Up for sale or not, the National Health Service was unsurprisingly a key battleground in the UK election campaign.
It was mentioned no less than a combined 78 times in the Conservative and Labour Party manifestos.
Political leaders understand the importance to voters of the health systems upon which they rely. But the economic burden of ill health, and particularly obesity, is not something that has been debated at length.
This despite the fact that a failure to address the challenge posed by the obesity epidemic will place an even greater strain on NHS resources.
Passing mentions to the prevention of disease in their manifestos aside, our would-be leaders could do so much more to highlight the human and financial toll of obesity and how by addressing these, the NHS could be made more economically viable and sustainable.
The costs of obesity are well known, not least to the current government. Public Health England states that the “annual spend on the treatment of obesity and diabetes is greater than the amount spent on the police, the fire service and the judicial system combined”.
Nearly a third of children in the UK are overweight or living with obesity and that figure rises to two thirds in adults. The UK is unlikely to meet the World Health Organization target of halting the rise of childhood obesity by 2025. It is not alone.
The Childhood Obesity Atlas developed by the World Obesity Federation identifies that the majority of countries in the world are unlikely to do so.
Yet a recent report by the OECD calculates that member countries currently spend 8.4 percent of their health budgets on treating obesity-related diseases – equivalent to about USD 311 billion.
Allocating funding to address obesity in the NHS is an investment – one that contributes to long-term health by helping to prevent the diseases with which it is associated, including diabetes and heart disease.
Supporting policies that address obesity outside the health system – including curbing marketing of unhealthy foods, taxes on sugary drinks, and improving access to opportunities for physical activity – are proven means for improving health.
The drivers of obesity – urbanisation, globalisation and a food system that pays scant attention to the health of those it feeds – are also being exacerbated by climate change.
By failing to radically change how food is produced, cities and transport are designed, the epidemic accelerates and the climate crisis worsens.
A recent Lancet report shows that there are interventions and policies that have the potential to reduce both the climate crisis and obesity.
For example, moving away from car-centred transport systems will get us to exercise more and cut down on vehicle emissions – a win for both human and environmental health. Similarly, improving our food systems can benefit people and the planet.
There are a number of practical steps that this government could implement to effect real change for the UK and our NHS. Firstly, the government should enact national fiscal policies which work to both reduce the price of healthy food and increase taxes on unhealthy products and producers.
By way of example, the Health Select Committee has in the past called for the VAT system to be adjusted to incentivise healthy foods.
Where appropriate, financial disincentives, such as the sugar tax that was introduced in the UK in 2018 on soft drinks, can also help to improve children’s diets.
Secondly, GPs and other primary care services must regularly monitor weight, with compassionate advice, treatment and care given as required.
Thirdly, schools, primary and secondary, could be offered incentives to engage with obesity management and prevention programmes, such as having walk to school schemes, healthy catering and health checks.
World Obesity Day on March 4 aims to increase the understanding of obesity as a disease and to recognise the role played by the environments in which we live and work.
Obesity has almost doubled in the UK since 1997 and this new government must now take action to ensure the health system does not collapse under the burden of rising obesity related cancer, diabetes and heart disease.
In doing so, the NHS and other health systems around the world could save on the enormous economic costs of obesity. Only by highlighting to voters that those costs are unsustainable, can real change be effected.
- Dr Carel Le Roux is a metabolic medicine physician and Reader in metabolic medicine at Imperial College London. He specialises in managing patients with obesity.
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