Sport England

The Nation's Biggest Supporter

Commons Health Committee report on obesity

Commons Health Select Committee Report
Obesity has grown by almost 400% in the last 25 years, so that now three-quarters of the adult population are overweight or obese (with 22% obese). England has witnessed the fastest growth in obesity in Europe, and childhood obesity has tripled in 20 years.

Painting a bleak picture, the Health Committee has noted that: "The positive trends of recent decades in combating heart disease, partly the consequence of the decline in smoking, will be reversed. Indeed, this will be the first generation where children die before their parents as a consequence of childhood obesity."

Obesity is linked to a wide range of diseases, such as heart disease, diabetes, renal failure, osteoarthritis and psychological damage. Only recently has the strong association between obesity and various cancers emerged and obesity is now regarded as the greatest avoidable cause of cancer after tobacco. The report calculates the cost of overweight and obesity to the nation at up to £7.4 billion per year, a figure which will rapidly rise.

Chairman of the Health Committee, David Hinchliffe, said: "Our inquiry is a wake-up call for government to show that the causes of ill health need to be tackled by many Departments not just Health... Wholesale cultural and societal changes will be needed if any headway is to be made. The urban infrastructure will need to be completely redesigned to encourage an active lifestyle... And schools will have to encourage activity and actively monitor the health of their children."

Causes of obesity
Obesity develops when there is a sustained imbalance between the amount of energy consumed by a person and the amount used up in everyday life. The combination of factors affecting both nutrition and physical activity, and the vicious cycle arising from these changes, is explained by Professor Andrew Prentice: "What has happened in our environment in terms of the history of human evolution is remarkable in the last two generations. We have never seen anything like this, where we have the coming together of the technological, electronic, television revolution and the highly available, high energy-dense and very cheap foods …Where physical activity comes in is that you rapidly get into a vicious cycle of inactivity, sloth and weight gain: as soon as you start to gain a load of weight, it is all the more difficult to go up those stairs. As soon as you start to become a little less fit, you resist doing those things which in the first place will help you not to become overweight, and so it rapidly becomes a vicious cycle."

The report notes that the average person now walks 189 miles per year compared to 255 miles 20 years ago. Levels of cycling have fallen by over 80% in the last 50 years. Fewer than 1% of school journeys are now made by bicycle and half the nation’s children fail to achieve the government’s modest target of 2 hours activity per week. At the same time, energy-dense foods, which are highly calorific without being correspondingly filling, are becoming increasingly available. The report explains that humans have evolved to be very good at recognising hunger, but very bad at recognising satiety. While in times of uncertain food availability, this asymmetry could help people survive famines, in today’s environment, it is very conducive to weight gain.

Solutions
The report calls for a sustained health education campaign to target obesity by raising individual awareness of its consequences. Crucially, it also emphasises the need for solutions to address environmental as well as individual factors, making healthy choices easier within the increasingly obesogenic environment.

The obesogenic environment needs to be tackled at the highest levels. It is not adequate to focus on the individual, especially the child, and expect them to exercise self-control against a stream of socially-endorsed stimuli designed to encourage the consumption of excess food calories. The report emphasises that as it is clear that people are now overeating in relation to their energy needs, solutions need to address both sides of the energy equation, nutrition and physical activity.

Nutrition
The report recommends an industry-led, voluntary withdrawal of television advertising of unhealthy food to children, together with a wide-ranging review of all forms of food promotion. In addition to this, industry should take active steps to reformulate foods to reduce their energy density, and to introduce healthy pricing strategies to make healthy choices affordable for all. It goes on to recommend the introduction of legislation to effect a traffic light system for labeling foods, either red—high, amber—medium or green—low according to criteria devised by the Food Standards Agency, which should be based on energy density.

The report argues that not only will such a system make it far easier for consumers to make easy choices, but it will also act as an incentive for the food industry to re-examine the content of their foods, to see if, for example, they could reduce fat or sugar to move their product from the high category into the medium category.

Activity
The report praises the recent measures and funding directed towards schools but describes as “lamentable” the fact that most of the nation’s youth fail to achieve the target of two hours of physical activity per week. It recommends that this should be raised to 3 hours, that activity should be broadened to embrace non-traditional activities such as dance or aerobics and that a school’s performance in terms of physical activity should form part of the Ofsted inspection.

The committee remarks that the key to improving activity levels across society is to boost activity in everyday life in areas such as transport. They describe as “scandalous” the failure of the Department for Transport to produce the National Walking Strategy that was promised 10 years ago.

The committee calls on the government to

Co-ordinate departments to achieve widespread use of pedometers to measure activity in the community
Take serious measures to boost cycling, such as creating properly segregated cycle lanes
Make all major planning proposals subject to a ‘health impact’ assessment
Encourage industry to make workplaces more active perhaps via fiscal incentives from the Treasury
Have a co-ordinating council for public health along the lines of those in Scandinavian countries

NHS
The report argues that while the NHS has an important role to play, both in the prevention and treatment of obesity, evidence received by the Committee suggests that this has not been as high a priority for primary care trusts as it should have been. To address this, the report recommends the establishment of a strategic framework for preventing and treating obesity within the NHS, underpinned by stringent public health targets. The strategy must include the expansion of services to treat obese patients within both primary and secondary care. A full range of treatment options should be open to obese patients, including behavioral or lifestyles approaches, counselling, drug therapy, and, as a last resort, surgery. In particular, children must have access to appropriate services, and should be screened for overweight and obesity annually within a school setting.

IN YOUR REGION

Graphic Version | How to use this site | Site map | A-Z Index | Contact Us

FEEDBACK | PRIVACY/DISCLAIMER