The focus on personal responsibility rather than official action on the government’s national food strategy is unlikely to address the UK’s obesity crisis, a leading public health authority has said.
Sir Michael Marmot, who has led pioneering research on health disparities, said the approach was not supported by evidence and was disappointed that the strategy had dropped many of the recommendations of Henry Dimbleby, senior adviser. of the government in matters of food.
While obesity was “terribly challenging,” Dimbleby’s ideas, such as an extension of free school meals and new salt and sugar taxes, were welcome, said Marmot, a professor of epidemiology at University College London.
Michael Marmot: “Are each of us making the individual decision to be overweight or obese?” Photo: Rex / Shutterstock
“Dealing with this is tricky, but I think Henry Dimbleby did it right,” he said.
Although other elements of Dimbleby’s proposals have been incorporated into the final strategy, almost everything related to health intervention has been removed, to be dealt with in a separate white paper on health disparities to be presented in later this year, potentially before the summer holidays.
In his report, Dimbleby argued that the state has “the moral authority to intervene in people’s lives to help them eat better.” However, the food strategy refers to the “important role of individual responsibility and choice,” a popular mantra among ministers.
In a newspaper interview [paywall] On Saturday, Health Secretary Sajid Javid said people “would make the right decision for themselves whether to smoke and drink, want to eat fatty foods”.
There was a danger, Marmot said, of creating an artificial ideological divide: “We agree that the government has an important role to play in health. There is an important debate about where it starts and ends, and people will put the line divide between government action and individual responsibility in different places.
“None of us want the government to tell us what we need for breakfast, lunch and dinner, but we’re all very happy to be able to check into a hotel room or send our kids to a school and know there’s no “We want the government to do that. We’re very happy when we turn on the tap and the water is safe to drink. We don’t want to have to contact a helpline first.”
“But if we all make individual decisions, why are obesity rates rising? Each of us makes the individual decision to be overweight or obese?
“When you see a social trend like this and you say the government shouldn’t step in because people are making their individual choices, I guess if you ask people, you’d like to have diabetes or heart disease to increase the their risk of cancer by a third, they would say, no, of course not. People don’t get fat because they want to. “
All this, he added, was closely linked to the marketing of unhealthy foods, especially the discount on increased portions: “The cost per calorie is half that for the extra amount. He says, ‘Come on, take more than you need. It’s cheap. ‘ People who say we leave it to the individual know that the laws of economics apply: lower the price, increase consumption.
“And then when you reach people with no purchasing power, it’s cheaper to give your kids bread and jam, or cookies, than to give them fresh fruits or vegetables.”
Inaction would have an impact on inequality and the government’s mission to level the country, Marmot argued: “What has happened is that the rise in childhood obesity in children from more affluent backgrounds has slowed and it has stopped, but it continues to increase in children from more disadvantaged backgrounds.
“So inequalities have increased and children who are obese are at least three times more likely to become obese adults. It’s not good for children and it’s certainly not good for their outlook on life.”
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Dimbleby has also criticized the government’s plan, saying it is “not a strategy” and warning that it could mean more children will go hungry.
Dimbleby’s proposal for new sugar and salt taxes “was not a complete change, but it is a step in the right direction,” Marmot said, recommending that the tax revenue be used to fund food. Fresh for the poorest households was “a great idea.”