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Introduction

Today’s upsurge in unhealthy eating habits and sedentary lifestyles has necessitated healthcare systems and public health policy implementers around the world to shift their focus from communicable diseases to lifestyle-related illnesses. One these illnesses, that has been in the public health limelight, for the past ten years in the UK is obesity. Obesity is increasingly recognized by the UK authorities and public health institutions as one of the leading causes of preventable deaths in the country. In a 2016 survey, approximately 26.2% of adults in England were found to be obese, while 35.2% were overweight, implying that an estimated 61.4% of the adult population in England are obese or overweight (Baker, 2018). The report further established that men are at a higher risk of being overweight or obese (65.7%) compared to women (57.1%).

Obesity is also prevalent among children. According to the NHS UK, at least one in every five children aged between 10 and 11 years in the UK is obese. This argument is supported by statistics from the British Nutrition Foundation, which maintain that an estimate of 16% of children between ages 2 to 15 are obese, and an additional 15% are overweight. Obesity and overweight have been cited by healthcare professionals as one the major risks factors for developing cancer, type 2 diabetes and cardiovascular diseases. Evidently, these statistics suggest the growing need for implementation of government healthcare policies to help address the problem of obesity. This paper explores prevalence of obesity in the UK with reference to age and gender, as well as the current government policies in place to address obesity as public health concern.        

1.      Obesity as a Public Health Concern in the UK

Obesity is no longer debatable as a public health concern in the UK. Instead, it is now fully recognized as a major contemporary health problem that needs immediate prevention measures. According to the British Nutrition Foundation (2019), obesity refers to a condition in which “abnormal or excessive fat accumulation in adipose tissue impairs health” (para 2 line 1). While there are several methods of classifying a person’s weight and determining whether he/ she is obese or not, the method in common use is the body mass index (BMI) that measures a person’s healthy weight against height. The method uses the criteria highlighted in table 1 below to classify a person as healthy weight, overweight or obese.

Table 1: BMI Scores for Determining Overweight and Obese in Adults (NHS UK 2018)

BMI is used together with waist circumference measurements to ascertain that the person is actually obese because some people may have higher BMI scores as a result of being more muscular. Based on this criteria men with more than 94 cm of weight circumference and women with 80 cm waist circumference are considered to have excess fat and hence obese.

According to a 2018 report by Baker, 62% of adults in England are either obese or overweight. Of those obese, approximately one tenth; that is 2.9% of all adults are considered morbidly obese (Baker, 2018). This is a significant increase from 2006 in which only 55% of adults were obese. As shown in figure 1 below, men aged 40 to 64 years more likely to develop obesity and overweight than women in the same age group.

            Figure 1: Prevalence of Obesity and overweight in England between 2015 and 2016                                  (Source: Career Research UK, 2017).

 A similar trend holds for children and teenagers aged 2 to 15 years as shown in table 2 below.

Table 2: Prevalence of obesity among children in the UK (Source: British Nutrition Foundation, 2018)

The risk of developing obesity seems to increase with age, especially among men as shown in figure 2 below. This is partly because as Brits grow and get employed, they adopt sedentary lifestyles and eat more fast foods with high calories, rather that cooking in order to meet their economic objectives.

Figure 2: Men and Women aged 45 to 70 years have highest Risks of developing                            obesity (source: Baker, 2018).

The levels of obese adults in England has increased gradually from 15.0% in 1993 to 23.9% in 2006, before reaching an all-time highest level of 26.2% in 2016. Overweight levels have also seen a similar trend – increasing from 55% in 1993 to 63.2% in 2016 as depicted in figure 3 below.

  Figure 3: Trends or Obesity and Overweight levels in England between 1993 and 2016 shows a gradual increase across the period (Source: Baker, 2018).

Consumption of fast foods and other sweetened junk foods with high calorie amounts as well as adoption of sedentary lifestyles have been cited as some of the major causes of obesity and overweight. Thus, the gradual increasing in levels of obesity and overweight between 2006 and 2016 is largely attributable to increased consumption of unhealthy and sugary fast foods. This is because the rising costs of living means that people have to focus on busy working schedules at the expense of cooking healthy whole foods. Additionally, increased focus on meeting economic objectives deprives Brits of adequate time to engage in physical exercises and other outdoor activities required for one to remain physically fit and lead a healthy lifestyle.

2.      Summary and Aims of Government Policies

            Obesity and overweight, if left unaddressed or untreated, can lead to other serious health conditions such as coronary heart disease and stroke, respiratory problems, high blood pressure (hypertension), different types of cancers, gallstones, type 2 diabetes, lever disease, sleep apnea, stress incontinence, asthma and reduced fertility (NHS UK, 2018; Baker, 2018). Obesity has also been found to reduce one’s life expectancy by approximately 4 to 9 years, depending on its severity, and that at least 2 in every 14 deaths in the UK occur as a result of the condition. The economic burden of treating obesity and overweight and their related health conditions is also exceptionally high. According to the UK department of Health and Social Care (2016), NHS spent an estimate of “£5.1 billion on treating and managing overweight and obesity-related ill-health” between 2014 and 2015 (para 2 line 3). As a result, many governments in the UK are implementing healthcare policies to prevent escalation of obesity and its related conditions as well as treat those who are already affected by the disorder.

Obesity, as a complex health problem, has many driving factors ranging from genetics to behavior, culture, environmental, and above all, imbalanced energy intake; that is, consuming more calories than one’s body can use. As such, initiatives and policies to address the problem requires combined efforts of both the federal government, local authorities, healthcare organizations, food manufacturers and even schools. For instance, John Blackshaw, a National lead for obesity and Healthy Weight maintains that; “there is no single solution [for obesity], we have to address the many factors that drive up [its] levels. We all – government, industry, local authorities and the public – have a role to play in that” (Quinlan, 2016). Because obesity often starts in childhood and continues through adulthood, current policies to reverse its growing trends seems to focus largely on childhood obesity.

In 1998, the UK passed the European Union Working Time Directive law that limits maximum working hours to 48 hours a week. The act was passed during Thatcher’s government and its core objective was to improve workers’ work-life balance, although it makes provisions for some employees to opt out depending on their financial objectives. European Court of Human Rights believed that working for 48 hours a week would ensure that employees have enough time to participate in physical outdoor activities as well as have positive eating patterns by preparing meals on their own.

As a result of growing concerns over the quality of school meals, the federal government, in 2000, implemented regulations that introduced “nutritional standards for school lunches” (Martin, 2008). According to the law, school meals were to be served together with fruits and vegetables. The objective was to promote healthy eating habits among children and help them maintain high nutritional standards through adulthood.  

In 2006, the UK intervened further in the health problem of obesity by making a proposal to prohibit food processing companies and retailers from advertising unhealthy foods that target children as primary consumers. According to Hastings et al. (2003), the foods advertised to children both in the UK and other countries across the world contain high levels of sugar, salt and fat that many research studies associate with the onset of obesity.

Moreover, “Healthy Weight, Healthy Lives” initiative was implemented in England in 2015 as a cross-government strategy to support and encourage people to maintain healthy lifestyles, particularly weight. The initiative includes Change4Live programme that aims to reduce levels of obesity and overweight among adults and children by “encouraging them to eat better and move more;” that is, engage more in physical activities (British Nutrition Foundation, 2018).

Public health agencies, schools and local authorities are also addressing obesity at local levels by implementing such initiatives as the “daily mile” as well as taking an active role in various programmes including the National Measurement Program and “Eat Better, Do Better” (Quinlan, 2016).   

3.      Evaluation of the Policies and Views on the Policies from relevant Charity/Pressure Groups

            The aforementioned policies and initiatives have various strengths and weaknesses as well as criticisms in their effectiveness to address obesity and overweight.

The 1998 European Union Working Time Directive policy was very effective in addressing obesity because it could help people have enough time to engage in physical exercises as well as prepare whole meals at home and adopt positive eating patterns, thereby, maintaining healthy weights. However, the policy was criticized by many agencies and organizations including the House of Lords because they felt it deny workers and the UK companies the flexibility they require to remain globally competitive. For some, the policy would reduce UK’s per capita income because it restricted overtime. As a result, it was amended to make provisions for workers to opt out the limit of 48 working hours a week.

The federal government’s move to regulate nutritional standards was also effective in combatting childhood obesity by ensuring that schools served healthy meals such as fruits, vegetable, meat and fish. Although the primary aim of this policy was to regulate intake of fast foods in schools, many schools are yet to comply due to the high costs of the suggested meal plans and inadequate government funding.                  

Concerning the law that regulates advertisement of unhealthy foods to children, the law has proved to be effective because it reduces children’s knowledge of and exposure to unhealthy foods, thereby, reducing their preference and consumption. For instance, Ofcom concluded in a 2006 report that this policy was necessary to limit children’s exposure to unhealthy food products because self-regulation among advertisers was insufficient in dealing with the problem of targeting such advertisements to young children. The Royal Society of Public Health supported passing of the law by insisting that “the avoidance of cost to broadcasters should not be “balanced” against the public interest of children’s health” (Martin, 2008 p. 15). However, the Food Advertising Unit challenged the policy by arguing that imposing restrictions on advertising HFSS foods will have insignificants impacts on obesity because it has no direct impacts on the children’s preferences and choice of food. 

4.      Conclusion and Recommendations

Existing government policies in the UK are not fully effective in addressing obesity because they seem to focus on childhood obesity caused by eating habits. The policies overlook other contributing factors such as culture, genetics and the environment of one’s upbringing. Based on information presented in this report, it is recommended that other measures and or policies to address obesity and overweight in the UK should include;

1. Introducing tax levies on sugar-sweetened beverages and unhealthy fast foods.
2. Implementing school programmes that emphasize co-curriculum activities

• Increased funding of schools to support whole food diet plans.