Obesity in the United Kingdom

A fish and chip shop in London SW7.

Media attention given to celebrity British chefs such as Gordon Ramsay, Heston Blumenthal, Marco Pierre White and many others with television shows and books encouraging home produced meals may have had a limited short-term impact on the growth of fast food chains such as McDonald's and Burger King.[12] Other fast food outlets, high street bakeries,[13] and chain coffee shops offering hot drinks with sugar levels over three times the daily recommended limit[14] have nonetheless continued to rapidly expand. A 2015 University of Cambridge study reported that the total number of takeaway restaurants including fried chicken, fish and chips, pizza, kebab, Indian and Chinese takeaway shops has risen by 45% over the preceding 18 years.[15] Similarly, popcorn, although a healthy snack by itself, becomes a high calorie snack once topped with butter and various other flavourings offered by cinemas. For example, a large sweet popcorn at Cineworld has 1,180 calories.[16] Popularity for the microwavable snack has increased dramatically over the 5 years to 2016, with total sales increasing by 169%.[17]

Professor Jimmy Bell, an obesity specialist at Imperial College London, has stated that contrary to popular belief, the people of the United Kingdom have not become greedier or less active in recent years. One thing that has changed is the food that they eat, and, more specifically, the sheer amount of sugar they ingest. "We're being bombarded every day by the food industry to consume more and more food. It's a war between our bodies and the demands our body makes, and the accessibility that modern society gives us with food."[18]

Obese people often have to be moved by firefighters, as they are beyond the capacity of the ambulance service. From January 2013 to May 2015, 5,565 firefighters attended 1,866 "bariatric rescues" in the UK. Each call costs around £400.[25] The National Health Service has only a limited capacity for scanning obese people, meaning that obese patients often have to be sent to distant hospitals to be scanned.[26] Hospitals in Scotland installed 41 oversized mortuary fridges between 2013 and 2018 to cope with larger corpses.[27]

In 2005, British chef Jamie Oliver began a campaign to reduce unhealthy food choices in British schools and to get children more enthused about eating lower calorie nutritious food instead. Oliver's efforts to bring radical change to the school meals system, chronicled in the series Jamie's School Dinners, challenged the junk-food culture by showing schools they could serve healthy, nutritious and cost-efficient meals that children enjoyed eating.[28] The British Government and Prime Minister Tony Blair promised to take steps to improve school dinners shortly after the programme aired. The programme prompted 271,677 people to sign an online petition on the Feed Me Better website, which was delivered to 10 Downing Street on 30 March 2005. As a result, the government added an extra £280 million ($316m USD) to help with the school meals plan.[29] Currently fried foods are only allowed to be served twice a week and soft drinks are no longer available, with only a small selection of beers and wines made available to pupils.[30] However, there are no limits on the amount of sugar that can be legally consumed in the School Food Standards.[31] The Department for Education and Skills created the, now defunct,[32] School Food Trust, a £60 million initiative to provide support and advice to school administrators to improve the standard of school meals. Sugarwise found that some children have been exceeding the recommended sugar limits at schools, and in June 2019, introduced a certification scheme for school catering.[33]

In 2013, 220,000 doctors in the United Kingdom united to form what they call a 'prescription' for the UK's obesity epidemic. The report presented an action plan for future campaigning activity, setting out 10 recommendations for healthcare professionals, local and national government, industry and schools which it believed would help tackle the nation's obesity crisis.[34][35]

Recommendations included:

• Food-based standards to be mandatory in all UK hospitals
• A ban on new fast food outlets being located close to schools and colleges
• A duty on all sugary soft drinks, increasing the price by at least 20%, to be piloted
• Traffic light food labelling to include calorie information for children and adolescents – with visible calorie indicators for restaurants, especially fast food outlets
• £100m in each of the next three years to be spent on increasing provision of weight management services across the country
• A ban on advertising of foods high in saturated fats, sugar, and salt before 9pm
• Existing mandatory food- and nutrient-based standards in England to be statutory in free schools and academies

Action on Sugar, a registered UK charity and lobby group, was also formed in 2014 by a group of medical specialists concerned about sugar and its impact on health. Research by the group has highlighted the amount of added sugar contained in both processed food as well as drinks sold by national retailers such as Starbucks and Costa Coffee.[14][36] Despite this, the proposed sugar tax was squarely aimed at high-sugar drinks, particularly fizzy drinks, which are popular among teenagers. Pure fruit juices and milk-based drinks were excluded and the smallest producers had an exemption from the scheme.[37]

In October 2011, British Prime Minister David Cameron told reporters that his government might consider a Fat tax as part of the solution to the United Kingdom's obesity problem.[38] A Public Health Responsibility Deal was subsequently announced in 2012 with voluntary pledges from the food industry and local business to promote healthy eating and physical activity.[39] The Public Health Responsibility Deal has been hailed by members of the UK's Food and Drink Federation and the Department of Health, but research published in 2015 by the London School of Hygiene & Tropical Medicine questioned the effectiveness of the voluntary agreement.[40] Policy based initiatives to improve diet, such as food pricing strategies, restrictions on marketing and the reduction of sugar intake, do not form a part of the pledges agreed by the food industry under the terms of the Public Health Responsibility Deal.

The world's largest McDonald's outlet pictured outside the 2012 London Olympic Stadium

The government made efforts to use the London 2012 Summer Olympics to help tackle obesity and inspire people into a healthy active lifestyle. Health Secretary Alan Johnson set up Olympic themed Roadshows and mass participation events such as city runs. A £30 million grant was also issued to build cycle paths, playgrounds, and encourage children to cut out snacks.[41]

As a part of the London 2012 legacy, Prime Minister David Cameron also announced an annual £150 million ($227-USD) boost for school sport. The funding is "ring-fenced", meaning it can only be spent on sports activities such as after school clubs, coaching, and dedicated sports programmes.[42] Prompting criticism about mixed messaging, Official sponsors of the 2012 London Olympics included McDonald's, Coca-Cola, and Cadbury.[43]

In the 2016 United Kingdom budget, the British Government announced the introduction of a sugar tax on the soft drinks industry, which came into effect in April 2018. Beverage manufactures are taxed according to the volume of sugar sweetened beverages they produce or import. The measure would generate an estimated £520 million a year in additional tax revenue to be spent on doubling existing funding for sport in UK primary schools.[44]

The National Institute for Health and Care Research (NIHR) has published a review of the research on what local authorities can do to prevent and reduce obesity.[45] The review covers things that local authorities can do in the built and natural environments (e.g. increasing access to green spaces) and in the food environment (influencing what people buy and eat). The report covers interventions targeting active travel, public transport, leisure services, and public sports, as well as covering efforts in schools and the community, weight management programmes, and system-wide approaches.

For England alone, Public Health England published data in May 2017 indicating that 63.8% of adults in England had a body mass index (BMI) of 25 or over with the most overweight region being the North East, where 68% of people were overweight, followed by the West Midlands at 65.7%.[49]

Wales has the highest child obesity percentage out of the four constituent countries of the United Kingdom and had a higher obesity rate than England.[51][52][53] In 2012, it was reported that 57% of adults in Wales were obese or overweight.[52] One in eight reception age children in 2019 were reported to be obese[54] and 3.3% of children were severely obese.[55]

• 
  Percentage of reception age children that are severely obese in Wales in 2017/2018
• 
  Percentage of reception age children that are obese in Wales in 2017/2018

In Scotland in 2019, 66% of adults aged 16+ were overweight.[56]

According to the Global Burden of Disease Study published in 2013, the United Kingdom had proportionately more obese and overweight adults than anywhere in western Europe with the exception of Iceland and Malta. Using data from 1980 to 2013, in the UK 66.6% of men and 52.7% of women were found to be either overweight or obese. The figures for Malta were 74.0% of men and 57.8% of women and for Iceland were 73.6% of men and 60.9% of women respectively.[57]

The UK had the fifth highest rate of obesity in Europe in 2015. 24.9% of the adult population had a body mass index of 30 or more.[58] In 2016 according to the Organisation for Economic Co-operation and Development nearly 27% of adults in the United Kingdom were obese, the highest proportion in Western Europe and a 92% increase since 1996.[59]