Obesity policy in England

Background

Obesity is a physical condition in which a person is very overweight, with a lot of body fat.

Obesity has many causes. An over-simplified description of the most common cause is “eating too much and moving too little”. The same phrase can be expressed more accurately as an imbalance between energy consumed and energy expended.

A person’s likelihood of being overweight or obese is affected by many factors, such as socioeconomic status, age, gender, ethnicity, where they live and whether or not they have a disability or medical condition. Governments have faced a challenge developing policy that is wide enough to address all of these factors.

Obesity prevalence in England Adults

The Health Survey for England, published by NHS Digital, provides estimates of obesity levels based on the body mass index (BMI) of a representative sample of people aged 16+.

In the 2021 survey, 25.9% of adults in England were obese and a further 37.9% were overweight, making a total of 63.8% who were either overweight or obese. Men were more likely than women to be overweight or obese (68.6% of men compared with 59.0% of women).

Children

The National Child Measurement Programme (NCMP) found in 2021/22 that 10.1% of reception age children in England (ages 4-5) were obese, with a further 12.1% overweight. These proportions were higher among year 6 children (age 10-11), with 23.4% being obese and 14.3% overweight.

The 2020/21 edition of the survey, which was carried out as a sample because of the Covid-19 pandemic, found large increases compared to previous years, with obesity levels at 14.4% in reception and 25.5% in year 6.

In 2021/22 survey obesity levels were lower than in 2020/21, but the figures were still higher than in previous years.

Obesity policy in England

This briefing provides an overview of the work of the UK Government in preventing and reducing obesity in England, which in recent years has primarily focussed on reducing obesity prevalence in children.

The Government’s response to obesity has mainly been set out across three chapters of its childhood obesity plan, published in 2016, 2018, 2019, and a further obesity strategy published in 2020. Within these, the Government has introduced a number of measures aimed at reducing the prevalence of childhood obesity. These have generated a wide range of responses from stakeholders, who in some cases, have considered the measures too weak, or conversely, disproportionately restrictive.

Public health policy is a largely devolved area. As such, it differs across England, Scotland, Wales and Northern Ireland. This briefing considers obesity policy in England but links to further information on obesity strategies in the devolved nations can be found below:

• Northern Ireland Department of Health, Obesity prevention
• Public Health Scotland, Healthy weight - Diet and healthy weight
• Welsh Government, Healthy weight strategy (2019)

This briefing focuses on measures which have garnered the most Parliamentary, social, health, business and regulatory interest. Three of these measures are highlighted below.

Restricting volume price and location promotions

In July 2020, the Government published its policy paper, Tackling obesity: empowering adults and children to live healthier lives. Here, it committed to legislate to end the promotion of foods high in fat, salt or sugar, by restricting volume promotions such as “buy one get one free”, and the placement of these foods in locations intended to encourage purchasing, both online and in physical stores in England.

The Government initially set out to implement its proposals in April 2022. However, following feedback from industry about insufficient time to prepare, the Government agreed (in July 2021) to delay this until October 2022.

The Food (Promotion and Placement) (England) Regulations 2021 (‘the Regulations’) were subsequently laid in Parliament in December 2021 with an intended commencement of October 2022.

In May 2022, the Government said it would allow for a second delay in implementation, but only on restricting volume price promotions. This was, it said, in light of challenging economic circumstances. On this basis, restrictions on volume price promotions were due to commence in October 2023.

However, in June 2023, the Government announced that it would delay restrictions on volume price promotions by a further two years – now requiring their implementation by October 2025. The Government said this would “allow the government to continue to review the impact of the restrictions on the consumers and businesses in light of the unprecedented global economic situation”.

The restrictions on location promotions came into force in October 2022.

Calorie labelling

In July 2020, the Government published its policy paper, Tackling obesity: empowering adults and children to live healthier lives. In it, the Government committed to introduce legislation to require large out-of-home food businesses to add calorie labels to the food they sell.

The Government introduced the Calorie Labelling (Out of Home Sector) (England) Regulations 2021 (‘the Regulations’) in July 2021. They entered into force on 6 April 2022.

The Regulations impose a legal requirement for businesses in England with more than 250 employees to display calorie information of non-prepacked food and soft drinks. Businesses within the scope of the requirements include restaurants, fast food outlets, cafes, pubs, supermarkets and home delivery services and third-party apps. The Government has encouraged smaller businesses, which are outside the scope of the Regulations, to adopt the requirements voluntarily.

Advertising restrictions

There has also been work on advertising, with the Government having consulted on introducing further restrictions on advertising products high in fat, salt and sugar (HFSS). There has been strong support from children’s health campaigners for additional advertising restrictions, while industry bodies have urged the government to “avoid any decisions that might have a damaging impact on industry, but little or no effect on lowering obesity levels”.

In February 2021 the Government announced its intention to introduce further restrictions on advertisements for products high in fat, sugar or salt being shown on TV before 9pm.

On 6 July 2021, the Health and Care Bill was introduced in the House of Commons. As anticipated, it contained new advertising restrictions to apply simultaneously to the whole of the UK:

• A 9pm watershed for advertisements of HFSS foods, applicable to television and UK on-demand programmes.
• A prohibition on paid-for advertising of unhealthy food and drink products online.

The Bill received Royal Assent on 28 April 2022. The advertising restrictions contained in the Health and Care Act 2022 (Schedule 18) were due to come into force on 1 January 2023. However, on 14 May 2022 the Government announced that their implementation would be delayed by a year – they are now expected to come into force in January 2024.

Further Reading

Obesity statistics, Commons Library briefing

Advertising to children, Commons Library briefing

Social prescribing, Commons Library briefing

The Soft Drinks Industry Levy, Commons Library briefing