Ozempic and supermarket health targets 'would halve obesity’ claims nudge think tank

The government could halve obesity by the end of the decade, via a combination of expanded access to weight-loss drugs like Ozempic and giving supermarkets mandatory targets on HFSS sales, a report by influential health nudge think tank Nesta has recommended.

After a two-year assessment of policies available to ministers, which looked at evidence from 3,000 different studies, Nesta has suggested a blueprint of “treatment and prevention”. It also includes calls for a compulsory front-of-pack health score system, further measures to crack down on junk food ads, and a ban on promotions for HFSS-laden takeaways.

However, the report stops short of recommending taxes on the food and drink sector because of the danger they would push up food prices and in the current economic climate find it impossible to attract sufficient political support.

In February, Nesta proposed supermarkets should face fines of up to 1% of their annual turnover if they failed to comply with a new system of mandatory health food targets, which it said the government should bring in to tackle the obesity crisis.

Its new blueprint follows last month’s House of Lords’ report, which called for a swathe of mandatory targets and taxes to be placed on the food industry to tackle the “broken” food system.

Nesta’s report advises health secretary Wes Streeting and Chancellor Rachel Reeves on the most cost-effective ways to tackle obesity, having studied 34 evidence reviews, involving a 17-member academic advisory committee and testing with 30 policymakers.

It found a combination of “treatment and prevention” was the most cost-effective route. It claimed the approach could prevent 157,000 cases of type 2 diabetes over five years – a reduction of around a fifth – equating to 95,000 fewer cases of hypertension over five years and 11,500 fewer cases of bowel cancer.

It said the package of measures would save £30bn in population health improvements, productivity gains, NHS and individual costs.

Read more:

• Will Labour act on damning obesity report proposals?

• Supermarket bosses oppose plans for FSA to take on war on obesity

• Little helps or Big Brother: AI’s role in health & obesity

Nesta suggested seven policies, which include extending access to weight-loss drugs to an additional 150,000 people a year, making all large food and drink businesses publish nutritional and sales information of what they sell, and incentivising large retailers to meet targets for selling healthier food.

It said the government should also require front-of-pack labelling, similar to the Nutri-Score system already used by some companies, further restrict junk food advertising on TV, online and public transport and stop online delivery platforms such as Just East and Deliveroo from advertising with online product placement adverts, such as pop-ups on their webpages or homepages.

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

However, while it found expanding the soft drinks levy with sweeping new taxes on salt and sugar, as recommended by the Lords’ report, would be “high impact and low cost” for the government by reducing average daily calorie intake in adults by approximately 45 kcal per person, with an annual benefit of £7bn a year, it said it would be hugely controversial because of the possible impact on pushing up food prices.

Nesta studied the proposals for a a levy of £3/kg which would be applied to sugar and £6/kg to salt sold wholesale for use in processed foods, or in restaurants and catering businesses, as suggested in Henry Dimbleby’s National Food Strategy, published in 2021.

“There is a risk that this policy would raise food prices for consumers,” Nesta found. “To address this concern, the National Food Strategy recommendation proposed that the revenue gained from increased taxation should be spent on increasing access to fruit & vegetables for people on low incomes.

“Governments should consider how this could be operationalised and ensure transparency when planning how revenue will be allocated.”

However, when deciding on the best blueprint for action, the report concluded on the taxation option: “This is an option that would be high impact and low cost for governments.

“While this is a package we would endorse, mandating a new tax on food will require significant political will that may be unlikely within the current context.”

The BRC has criticised Nesta’s proposals for mandatory targets because they only cover supermarkets. However, Nesta claims the policy alone could reduce obesity rates from 29% to 22% within five years, with the policy backed by consumer group Which?.

Its proposals for prevention go further, however, with suggested policies such as restricting advertising of HFSS products, including on TV, online, and on public transport.

It calls for a ban on all price promotions of HFSS foods for large out-of-home businesses such as restaurants, coffee shops and fast food outlets, and a restriction on location promotions of HFSS food and drink on delivery platforms.

Nesta also looked at the raft of new drugs in the NHS available to fight obesity. Last month, Streeting announced that unemployed people would be given access to weight-loss drugs under government plans to get them back to work, saying that the new class of medication could have a “monumental” impact on obesity and getting Britain working.

Nesta found that weight-loss drugs were highly effective at reducing obesity, but also hugely costly. On current market pricing it would cost around £8.5bn per year to treat everyone living with obesity (around three million people with a BMI of 30 or over). with the weight-loss drug semaglutide. This would reduce obesity by 41%.

It recommends the government ringfences £500m annually to fund weight-loss medicine prescriptions for adults in the UK, including semaglutide, also known under brand names Wegovy, Rybelsus and Ozempic.

“Halving obesity is possible but needs a new approach,” said Hugo Harper, director of healthy life mission at Nesta.

“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.”

Read more:

• Wes Streeting pledges to ‘work with industry to tackle obesity crisis’

• UPF vs HFSS: Making sense of the new health agenda

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 this blueprint – with their focus on creating healthy food environments – allows policymakers 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 policymaking in an area that has eluded effective action for decades.”

Sue Davies, head of food policy at the consumer group Which?, added: “Research has repeatedly found that people want retailers to do more to support them in making healthier choices.

“Six in 10 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.”