397. Often the purpose of a select committee inquiry
goes beyond the simple 'tick box' approach of making recommendations
to Government and seeing how many are accepted. We believe that
the very fact of our holding this inquiry has contributed (alongside
many other important reports and studies) to the huge publicity
that the subject of obesity has prompted over the last year or
two, and has helped to raise its profile. The Daily Telegraph
offered 177 articles on obesity in the year leading up to our
inquiry and 337 in the year of our inquiry.
398. One of our witnesses argued that it might be
helpful if more stigma attached to obesity so that people made
more effort to lose excess weight.
We totally disagree with this suggestion. Nevertheless, we have
observed an odd tension in society. The world of popular culture,
teenage magazines, film, music and sport is usually dominated
by fit and slim people. It is generally accepted that these are
role models and that people aspire to emulate them. Yet the average
person is remorselessly getting heavier and moving further and
further away from the ideal. It is as if the pressure to conform
to the stereotype, and failing, is pushing people in the opposite
399. We have posited a wide range of measures in
our report which attempt to address the issue of obesity. As many
witnesses who appeared before us acknowledged, no single measure
is likely to reverse the tide of obesity; a wide range of different
measures is more likely to have an impact.
400. The rapid rise in obesity is now leading to
a proliferation of meetings, conferences and pronouncements on
this subject. This is in part extremely welcome in that it raises
the awareness of the public, health professionals and policy makers
in respect of a vitally important subject. However there is a
danger that this could lead to policy overload, as different emphases
are givennow on exercise, now on diet. There is a danger
that this issue is characterised only within a polemical debate,
stressing only the role of a 'devious food industry' on the one
hand or the evils of the motor car or gameboy on the other. The
evidence we heard suggests both 'energy in' and 'energy out' must
be addressed, and indeed, part of the policy confusion is that
there is inadequate liaison of policy response between the two
'sectors' of the obesity business. This can easily be exploited
by vested interests resistant to change.
401. Many of the measures we recommend relating to
physical activity would take years to implement, notably our call
for a fundamental cultural change in urban planning to facilitate
active travel and active workplaces. It would take even longer
to measure the impact of these measures. Nevertheless, we believe
it is vital that Government takes seriously its responsibilities
to help people become more active.
402. We have commended the commitment and funding
now being devoted to organised sport and physical activity in
schools. Many of our other proposals would involve substantial
public expenditure, but the dire threat to public finances as
well as public health if the obesity epidemic progresses unchecked
persuades us that this expenditure is justifiable.
403. It would be very difficult to disaggregate
the possible impact of any of the recommendations we make. We
have argued for a coherent package of measures, addressing both
sides of the energy equation. We believe they would have more
chance of being effective if implemented in full rather than in
a piecemeal fashion. However, it is clearly important that some
steps are taken to monitor the effectiveness, and the cost-effectiveness
of what we propose, in line with the recommendations of the Wanless
report on public health. The National Audit Office undertook an
influential and ground-breaking report on obesity in 2001. We
know that they have maintained an interest in the subject thereafter.
So we would like the National Audit Office to conduct further
work on the value for money implications of measures taken to
combat obesity, since this will be one of the greatest pressures
on NHS resources over the coming decades. In calling for this,
we also note the point made in the Scrutiny Unit analysis annexed
to our report that there is a "severe lack" of official
estimates of the costs of diseases relating to obesity. We recommend
that the Department undertakes urgent work to establish better
estimates of the cost of treating diseases to allow it to manage
its resources more effectively.
404. We believe it is important to offer some perspective
on the likely effectiveness of some of the short-term measures
we propose in relation to food. One tool for doing this is provided
by a substantial piece of research conducted by the investment
bank J P Morgan. In a report published in April 2003, the bank
investigated the possible impact of the growth of obesity on the
They looked from the perspective of the investor at the possible
risks to the volumes of the food industry of greater regulation.
Their findings are summarised in the table below:Table
7: J P Morgan analysis of the impact of regulation on the food
||Likely impact on the food industry
|Total ban on advertising of food and beverages to children on TV
||"We think volumes would suffer. This is because not only are children significant consumers of the segment themselves, through 'pester power' they also drive broader retailing of the category
manufacturers would be faced with the double challenge of shifting the portfolio to healthier products while also finding alternative and innovative ways of selling these to children."
|Labels having to have better nutritional information
||"The US experience proves that labels containing more information about nutrition do not necessarily encourage people to adopt lower-calorie diets or reduce consumption."
"We feel that nutritional labels on European food products may not change consumption patterns."
|Targeting of super-size products
||"These products carry a higher margin than regular products
were these products to become the target of regulators we believe it would have negative implications for volume growth."
|Provision of warning labels for high-energy bars containing more than 500 calories eg Cadbury's Boost
||"We believe warning labels may eventually be imposed with a negative effect for the category."
|Ban/Tax on Unhealthy Products
||"Moderate taxes may not necessarily lead to a decline in obesity rate but will probably help government to finance the costs of informing consumers and treating patients."
405. This analysis is restricted to the impact of
possible regulation of the food industry, particularly that targeting
so-called junk food manufacturers. It is interesting to note that
labelling, which relies on giving consumers more of an informed
choice, is seen as likely to have relatively little effect on
volumes. Conversely, more draconian measures aimed at reducing
the choices available, are seen as more likely to be effective.
406. This raises a question very much at the heart
of the debate, and one that we explored throughout our inquiry:
how much is obesity the responsibility of the individual making
life-style choices; and how much is it the responsibility of Government?
This is not simply a philosophical question. It has political
ramifications. One reason it is very difficult for governments
to intervene is that they risk criticism for operating a 'nanny-state',
interfering in the lives of their citizens.
407. We fully accept that there is a degree to which
obesity is the personal responsibility of individuals. This is
clearly not so plausibly the case for children, who are usually
deemed less able to make informed choices. Even here, however,
we concede that parents do have a responsibility to try to feed
their children healthily, though we acknowledge that, often, unhealthy
food is cheaper than healthy options.
408. Whatever stance governments favour politically
or philosophically they will inevitably have to deal with the
consequences of the epidemic of obesity. If the very existence
of the NHS in its present form is threatened by costs spiralling
totally out of control it is hard to see that the Government will
not, ultimately, be forced to intervene.
409. Overall in our report we have looked for
positive solutions. We have noted the example of Finland, where
the force for change came from a grass-roots consumer response
which took Government with it, rather than vice versa. We have
at several junctures recommended voluntary agreements rather than
regulation. We have chosen to accept the word of many representatives
of the food industry that they wish to be part of the solution
as well as part of the problem. Our belief is that this is a line
worth pursuing, not only because it is politically far easier,
but also because it could achieve results more quickly than a
protracted battle to implement regulation.
410. Other pressures will be brought to bear on
the food industry. Consumers may start to demand healthier products
once unhealthy ones are properly labelled. Litigationwhich
is already happening in the USAmay alter the products available
and customers' perception of those products. The greatly increased
media attention to the problem of obesity may ripple through society
and produce a change in behaviour.
411. This is an optimistic way of looking at the
future. However, the recent past trends in the growth of obesity
and overweight across the population must temper such optimism.
Our concluding thought is that the Government must be prepared
to act and intervene more forcefully and more directly if voluntary
agreements fail. We recommend that the Government should allow
three years to establish those areas where voluntary regulation
and co-operation between the food industry and Government have
worked and those where they have failed. It should then either
extend the voluntary controls or introduce direct regulation.
388 Q195 (Professor Julian Peto) Back
J P Morgan, European Equity Research, Food Manufacturing: The
Big Issue, pp. 15-21 Back