fitting very neatly into broader debates about individual rights and freedoms.

However, a government keen to leave the spectre of stringent COVID restrictions behind it in the wake of a successful vaccination programme shouldn’t take its eye off the fact that a growing number of charities, think tanks, business groups and MPs have repeatedly raised many of the same concerns.

The most controversial elements of the strategy are twofold. Firstly, there is the proposed ban on banning the advertising of high fat, salt and sugar (HFSS) products being shown on TV and online before 9pm by 2022, and the upcoming consultation on introducing a total HFSS advertising restriction online.

This has united in opposition food retailers, especially many of those within the small business community, media outlets relying on advertising income, and traditionally Conservative-aligned groups with more libertarian instincts.

Many small takeaway and bakery businesses have voiced their concerns about the prospect of an online ad ban. Under the proposed new guidance, it is unclear whether, for example, a one-person bakery business would be prevented from posting images of cakes and biscuits to social media platforms such as Instagram or Pinterest. Given that small companies like these rely on social media and word of mouth to make sales – to a much greater extent than large businesses with a high level of name recognition – many have expressed fears about the damaging effect the new regulations could have on the future viability of their business.

While Health Minister Jo Churchill was steadfast in her assurances that the purpose of the new regulations is to target companies with over 50 employees in England, it remains unclear how the Government will ensure a blanket ban on a specific type of advertising impacts only medium and large businesses in the food sector. As Shadow Health Minister Alex Norris raised during last week’s debate, online policy has historically been difficult for the Government to do well, exemplified by the wrangling over the Online Harms Bill. Moreover, social media platforms often struggle to implement nuanced content restrictions, sometimes opting instead to remove certain content automatically if in doubt.

Other organisations, including the Adam Smith Institute and the Consumer Choice Center, have taken things a step further, arguing that the ad-ban strategy could constitute a lot of risk for very little reward, and querying why the Government is pushing ahead with the measure when its own impact study suggested a child’s daily calorie intake will reduce by 1.74 kcal as a result of its implementation.

Both of these questions will be important ones for the Government to answer to reassure the business community, especially as businesses that have been supported by government schemes during the pandemic face the prospect of making loan repayments in an uncertain climate, increasing wariness at the prospect of another regulation they will have to make business changes in order to implement.

The second element of the strategy that has met considerable pushback is the plan to introduce legislation requiring large out-of-home food businesses, including restaurants, cafes, pubs and takeaways with more than 250 employees, to add calorie labels to the food they sell.

Charities and third-sector groups in the mental health space, as well as a number of concerned MPs, have argued against this policy, citing the potentially severe negative impacts on people living with and recovering from eating disorders. Beat, the UK’s national eating disorder charity, has launched a campaign against the proposal, calling on supporters to write to their MPs and highlight research demonstrating the threat it poses to people with eating disorders.

Beat recently carried out a survey targeted at people who had either experienced an eating disorder or supported someone who had, seeking their views about calorie labeling on menus. This survey found that 93% of respondents thought that the introduction of calorie labelling on menus would be ‘negative’, or ‘very negative’ for people with eating disorders, and 84% did not think it could be introduced without posing risks to people with eating disorders.

Research has also found that when making hypothetical food choices from a menu that includes a calorie count, individuals with anorexia and bulimia are more likely to order food with significantly fewer calories, whereas people with binge eating disorder are more likely to order food with significantly more calories, exacerbating eating disorder behaviours. Lib Dem MP Wera Hobhouse, who chairs the APPG on Eating Disorders, raised this in Parliament on Thursday, noting that many people with eating disorders also live with obesity, and therefore “a reductionist approach to nutrition means that the obesity strategy risks harming some of the very people it is designed to support”.

This issue has the potential to affect a lot of people. An NHS England Health Survey conducted in 2020 found that 16% of adults aged 16 and over screened positive for a possible eating disorder. It’s also an argument that has had a reasonably high level of cut-through with MPs, including Sarah Champion, who wrote an article calling for an immediate review of the strategy during Eating Disorder Awareness Week earlier this year.

Most pressingly for the Government, the recent report resulting from the Women and Equalities Committee’s inquiry into body image stated, “the Government’s latest Obesity Strategy is at best ineffective and at worst perpetuating unhealthy behaviours”, calling on the Government to “immediately scrap its plans to for calorie labels in restaurants, cafes, and takeaways, as these could negatively affect those with, or at risk of developing, eating disorders”.

After his personal brush with COVID, Boris Johnson has undergone a noticeable shift in mindset on public health and nutrition, and Health Secretary Matt Hancock has described tackling obesity as a “particular obsession” for the Prime Minister. Given this, despite the concerns over unintended consequences, it looks unlikely that the Government will climb down from the strategy without a considerable fight.