• Government should expand access to weight-loss drugs - but relying solely on weight-loss drugs to halve obesity would cost £8.5 billion a year
• To cut obesity, policy measures must go beyond weight-loss medicines and include incentives for businesses and supermarkets to sell healthier food to prevent disease as well as treat sickness
• Policies that focus on information, voluntary action and education will have little impact on reducing obesity
• “Required reading for Wes Streeting and Rachel Reeves”, former Cabinet Secretary says.

LONDON, 3 November 2024 – It is possible and affordable to halve obesity by the end of the decade if the government implements specific prevention policies, alongside wider access to weight-loss drugs, first-of-its-kind analysis has revealed.

Research and innovation think tank Nesta created a tool in collaboration with leading UK academics and the business HealthLumen to compare the cost and effectiveness of 30 different health policies – the first time this kind of analysis has been published in the UK.

The findings debunk many prevailing myths around which policies actually work to reduce obesity, with public education campaigns found to be particularly ineffective relative to their cost.

Instead, Nesta recommends a combination of evidence-based health policies as part of their ‘blueprint for halving obesity’. It is a plan to “prevent disease as well as treat sickness” - and recommends expanding access to weight-loss drugs alongside imposing healthy food targets for retailers and advertising restrictions on unhealthy food. If Implemented together, these policies could halve the rate of obesity (around 10 million fewer people living with obesity) in the UK over five years.

This would have a significant knock-on effect on obesity-related diseases. It is estimated that 157,000 cases of type-2 diabetes would be avoided over five years - a reduction of around a fifth. Halving obesity would lead to around 95,000 fewer cases of hypertension over five years and 11,500 fewer cases of bowel cancer.

The findings follow a 10-month inquiry by the Lord’s committee on food, diet and obesity. Peers called on governments to put in place policies to fix the UK’s broken food system.

Based on previously published analysis from Frontier Economics it is estimated that a reduction in obesity of 50% would deliver benefits of around £30 billion in population health improvements, productivity gains, NHS and individual (caring) costs.

The seven policies Nesta recommends are:

• Extend access to weight-loss drugs to an additional 150,000 people a year
• Mandate all large food and drink businesses to publish nutritional and sales information of what they sell
• Incentivise large retailers to meet targets for selling healthier food
• Ban price promotions on unhealthy food by medium and large restaurants, takeaways and similar businesses
• Require front of pack labelling, similar to nutri-score, on food and drink retail packaging
• Further restrict junk food advertising on TV, online and public transport
• Stop online delivery platforms from advertising with online product placement adverts, such as pop-ups on their webpages or homepages

Alongside the analysis, Nesta commissioned Opinium to survey the public about various policies to reduce obesity, with the research finding that Nesta’s recommended policies commanded broad support.

The analysis also examines three other sets of policy options including a ‘treatment only’ option; a ‘tax, regulation and treatment’ option, and an ‘education, incentives and services’ option.

• Based on current market pricing, the analysis found that it would cost around £8.5 billion per year to treat everyone living with obesity, around 3 million people with a BMI of 30 or over, with the weight-loss drug Semaglutide. This would reduce obesity by 41%.
• Using a combination that includes weight-loss drugs (at a much smaller scale of around 150,000 people) and new taxes on HFSS food could reduce obesity rate by 50% and costs around £963 million per year.
• The analysis found a number of oft-touted policies to be ineffective at reducing obesity including active travel policies (0.4% reduction in obesity prevalence) and mass media campaigns to promote healthy eating (0.6% reduction).

Nesta’s recommended seven ‘prevention and treatment’ measures combine a low-cost, high-impact set of prevention policies alongside increased government funding for weight-loss drugs. The cost to government is estimated at around £520 million a year, most of which is allocated for the additional weight-loss drugs. This is around 16 times cheaper than relying on weight-loss drugs alone.

As part of its recommended way forward for government, Nesta recommends ring fencing £500 million annually to fund 150,000 new GLP-1 weight-loss medicine prescriptions for adults in the UK, including semaglutide, also known under brand names Wegovy, Rybelsus and Ozempic. This intervention alone would reduce the national obesity rate by around half a percentage point (from 29% to 28.5%).

Alongside this, Nesta also recommends mandatory healthy food targets to incentivise the UK's largest 11 grocery retailers to offer healthier food options. The policy is backed by consumer group Which?. This measure would improve the health of the whole population and responds to the food industry’s call for level playing field regulation from government. This policy alone would have a large impact on the obesity rate after 5 years, with a reduction of 7 percentage points from 29% to 22%.

Hugo Harper, director of Nesta’s healthy life mission said: “Halving obesity is possible but needs a new approach. The evidence shows that weight-loss drugs work, but it’s far too expensive to rely on them to treat our way out of the nation’s obesity crisis. Alongside expanding access to weight-loss drugs for the people most in need, policies must make it easier and more affordable for everyone to have healthier food, so fewer people end up needing treatment.

“The food industry has to do its part. That’s why the government should regulate to incentivise retailers and businesses to sell healthier options. This work shows that we can combine the best prevention policy with advances in treatment to radically improve the health of the nation. Crucially, these policies together are good value for money at a time when there’s not a lot of spare cash in government.”

Nesta’s analysis raises the bar for evidence-based health policy. More than 680 policies and strategies to reduce the rate of obesity have been published by successive governments since the late 1990s. Despite this, obesity has doubled in that period. Almost two-thirds of adults in the UK are living with excess weight or obesity, a major contributor to rising rates of type 2 diabetes, as well as heart disease, stroke and other chronic illnesses.

The lack of a reliable way to compare different policy interventions until now has been a barrier to effectively tackling obesity, leading to misguided and poorly evidenced strategies that don’t move the dial on obesity.

Nesta’s new analysis and online tool are intended to assist policymakers and academics with comparing, choosing and designing the most impactful and cost-effective health interventions. The project was supported by an advisory group of 17 leading experts from universities including UCL, University of Oxford and University of Edinburgh.

Lord Gus O’Donnell, former Cabinet Secretary, said: “Tackling obesity is crucial for the health and wellbeing of hundreds of thousands of people. It will also deliver benefits in terms of productivity gains and reduced NHS costs. Nesta’s analysis highlights ways to halve obesity that are both affordable and achievable. It should be required reading for Wes Streeting and Rachel Reeves.”

Helen Kirrane, Head of Policy and Campaigns at Diabetes UK said: “This report demonstrates that the Government needs to take decisive action across a range of measures to both treat and prevent obesity. Diabetes UK wants to see improved access to affordable, healthy food, better open space provision to promote physical activity, and a fairer and fully resourced system to deliver tailored and sustained weight management support. Measures like these alongside increasing the availability of weight loss drugs will help to tackle the challenges presented by this growing health crisis and save the NHS millions of pounds in treatment and ongoing care costs.”

Professor Theresa Marteau, director of the Behaviour and Health Research Unit at the University of Cambridge said: “The shockingly high rates of obesity in adults and children in England continue to rise, particularly amongst those living in the most disadvantaged neighbourhoods. These are driven in large part by our unhealthy food environments – from the tempting promotions in stores to the ads on our phones and at bus stops. The packages of policies in Blueprint – with their focus on creating healthy food environments – allows policy-makers for the first time to compare the effectiveness and costs of different policies that together could tackle obesity in all communities. This is a potential game-changer for policy-making in an area that has eluded effective action for decades.”

On the need for health targets, Sue Davies, Head of Food Policy at the consumer group Which?, said: “Which? research has repeatedly found that people want retailers to do more to support them in making healthier choices. Six in 10 (60%) consumers said they would support the government introducing health targets for supermarkets. Nesta's analysis shows that mandatory food targets would incentivise retailers to use the range of tactics available to them to make small but significant changes, which would make it easier to eat a balanced diet and ultimately help people lead healthier lives.”

Dr Kate Tudor, principal researcher at Nesta said, “We set out to close a gap in the policy landscape. Until now it was too hard for policymakers to compare the likely effectiveness and costs of different ways to reduce obesity. We also show that it’s not just about individual policies - but rather the package. There are combinations of policies that work together more effectively than others. In our current economic climate, we know how important it is that investment is focused on the approaches that have the biggest impact for the lowest cost.”

Ends

Spokespeople are available for background or broadcast interviews. For more information on the analysis or to speak to one of the experts involved, please contact Kieran Lowe on 020 7438 2628 or [email protected]

• The Blueprint toolkit is the result of a 2 year collaboration with academic experts and civil servants in the field of obesity, health and the food system.
• It included:
  • 34 evidence reviews, 3000+ studies screened
  • Supervision from a 17-member academic advisory committee
  • User testing with 30 policy makers
  • Gold standard (Hall model) method for modelling impact
  • Independent cost modelling by HealthLumen
  • Evidence rankings reviewed by 40+ academics and experts
• The technical appendix accompanying the work is available here and a summary of the methodology is available here.
• The policy note is available here.
• In 2023, the Institute for Government found that since 1992 there had been at least 14 strategies, 689 policies and 10 targets around the issue of obesity.
• In 2022, Cancer Research UK estimated that more than 21 million UK adults will be obese by 2040, equating to almost 4 in 10 of the UK adult population (36%).
• Nesta commissioned Opinium Research to conduct a survey of 2,050 people in the UK from 30-31 October 2024, with results weighted to be nationally representative. Full polling results are available here.