Britain is overweight. In recent decades, obesity has reached epidemic proportions, and it is growing into a silent but deadly health crisis. In 30 years, the level has doubled. It is costing people and the nation dear, and the time has come for war to be declared, with all means at the disposal of the NHS deployed to fight it. This means that “weight-loss jabs” such as Ozempic, which can have such a remarkable effect in a relatively short time, need to be made much more widely available. The case is overwhelming.
More than one in four Britons is obese, according to figures derived from data released by NHS Digital, with the prevalence of the issue generally climbing above 70 per cent in the cohort aged 55 to 74 years. Even among four-and five-year-old children, one in 10 has a body mass index sufficiently high to be classified as obese. Plainly, something is very badly wrong with what might be termed the British body politic.
In the long term, preventative medicine, health education, fiscal policy (such as levies on sugary drinks) and encouraging an active lifestyle are the best ways to get the country back to fighting fitness with minimal side effects and complications. However, the obesity epidemic is so severe, so costly to the NHS, and so damaging to the economy, that every possible measure should be taken to restrain, and reverse, this most pernicious of trends in health.
That is because obesity is obviously a problem not just in and of itself, but because of what it leads to. The consequences of people becoming dangerously overweight, or even moderately so, are manifold and distressing: highly preventable illnesses such as type 2 diabetes, cancers, heart disease and stroke, with their subsequent physical and mental disabilities, and the depression so often associated with drifting into corpulence.
There are, perhaps surprisingly, no precise figures available for how much the NHS spends, or plans to spend, on weight-loss drugs, but it seems to be in the hundreds of millions of pounds. Set against that is the much more considerable cost of treating the conditions that arise among an unfit population, the sum spent on social security to assist people with disabilities derived from excess weight (such as heart disease, weak joints and mobility issues), and the still greater damage to the whole economy in terms of lost output.
The National Endowment for Science, Technology and the Arts (Nesta), an underestimated source of creative policy thinking, says that the combined costs of obesity and people being overweight could rise to as much as £150bn per year in the next decade. More immediately, Nesta calculates that the UK could save around £53bn a year by extending weight-loss drugs to an extra 150,000 people, and by implementing policy changes, such as rules around the way retailers sell food. The obesity crisis also exacerbates social and ethnic disparities in health, which no society should tolerate.
Various drugs developed in recent years with the principal aim of treating type 2 diabetes have been demonstrated to show encouraging results for weight loss as well. This has been recognised by the National Institute for Health and Care Excellence, which is encouraging doctors to adopt a more flexible approach to prescribing them to patients at an earlier stage in their care, and particularly to people with co-morbidities.
Given the economics of these drugs, there could be even wider applications, certainly in cases of severe obesity and for people who are overweight and unable, for whatever reason, to stop their weight gain. After all, if all that was required to end the obesity crisis was willpower, it would long since have dropped away. As is so often the case, the key to good public health lies in approaching the world as it is, and not as policymakers would wish it to be.
The Nesta research also points to how common-sense changes undertaken by the private sector and by government can underpin medical interventions such as weight-loss jabs. Indeed, these are essential, because it is acknowledged that people often put weight back on after a course of treatment. The drugs are not free of side effects, are not for everyone, and are not a panacea.
Food manufacturers, fast-food outlets and retailers should look again at their marketing practices, and follow a healthier code of conduct in respect of promoting products that are cheap and tasty but excessively fatty and sugary. There are, for example, relatively few instances of, say, raw carrots and fresh tomatoes piled up temptingly at the checkouts, or on buy-one-get-one-free offers.
The government, so short of tax revenue, might usefully look at how the success of the fizzy drinks levy can be expanded to other drinks and foodstuffs. Britain, in other words, is far from defenceless in the fight to be fit.
