How far should government get involved to reduce obesity?

2:08 pm - October 21st 2011

by Ben Mitchell    

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Last week we had a great example of what I’d call “you’re free to die in a ditch if you so choose” Conservatism.

The government launched its own obesity strategy and came out with this groundbreaking policy proposal: eat less. That’s it.

The public just need to be more “honest with themselves about what they’re eating and drinking,” said Professor Sally Davies, the country’s chief medical officer, who’s clearly swallowed this bilge hook, line, and sinker.

No more interfering, bossy, ‘nanny state,’ as Andrew Lansley, the Health Secretary, and his Conservative colleagues like to decry. Instead he spoke of the limitations of government action alone, preferring partnership over legislation.

This comes off the back of a report by one of the world’s leading medical journals, The Lancet, which said that governments weren’t doing enough to tackle obesity. It speaks of the increased cost to the UK in terms of rises in diabetes, heart disease, stroke and cancer, if the government continues to sit back.

But the government’s softly-softly approach won’t work.

Such an approach has been rejected by The Lancet and the House of Lords, whose report this summer argued that the government’s strategy was neither successful nor based on scientific evidence.

This included failures to implement a system of food labelling and a restriction on junk food advertising during childrens’ TV programmes.

Instead we have a “public health responsibility deal” and a government allowing companies like McDonald’s and PepsiCo to help draw up public health policy.

Its no surprise then that the Department for Health predicts that the direct costs of obesity will double from £4.2 bn by 2050.

Short term: do very little, make friends with big business, avoid accusations of nannying by the right wing press. Long term: pay far, far more in health costs, then complain about budget deficits to the NHS, cut its funding.

More Conservative ideology governing public policy.

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About the author
Ben Mitchell is an occasional contributor. He is a freelance political analyst providing commentary on current affairs. Blogs more frequently at Left Foot Forward and Ben Mitchell Writes.
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Reader comments

1. MonkeyBot 5000

I agree that telling people to eat less might seem a bit simplistic, but advertising and food labelling regulations won’t do a damn thing either if people keep stuffing their faces with burgers and cake.

2. Barrington Womble

So, how far should government get involved to reduce obesity?

Well, yes certainly McDonalds and Pepsi shouldnt be drawing up health policy, but I find it difficult to get on board the argument that Government should be doing something. Starvation is bigger problem than obesity, it’s just that we dont get to see it here in the UK . How many children die of hunger in the world every day ? According to these figures its 15 million annually.

Thats 41 000 A DAY

4. Torquil Macneil

Yes I am not quite sure what is being advocated here. Just more food labelling? I don’t feel very strongly about that but I can’t imagine it having much effect. It seems to me pretty clear that people are just eating more calories because calories are getting cheaper and that is none of the governments business. If the government doesn’t want to pay for the health consequences, then it can withdraw heath cover for obesity related disease (it would be fun watching it try at any rate), rather than deciding it should have say in what we eat. Remind me what the name of this blog is again. Something Conspiracy?


In related news, the government is putting foxes in charge of the henhouse…

What we need, if we’re ever going to get uncorrupt government in this country, is separation of corporations and state.

6. theophrastus

The only way the UK obesity epidemic will ever be dealt with is if people eat less and exercise more. And they will only do those things if obesity is stigmatised in the same way that smoking was and is.

7. Torquil Macneil

That’s right, fatties should be forced to eat outside where we we can all jeer at them!

This included failures to implement a system of food labelling

Do you really think these lardarses waddling out of Macdonald’s and other proletarian eateries can read or understand numbers? Fat chance. They are victims of Labour’s education policies.

….and a restriction on junk food advertising during childrens’ TV programmes.

Are you seriously telling me these people allow their kids to watch TV?


9. the a&e charge nurse

[7] “They are victims of Labour’s education policies” – haven’t similar patterns of obesity emerged in America, Germany and Australia – yet you think this worldwide trend is due to ‘Labour’s education policies’ – sounds like you need a bit of education yourself?

Some days I might get through about 1800 calories, some days about 2500, fairly fit, physical lifestyle. I’m not fat and I’m not thin.
I accept that a lot of people eat rubbish – you only have to see what is in their shopping trolleys but what goes into food really does worry me.
People eat chicken believing it to be a low fat white meat. There’s is about 30% more fat in chicken today than the 1950s.
Check out what is missing from fruit, vegetables, bread etc.
Reluctantly I have to agree that people will not always read what is on food labels but the fact that government and its paymasters are so reluctant to improve this tells you they don’t want you to know what is in the food.
Having spent some years printing warning literature for the pharmacological / veterinary industry you wouldn’t want to know either.


Yes because stigmatising groups of people always helps, doesn’t it? Let’s make fat a moral issue. Thin people good; fat people bad.

When we’ve shamed fat people into thinness then perhaps we can start on the gingers?

12. Torquil Macneil

What I want to know is what we are going to do about al those people who waste billions of NHS resources with their unnecessary recreational sports injuries. Do you think warnings will be enough or should we take more drastic action? Perhaps a tax on any sporting activity more hazardous than a brisk walk?

the government’s strategy was neither successful nor based on scientific evidence.

That could be said about virtually all the political speech about “obesity”, and every related government strategy since the 80s. That being the case, “do very little” may well be an improvement.

1) Life expectancy for someone with a BMI of 30-35 is statistically identical (in large-scale population studies in the US, Canada and Germany) to the life expectancy of someone with a BMI of 18.5-25. BMI 25-30 may have a higher life expectancy than either; there are hints in the data but they’re not statistically significant. BMI 35+ is only linked with a 1.3ish risk factor compared with 18.5-25 (for comparison, smoking has a risk factor of around 20 when compared with not smoking) which is negligible.

So, given that, and given all the well-known things that apparently kill fat people … what’s killing all the thin people?

2) BMI, which the definition of “obesity” is based on, is utterly rubbish and has no basis in scientific logic. The boundaries between “the government likes your weight” and “the government hates your weight” are arbitrary.

3) Correlation is not causation. For just about every “obesity-linked” health condition there is very little evidence as to whether:
– extra weight causes the condition
– the condition causes extra weight
– the condition is easier to diagnose in heavier people, but is underdiagnosed in lighter people
– both the condition and extra weight have an underlying cause.

3a) And that’s not counting the health conditions where the medication used to treat them has weight gain as a known side effect. (And that side effect, because of the “obesity will kill you and eat your soul” rhetoric, then discourages people from taking their necessary medication. Oops)

4) Human bodies are not bunsen burners. We actually know very little about how food intake affects digestion and metabolism – but it’s not as simple as the GDAs on the back of the packet suggests.

5) For all the talk of the “obesity epidemic”, BMI distributions in the UK have been fairly constant for most of the last decade anyway.

6) The amount of fuss the government makes you’d think fat people were a zombie cult coming to destroy the world, not a bunch of people who happen to be larger than the government likes.

7) We have absolutely zero ways to intentionally change a person’s weight that are both safe, and effective long-term. That being the case, we might as well worry about people being too tall instead (also associated with slightly lowered life expectancy, also more common now than 50 years ago), or having a genetic tendency to cancer.

8) The focus on weight loss means that the real benefits of eating good quality food and exercising get lost. Programmes that concentrate on those real benefits are considerably more effective in practice at improving health outcomes.

9) When are we going to launch a government campaign against joining the army, climbing mountains, crossing the road, or carrying out other actions that increase the likelihood that you will need expensive medical treatment?

Muzzle Eric Pickles now!

Lets face it, the processed food most supermarkets sell is just an offshoot of the chemical industry. Take a look at the ingredients on the wrapper of pretty much anything and wonder what the hell all that stuff is doing in there. “Fresh” food’s not much better, by the time its got here from Kenya any nutritional value in a vegetable has long since gone.

Think about the grim future that awaits you being abused or neglected in a nursing home (if even that standard of “care” exists in a couple of decades) and chips for breakfast and a rapid coronary starts to look appealing

I’ve skimmed the report and there are the typical errors:

1) Eat less, move more is pretty useless advice and not scientically based. The obesity epidemic pretty much follows a timeline of fat being removed from our foods and carbohydrates and sugars being added. Instead of giving the same tired calories in-calories out rubbish advice, which leads to people attempting to diet with low calorie, processed versions of their favourite foods, more direct advice to avoid sugars and processed foods, and eat real food should be given. And they should stop blaming saturated fat for the problems of obesity, this is based on poor science, with fudged data by a guy called Ancel Keys and there has been no good science done since that proves any causation between saturated fat, obesity or heart disease, only really bad studies showing ‘correlations’ which are badly designed, using food recall questionnaires and not taking into account other factors.

2) Obesity does not in fact cause heart disease, diabetes, cancer etc. There is a correlation, but this is due to there being the same cause of all those conditions – poor diet. To blame obesity for heart disease and diabetes is like looking around the street when its raining and assuming the movement of windscreen wipers causes umbrellas to open! – no they are both in reaction to rain.

Intake of processed foods, particularly processed carohydrates, sugars and processed oils aremost likely to blame for obesity, heart disease and type II diabetes. It has now been discovered that LDL has large and small particles and it is the small particles that are very damaging and levels of smal ldl particles correlate exactly with carbohydrate intake. Working as a nurse, I saw many type II diabetics and heart disease victims – many were slim, therefore obesity in itself cannot be the causative factor.

3) In fact the obese cost the state less over a lifetime than a slim healthy person. The reason being that the obese die earlier, usually after working for the same amount of years as a slimmer person, and having paid all their taxes they die and don’t claim as many years of state pension and other benefits and also don’t use the very expensive NHS care that the elderly need – all those medications, check ups, procedures, hospitalisations etc etc that older people will eventually need to keep them alive. Though this obviously shouldn’t impact policy, it does mean the obese should stop being blamed for the economic implications of their condition.

4) To blame obesity for all these problems (wrongly), is just causing a villification of the obese themselves, which really doesn’t help them with their problem. What does help?

Good advice over what to eat, not how many calories to eat. Proper support, without judgement.

Stop pushing ‘healthy whole grains’ which may be fine for healthy people, but not so good for those with a weight problem where ‘healthy whole grains’ contain damaging gluten and are often packaged up with sugar and high fructose corn syrup, not to mention that these grains can cause neurochemical reactions like an addiction in the susceptible.

Stop bashing healthy, natural fats like butter. Start bashing heavily processed and hydrogenated oils and fats, grains and sugar.

Subsidise natural foods – meat, fish, veg, fruit, nuts etc

Stop judging and demonising. While you’re judging the fat person in front of you, all around you are people who do much worse than simply put on weight, they just don’t wear their sins on the outside for all to see.



FFS don’t give them any more ideas. I can see that bleeding well happening.

17. Northern Worker

I think the prodnoses should butt (sorry, couldn’t resist) out of our lives. All this hectoring really has to stop, although it’s unlikely now that Cameron employs a ‘nudge unit’ to make us do as we are told.

Obesity – apparently at five feet nine inches and 13 stone I’m borderline obese according to my doctor when I went for a flu jab. He went through some questionnaire and then warned me to cut back on food. Rubbish! I don’t look obese or even fat. The BMI stuff is obviously made up by all these fake charities. Besides, the nurse is 15 stone and 5 foot.

18. Leon Wolfson

It’s also a slap in the face for people who are skipping meals to keep a roof over their head.

Exercise? You need to have enough energy, and eaten sufficient calories. Otherwise you’re just going to exhaust yourself.

What should the government do?

Bring back jiving as the popular dance form. There wasn’t much obesity in those times.

Just give everybody a copy of Eric Schlosser’s Fast Food Nation. If that doesn’t change your eating habits nothing will

There’s definitely an issue of concern here, but it’s not as simple as it appears. The changes to the way we live and the greater availability of high calory food are a factor, but what about epigenetic factors? How much has the environment of our grandmothers affected our metabolisms? I used to think fatties were to blame for their conditions, but I believe it’s becoming evident that modern metabolisms may be influenced by inherited factors due to, in particular, what happened to our grandmothers when our mothers were gestating.

In that there are public health concerns then government needs to be involved, but merely lecturing on diet or taxing food is not the answer.

To describe the government’s policy as simplistic is an understatement. It offers no solutions, it ignores the fact that obesity can be a symptom of another underlying health problem such as disability, musculoskeletal disorders or mental-health issues such as depression and is not simply down to the individual being ‘lazy and greedy’ as it is commonly portrayed, it ignores the links with socio-economic deprivation and the prevalence of heavily processed convenience foods (usually the cheapest food on offer) in our supermarkets.

If anything the government’s policy seems to be laying the groundwork for announcing that the obese will be treated differently from everyone else when it comes to healthcare, probably forcing them to pay (or should that be pay again since they’ve already paid their taxes once) for that healthcare privately. That’s what personal responsiblity means to this government – pay again.

Sadly the general public will happily agree with this because fatties are different from them and so should be stigmatised and treated differently from ‘normal’ people… because that how they are treated already by the less evolved members of our society.

The ‘ concerned ‘ social reformers who have been hectoring and haranguing the public since the 19th century should take their views to the ultimate conclusion and hand out only approved food in rations from state stores. One simply can’t trust the public if they are left to their own devices to eat only approved food. The concerned social reformers know what is best and after all they are only doing what is best for the public because people are too stupid to know that themselves.

Approved food, housing and energy are all things that should be cheap or free. Cheap alcohol? I am afraid that the consumption of alcohol is definitely unapproved behaviour in the eyes of the cadres, so should be made more expensive. If the public are indifferent to state propaganda otherwise known as public information broadcasts about smoking. Mete out collective punishment through the tax system for defying the state. Moreover, use authoritarianism against those who defy the state by smuggling. Illegal drugs are OK for the social reformers, but on no account should they be legalised. Can’t have the masses engaging in possible unapproved behaviour. The regulation of what people should eat especially the working classes fits perfectly into the paradigm of one group deciding what is best for everyone else. A proud British tradition. The social ‘ reformers ‘ are truly the inheritors of the puritan ethos.

Good grief, the buggers have actually done something sensible and you decide that this is the thing to have a bitch about?

25. theophrastus

Abolish socialised medicine and I’d be happy for fatties, boozers and smokers to do what they like. As things stand, they all cost the NHS money and resources which could be used elsewhere.

Moreover, fatties impose costs on the rest of society becuase they move more slowly and take up more space. Fatties should pay more for airline seats – ever spent four hours in economy class with a fatty protruding into your seat?

@11: The left stigmatises smokers, climate change sceptics, racists…Do you disapprove of that? Stigmatisation is is only another term for social pressure to conform to the norms of a community.

Good piece, Ben. Especially clear that self-regulation will not work (see examples of press and City) – my own NS piece here.

27. Manon ClaphamOmnibus

The only way,to take up the learned Professor point,for the public to be more “honest with themselves about what they’re eating and drinking, is for the same public to be informed about what they are eating. Yet the supermarkets,some in particular, are going the extra mile in opposing proper food labelling. Moreover the notion of honesty presupposes a clarity in interpretation.For that clarity you have to be educated in nutrition. Most people are not. Thats why the government has a role in monitoring and educating. The reality for many working people is they skip meals, eat on the fly and live highly stressed lives requiring alternation between sugar and alcohol. The result is very often depressed cortisol levels, adrenal fatigue and insulin resistance leading to a number of diseases, which will increasingly prove an expensive drain on the nations resources. The reality for poorer people is to bulk out on carbs because they’re cheap . The way to go, I think, is to encourage more home cooking and tax sugar and salt and alcohol very heavily to subsidise fruit and vegetables.

28. bud heavy horn

Health care free at the point of need supports this self destructive behaviour and the culture in the UK of not taking responsibility for ones own choices. Those needing treatment for ailments relating to obesity should be charged the full market rate. Only then will a culture of responsible behaviour be cultivated.

I rather like the idea of this , can we have some laws to stop women getting so fat , its really selfish of them to look so utterly unattractive. You could either stop them eating chocolate or, perhaps better force them to go to the gym (and not just to sit around nabbing wit their friends in the bar)
Another thing, why not force then to learnt to cook properly then we wouldn`t be desperate to snaffle a burgerat any opportunity.
Their mothers had slim waists fresh complexions , beautiful clothes and could rustle up a tarte citron whilst having screaming sex feeding a baby and looking like a goddess. They were real women.
I `m sure men won`t mind a bit more football and golf so its fair, but for women the full majesty of the law will be required to produce the pony calved pouting sinewy seductress we deserve. Stop fat women,stop the causes of fat women and lets have real deterrents … like denying them soap operas and Hallo. ..I might even support a moderate custodial sentence for persistently ugly fart women..too much ?

@ Theo


If I opt out of the NHS can I worry about my own weight rather than have the government involved? Seriously, this should be an option.

But, in fact, the cost to the Health Service is something of a smokescreen. They don’t want us to get fat because they love us and want us to have long happy lives……..

Good comment by Jehane (though I’m agnostic on the whole satfats thing). It’s also worth remembering that, for many, modern diets actually make it very difficult to stop eating. Greed can be defeated with a lot of willpower but – for the most part, at least – it’s not a conscious choice. Stephan Guyanet is recommended on this point…

The human brain evolved to deal with a certain range of rewarding experiences. It didn’t evolve to constructively manage strong drugs of abuse such as heroin and crack cocaine, which overstimulate reward pathways, leading to the pathological drug seeking behaviors that characterize addiction. These drugs are “superstimuli” that exceed our reward system’s normal operating parameters. Over the next few posts, I’ll try to convince you that in a similar manner, industrially processed food, which has been professionally crafted to maximize its rewarding properties, is a superstimulus that exceeds the brain’s normal operating parameters, leading to an increase in body fatness and other negative consequences.

32. Paul Newman

What about this opting out of the NHS idea though , I think you could buy about £500,000 of health care insurance with the taxes you throw at it. I `m not convinced the NHS is such a bad deal though

Opting out of state education that would be a good idea

33. Manon ClaphamOmnibus


Great parody but misses the point on practically every level. Would people who might suffer ill health rather be directed by rational policy making and education to good health or be told by State medicine (or private medicine) that they’ve wrecked their health through uninformed health choices. Rational markets required informed purchasers. My experience is that most people havent a clue about the long term implications of what they eat and are quite upset when they find out.

34. Leon Wolfson

@23 – You laugh, but there’s a serious case now for returning to rationing for basic foodstuffs to ensure the poor don’t starve.

@ 33. Manon ClaphamOmnibus

I am all in favour of people being better informed. However, I am a sceptic that haranguing and lecturing the public has much positive effect. Information about mass produced food is good. Pretty much guaranteed to make me stop buying a product is when I watch a documentary of the food product being made. Same goes for documentaries detailing the appalling conditions for some animals kept for the food industry. However, those documentaries are educational that seek to inform. What tends to come from the state is propaganda that has an explicit purpose of changing behaviour towards approved behaviour. We need more education and less propaganda.

Did you miss the headline, Leon?

” How far should government get involved to reduce obesity? ”

Now you may have concerns about people starving. Yet, Leon that would tend not be the obese. It is certainly a scandal in a world of abundant food that people do indeed still starve. Moreover, it would be outrageous if people were starving in this country. If there are people starving they should certainly be given food.

The writer does not say how far HE thinks government should get involved to reduce obesity. Does he advocate fat taxes or social services removing obese children from their parents?

“But the government’s softly-softly approach won’t work.”

This shows how most liberals attack Conservative governments for being too tough on things they deserve a far softer hand (like crime and anti-social behaviour) but then attack them for being too soft on things they want the rod swung on.

You might well be right about most people being unaware of the damage they do to their health by following certain diets, but my best guess about this policy is that it will give the NHS a ‘get-out’ clause when having to ration resources after the tories have plundered it.
It’s the 21st century version of Samual Smiles’ ‘Self-Help’. but with a more cynical edge.

38. Leon Wolfson

@35 – I was responding to your post. And charities are trying. But..their funding has been slashed as well. Which is why, as I said, we need to think about rationing again. We’ve, sadly, fallen that far lately.

Surely it’s obvious that economic inequality causes obesity. Just making the poor pay more for certain foods isn’t going to change anything.

Try @19.

The working class youngsters who went jiving in the 1950s weren’t obese as that video clip of Chris Barber’s jazz band shows. It was great exercise, much more so than the current fashion for flopping around to music. Of course, alcohol was much less affordable then and there weren’t all those party drugs to Tune in, Turn on and Drop out with on benefits.

Junk Food is the problem. No-one gets fat from eating steamed vegetables.

“Eat Less Junk Food” should be the policy.

The right comparison is “Quit Smoking” campaigns.

Government can legislate restricted advertising and *display* of Junk Food in shops, which would make a massive difference. Health warnings on Junk Food, in shops and restaurants would also help – just like warnings on cigarette packets. Finally, a heavy tax on Junk Food would also make it less attractive to buy and would encourage food companies to produce healthier stuff.

Is Ben Mitchell suggesting that the answer to obesity is to “eat more”?
“Eat less” is, believe it or not, the most important message in tackling obesity. Running marathons does help, but only for those who can jog or walk, not waddle to the start line. For those who are tending towards obesity, dieting has to accompany exercise to reduce weight, for those who are obese it probably needs to precede it because those who are obese are liable to heart attacks if they start taking strenuous exercise without gently working up to it with diet and gentle exercise.

I’m very much with you in that the Government should be doing something about the ‘obesity’ crisis (even though a high percentage of those whose lifestyles cause the diseases listed in your post aren’t obese or overweight and a good deal of those who are obese live healthy lifestyles and aren’t at risk of disease) and that getting fast food companies to draw up health policies is SO wrong. But, I know from your article that you don’t actually know much about obesity, eating disorders or anything to do with this subject at all and while your article is well intentioned, you could be adding to the problem and not achieving your aim.

In fact, this article seems to me to be more appropriate for a right wing forum or blog.

There is far more to the ‘obesity’ epidemic story than you understand and we are in a much worse situation than you predict here because this subject has layers that big business has managed to use sleight of hand to ‘pull the wool over the eyes’ of the Government, the media and the public (and you) to the extent where understanding is so confused and filled with half truth that even people (like you) who think they are fighting for a solution are tricked into digging us more deeply into the problem that is lining the pockets of the weight loss industry (diet and pharmaceuticals).

First of all, you say this:


The study that you refer to here is The Lancet Obesity Series describing the global initiators of the ‘obesity’ epidemic – a study by Professor Boyd Swinburn and Dr Gary Sacks from the World Health Organisation Collaborating Centre for Obesity at Deakin University in Melbourne, Australia.

Professor Boyd Swinburn is the Chair of the International Obesity Task Force and Dr Gary Sacks is also a member. The International Obesity Task Force plays a key role in determining policy for the World Health Organization. The International Obesity Task force is funded by the pharmaceuticals industry – part of the global weight loss industry said to be worth US$586.3 Billion by 2014.

So your example of a source of information as a basis of Government policy is just as reliable as that coming from McDonalds and Pepsi Co.

The Government needs to seek out truly independent research before making any policies that affect the health of the public.

And, with respect, you also need to do some research.

It seems to me everyone has a strong opinion about this subject yet everyone is happy with a generalised media-led education about it. It doesn’t take much to dig a little deeper than the tabloids to find out the truth on obesity.

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  1. Liberal Conspiracy

    How far should government get involved to reduce obesity?


    @libcon How far should government get involved to reduce obesity? / Not at all, considering their known greed.

  3. Ben Mitchell

    How far should government get involved to reduce obesity? | Liberal Conspiracy via @libcon

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