In ages past, fatness was widely treated as a matter of fun, or at least of idiosyncrasy. To the merriment of his audience, Sir John Falstaff recalls in Shakespeare’s Henry IV, Part 1 when he “was not an eagle’s talon in the waist, [and] could have crept into any alderman’s thumb ring”. Obesity, then a rarity, is more properly regarded in the 21st century as a public health crisis. Almost a third of British adults are obese and a quarter of children are obese or overweight when they start school.
We report today that 60 health experts have written to Jeremy Hunt, the chancellor, urging him to make public health measures, including tackling obesity, central to his budget, to be delivered on March 6. Their call is right. Obesity is an economic and social problem that constrains growth and exerts pressure on the health service. There is no need for an anti-obesity strategy to amount to big government or the nanny state; it merely requires using the price mechanism and regulatory powers sensitively to encourage changes in consumption habits.
The letter’s signatories include the heads of the Royal College of Physicians, the Royal College of Anaesthetists, the Royal College of Midwives, the Royal Society for Public Health and dozens of health charities. They cite the work of the independent Times health commission in recommending interventions to combat obesity, and say: “Bold new action to create healthy Britain is the clearest, untapped path to prosperity we have.”
• The Times Health Commission’s 10 recommendations to save the NHS
The argument is compelling. Public health is an investment rather than a cost. People who are obese tend to be less productive and more prone to physical and mental illness. Though there is a partially offsetting effect of those who die prematurely and hence do not take up the state pension, this grim utilitarian consideration is not an argument for inaction. An analysis last year by Frontier Economics, a consultancy, and commissioned by the Tony Blair Institute, estimated that the prevalence of obesity costs the UK £98 billion a year.
Advertisement
The role of economic policy in combating obesity is not to load taxes on to already hard-pressed consumers. It should, rather, be to encourage the switch to healthier produce. There has been no consistent approach to that end in British policy, though a levy on soft drinks introduced in 2018 aims to incentivise manufacturers to reduce the amount of sugar in their products. Since its introduction, the equivalent of some 45,000 tonnes of sugar have been removed from soft drinks.
This type of tax is often condemned as regressive and discriminatory but the objection is not persuasive. A levy is not a penalty on people who are overweight but rather a tax on consumption of a particular good. Those who consume sugary drinks (or, by extension, foods high in saturated fats) retain that choice, and if they exercise it then they pay a more accurate reflection of the costs to society.
More widely, public health campaigns and regulation are scarcely draconian policies. They can save lives. The government says that it remains committed to outlawing multibuy promotions like “Buy One Get One Free” on unhealthy food from next year and banning television advertisements for these before the watershed of 9pm.
It must not tarry in this. And, amid dire opinion polls for the Conservatives, Mr Hunt should properly consider how best to marry economic and health policy to promote the public good for years to come.
