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Tax, regulation and treatment package

This package is an illustrative example of another route to halving obesity. It compiles effective policies that would improve population diets through fiscal levers to improve the formulation of foods at their source while implementing regulation to improve product promotions at retailers in addition to targeted policies for individuals. Alongside interventionist prevention policy, it also provides funding for targeted weight management programmes for individuals and families with the greatest need. 

7 included policies:

Ban all price promotions of discretionary foods in the retail sector (excluding small and micro businesses)

Promotions have a significant impact on what and how much we buy. Evidence shows that price promotions are an extremely popular form of promotion for discretionary, unhealthy food categories in retail settings. For the retail sector, consistent with previous policy relating to location restrictions, the policy would not apply to small and micro businesses. Restricting these promotions in medium and large retail businesses (alongside a similar policy for the out-of-home sector, as detailed in the policy below) would impact population purchasing and consumption habits with a large subsequent reduction in obesity levels.

Extend the Soft Drinks Industry Levy

The Soft Drinks Industry Levy (SDIL), informally known as the ‘sugar tax’, applies a levy to the producers and importers of sugar-sweetened beverages based on the sugar content of the drinks. Currently, the levy only covers soft drinks with added sugar. Extending the SDIL to cover sweetened milk-based drinks would broaden the scope of the levy. The aim of this policy would be to encourage manufacturers to reformulate their products and nudge consumers to make healthier choices through price disparities in products. 

Everyone with a BMI of 30 or above is offered a free referral to a total diet replacement programme via primary care

Holistic behavioural weight management programmes (BWMPs) that incorporate dietary and physical activity components have been demonstrated to be an effective service for weight loss. This policy focuses on behavioural weight management programmes that include a total diet replacement (TDR) programme specifically, as this is more effective than dietary advice and behavioural support alone. Though effective, at present, these services face constraints on the scope of their provision, being limited to around 35,000 places per year and not uniformly available across the UK. Increasing referrals to these effective services will help more people move to a healthy weight.

Provide £85 million of funding per year for the increased rollout of family-based programmes to the local authorities with the highest childhood obesity rate

Family-based programmes aim to manage children’s weight by involving parents due to their significant influence on factors like diet and activity. These programmes, often funded by local authorities or Integrated Care Systems, offer activities such as nutritional education and physical activities, aiming to instil lifelong healthy habits. We estimate that £85 million of funding would provide support to over 250,000 additional families. This policy would ensure the targeted provision of this service in the areas with the greatest need. It is a more complex weight management service requiring significant funding to ensure its provision. 

Ban all price promotions of discretionary foods in the out-of-home sector (excluding medium, small and micro businesses)

Promotions have a significant impact on what and how much we buy. For the out-of-home sector, the policy would not apply to micro, small and medium-sized businesses. Restricting these promotions in large out-of-home businesses (alongside a similar policy for the retail sector, as detailed in the policy above) would impact population purchasing and consumption habits with a large subsequent reduction in obesity levels.

Implement broad levy on salt and sugar – £3/kg on sugar and £6/kg on salt (as presented in the National Food Strategy)

The proposed salt and sugar tax seeks to drastically improve the formulation of foods. Manufacturers will be incentivised to reformulate their products to contain less salt and sugar thereby improving the healthiness of products people consume at their source. It also could work by making these products relatively more expensive, thereby discouraging their purchase. Both mechanisms of the tax are highly impactful for improving population obesity levels but bring a significant cost to industry. 

Extend access to pharmacological interventions by providing an extra £500 million per year of ring-fenced funding to provide increased access to NICE-recommended weight loss treatments (Liraglutide and Semaglutide)

Weight loss treatments have drastically improved in their effectiveness and are critical for helping people living with the most severe burdens of obesity today. However, these treatments alone will not address the systemic issues in our food environment that cause obesity, nor reduce the number of people seeking help for excess weight in the first place. That is why we only recommend this policy be implemented in addition to the other population-level prevention policies in our package. These novel treatments will only be truly transformative alongside sustained efforts to address obesogenic food environments.