We were warned.
Again and again, public health experts shouted from the rooftops about the risks of obesity to our collective health: cancer, heart disease, diabetes, and now Covid.
The statistics are sobering. A landmark report from the World Obesity Federation today shows 90% of global deaths occurred in countries with high obesity levels. The average death rates in countries with high obesity levels were ten times higher than those without overweight populations. Not a single nation with low levels of obesity (less than 50% of the population overweight) had more than ten deaths per 100,000 people, while no country with death rates above 100 per 100,000 had less than 50% of their population overweight.
Take Vietnam, which has the lowest overweight population globally, and the second-lowest Covid death rate, with just 35 deaths. Then look at the UK, which has the third-highest death rate at 121,000 and the fourth highest obesity rate globally.
The correlation is clear. Failure to keep public policy promises on tackling obesity has cost many lives. Old age – the other major cause of Covid deaths – is unavoidable, but having overweight and obese populations is highly avoidable.
Surely now, the lesson for post-pandemic Britain is a massive shakeup to public health policy?
That’s why governments worldwide agreed to a set of targets to tackle obesity in 2013 at the World Health Assembly, committing to halting the rise in obesity at 2010 levels by 2025. The latest data shows most countries have comprehensively failed in the task they set themselves, with a less than 10% chance of hitting their target. On current trends, one in five adults worldwide are expected to have obesity by 2025, yet all countries fall short of 2025 targets.
It’s a stern message for grieving families and people who have lost jobs and income to hear: much of this crisis was preventable. Much of the death toll, the prolonged and repeated lockdowns, and the resounding hit to the economy was avoidable. Surely now, the lesson for post-pandemic Britain is a massive shakeup to public health policy?
For too long, policymakers have treated obesity as as primarily a matter of personal responsibility, and scorned efforts to turn the tide as the nanny state. But the root causes of obesity are complex: just telling people to eat less and move more won’t cut it. The drivers are often deprivation, affordability of food, genetic and mental health factors, lack of healthy food choices and lack of nutrition education.
No-one knows better than me that personal responsibility is vital. I shed eight stone through blood, sweat and tears – but I can afford fresh fruit and vegetables, a gym subscription and had access to research and data to show me what the unhealthy ultra-processed food I was consuming was doing to my body. For many of the overweight population, that simply isn’t the case. With a food industry intent on marketing and selling as much lousy fat and high sugar products as they can get away with, it’s instead up to governments to use the levers that only they have to address the root causes.
Slowly but surely, over the last few decades, the arrival of ultra-processed food on our supermarket shelves has seen products become more calorie-dense, more affordable and more aggressively advertised. It will come as no surprise that the rise of the global obesity epidemic coincides with these food environment changes.
Boris Johnson made encouraging and welcome noises after his coronavirus scare last year, but I worry his advisers underestimate the scale of the change required.
Studies from Latin America show that marketing strategies designed to appeal to children through cartoon characters, promotions, and product placement significantly impact consumption. In 2017, when I was deputy leader of the Labour Party, an influential political figure boasted to the Sun newspaper that she had “saved Tony the Tiger” by intervening in a Department of Health obesity strategy to scrap proposals to ban aggressive marketing of sugary foods to children.
I’m afraid she succeeded. And just four years later, we have the fourth highest obesity rate and third highest covid death rate globally.
I know many good people have tried to tackle this issue, but only leadership from the top can make the sweeping, systemic changes we need to shift the dial. Boris Johnson made encouraging and welcome noises after his coronavirus scare last year, but I worry his advisers underestimate the scale of the change required. If there were a simple solution, we wouldn’t have such an entrenched global problem: we need a comprehensive, joined-up solution that cuts across government departments and brings communities, families, and all political parties on board.
The case for investment in public health and a comprehensive obesity strategy to prevent future pandemics and help our economic recovery is overwhelming. We now know that an overweight population is a pandemic waiting to happen: it’s not just Covid; other respiratory epidemics like bird flu and MERS both impacted people living with obesity far more severely.
If ‘build back better’ means anything, then tackling obesity has to be top of the list.
Tom Watson is a former deputy leader of the Labour Party. Follow him on Twitter at @tom_watson