We need to reassess where responsibility lies for obesity and who should be spending the money to tackle it. The National Institute for Health and Care Excellence (NICE), which advises the National Health Service in England, has published new guidelines on tackling obesity, which it says is an “immense problem”. They say the number of obese people having weight loss surgery needs to double or triple to cut the long term costs of type 2 diabetes.
These guidelines follow a report by the McKinsey Global Institute, which found that obesity costs the world nearly as much as war, armed violence and terrorism put together. The report made a number of suggestions that have been lacking in many analyses of this huge issue.
The report identified that while business has been increasingly implicated in the obesity issue, individual responsibility remains the mantra of many reports. While reports continue to exhort individual responsibility and control, the Body Mass Index of the West continues to rise. It is clearly difficult for people to understand what the best option is when it comes to food.
Research has shown that humans are only partly rational and often respond automatically and routinely to the demands of their immediate environment. Contrast this with the number of policies that assume individuals are capable of making the virtuous decision of changing their behaviour of their own accord.
While the McKinsey report has not ruled out the role of individual responsibility, it has taken a more holistic line on the obesity issue and highlighted the problems inherent in some current initiatives. One such initiative is the UK coalition government’s Responsibility Deal, a voluntary scheme where companies sign up to pledges which include reduction in salt, fat and sugar. The Responsibility Deal has received criticism from public health leaders as companies have done little to change their production and marketing of unhealthy foods because of it, and some have even reneged on pledges.
Another problem with business’ current role in the obesity crisis has been recognised in that a single company opting for an intervention runs the risk of harming its competitive position. Similarly, signing up to a pledge that all companies agree on inevitably leads to watered down measures to avoid harming collective competitive positions.
So, while Coca Cola has committed to promoting its low calorie drinks more, it continues to market its calorific classic brand, and its newly launched Coca Cola Life is only 50% less calorie-loaded than classic Coke. We must think seriously as to whether fighting obesity should be a marketing opportunity in this way – why not just take classic Coke off the market or reduce its sugar content, without a new product launch? The answer is obvious.
Trial and error
Getting interventions right is another challenge highlighted by McKinsey. Some promising ideas fail in practise and need to be further refined through trial and error, and some need even more time to become understood. One pioneering intervention has been the use of calorie counts on restaurant menus.
Calorie counts have been required on menus in New York City’s restaurants and coffee chains since 2008, but findings to date show ambivalent results with some indication that there has been little change in calorie intake. This intervention may provide better results in due course as other initiatives to help understand calorie intake take root as people become more aware and used to calorie counting.
Other ways of steering people away from food with a high sugar content have been tried in the UK. There is the traffic light system, for example, which uses colours to indicate levels of how harmful food is. Ingredients are still measured in grams for this, however, which don’t convey a whole lot to many of us. Instead it has been suggested that sugar should be expressed in teaspoons, which is a measure we can all relate to.
This year, Labour MP Keith Vaz introduced a parliamentary bill for the sugar content on food labelling to be represented in number of 5ml spoonfuls per 100g. Even better might be labelling to show the total teaspoonfuls in the packet? This is an intervention that businesses could make which really helps the individual exert responsibility.
The problem is that there is just too much sugar in our food and too much sugar available to eat, which we’re often consuming unawares. A documentary coming out in 2015, “The Sugar Film” shows how a great deal of food that is low in fat actually has a high sugar content. From low-fat yoghurts and muesli bars to cereals and fruit juices, eating these apparently healthy foods can still lead to weight gain. So by low-fat measures alone, it’s time businesses came clean on sugar in a way we can all understand.
Responsibility lies at the individual, political and business level. It’s necessary that new ways of steering people away from foods with high fat and sugar contents are broached. And that the food and drink industries take more responsibility for the products they are marketing to us.