Obesity and Fatty Liver Disease

Ben Coleman Excerpts

Tuesday 28th October 2025 Westminster Hall

[Dr Chambers]

Fantastic. Hopefully it will improve people’s mental health—and if they leave halfway through, it will probably improve their physical health, too. That is a fantastic initiative.

Other Members have talked about the soaring rate of liver deaths, which has shot up in the last 20 years. The hon. Member for Worthing West talked about it costing the NHS £6.9 billion directly, and some studies show that it has cost the economy over £100 billion in other ways, such as from people being off work.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I suggest to the hon. Member that one of the principal reasons that non-alcoholic fatty liver disease has shot up so radically in recent years is the increasing prevalence of food that is simply bad for people and is causing them damage—in particular, food that is high in fat, sugar and salt. For that reason, the Health and Social Care Committee, of which I am a member, is currently doing an inquiry on food. Does the hon. Member agree that the Government need to focus on making healthy food more affordable and accessible, and to tackle the advertising and marketing of so much of the unhealthy food that is out there?

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship this morning, Mr Efford. I congratulate the hon. Member for Worthing West (Dr Cooper) on securing this important debate, and I thank the British Liver Trust and others who provided information and reading material in advance of today’s debate.

Fatty liver disease, as has been said, is often asymptomatic in its early stages. Even when symptoms do occur, they can initially be non-specific symptoms such as tiredness and feeling generally unwell. Initially, the fat deposits in the liver; in the next stage the fat causes inflammation, which causes metabolic dysfunction-associated steatohepatitis. It can then progress to fibrosis and then cirrhosis. As mentioned earlier, liver deaths have increased substantially in the last 50 years, but early detection can help to prevent them. What is the Minister doing to ensure that liver function tests and fibroscans are more available? Does she regret having to delay her workforce plan? Will that have an impact on the treatment of liver disease?

As many have said, fatty liver disease is caused by obesity. Two thirds of adults are now overweight or obese, but obesity starts in childhood. As an NHS consultant paediatrician, I have in my time seen a 12-year-old weighing 120 kg and a nine-year-old weighing over 90 kg—around three times the weight of an average nine-year-old. That has a serious cost in terms of life expectancy, taking three to 10 years off a person’s life. It also has an economic cost to the state of about £11.4 billion on the NHS, estimated at £75 billion per year when taking into account the wider economic factors.

We all know someone who has struggled with their weight and who has had huge success recently, including Members of this House who have talked about it in other debates, using Ozempic, Wegovy or Mounjaro. That is great, but do we want a future where a substantial proportion of the population are dependent on medication to maintain their weight?

[Ben Coleman]

If I may bring the hon. Member back to childhood obesity, does she agree that there is a serious problem with sugar being pumped into so much baby food? Does she therefore welcome what the Government have finally done after many years of the issue’s sitting unaddressed? They are giving the industry 18 months to take the sugar out of baby food and to stop marketing basically unhealthy products, which no one should buy, as healthy or healthier. Does she welcome what the Government are doing here?

[Dr Johnson]

I certainly think it is wise to ensure that people get off to a good start in infancy and that unhealthy products are not advertised as healthy if they are not, although the definition of healthy is somewhat elusive and difficult to pin down. It is also important that we do not routinely feed little babies under one high-sugar foods, although I do not want to see them fed artificial sweeteners, either. It is about making things less sweet, so the reformulation will need to be done carefully. That is my personal view.

Going back to the medications, we know they can be very helpful for some and can improve their health. They may be able to help with fatty liver disease as well, although they are not licensed yet. Can the Minister update us on when the Government expect applications to be approved and whether the NHS is ready to deliver for all eligible patients? We have heard about the prevalence and burden of the condition across the country and the number of people affected. What is she doing to ensure that the NHS is ready so that, when these drugs are licensed, it has the capacity, workforce and money to provide them?

We have seen that drug prices can change quite dramatically. In August, Eli Lilly announced a huge price increase for Mounjaro. What plans does the Minister have to guard against that? Will she update the House on negotiations on the voluntary scheme for branded medicines pricing and access?

We understand she is reviewing the National Institute for Health and Care Excellence quality threshold; when does she plan to reach a conclusion? We have seen investment in this country’s life sciences sector by companies such as Merck and AstraZeneca being withdrawn from the United Kingdom or paused due to the environment created by the Government. We need urgent action to support that sector. Will the Minister update the House on discussions she has had with industry and the Treasury on that?

Medications are part of the issue, but there are also surgical implications. Many people who have lost large quantities of weight require surgery for excess skin, which can cause further medical problems. What is the Minister doing to ensure there is an assessment of demand for post-weight loss surgery? Are surgeons and capacity available to deliver it where medically indicated?

As many have said, prevention is better than cure. We know that fewer than one in three people eat five portions of fruit and veg a day, and that that is falling. We also know that starting early is important and have talked about children and infants. What is the Minister doing to ensure that school food is healthy and good for children? What work is she doing with the Department for Education on food choices and preparation, particularly advice on food that can be made in advance or quickly? We know that many young people will become adults in households where there are two working parents, where one of the largest challenges is not just the money needed to buy food, but the time required after returning from work to prepare and deliver it to children before they do their homework and go to bed.

We have talked about reformulation. The soft drinks industry levy has reduced sugar per 100 ml by 47.4%, but I am concerned that is leading to an increase in artificial sweeteners rather than a reduction in the sweetness of the product, ultimately meaning that people are still hooked on the sweetness. What does the Minister think of that? Some hon. Members talked about the advertising ban on less healthy food. Will the Minister tell us why that has been delayed until next year?

Why have the Government added the brand exemption? Do they think the addition of the brand exemption will make it harder for new market entrants, compared with well established brands? If I whistled the short tune for one food brand—I will not—it would be immediately recognised, without further introduction. That would be more difficult for advertising new entrants to the market.

The 10-year plan talks about mandatory healthy food sales reporting. Will the Minister update us on what she defines as healthy? There are also mandatory targets on healthiness of sales. What does that mean and when will it be implemented? We understand there is a planned update to the nutrient profile. Some are concerned that the free sugars that that includes mean that items such as date paste will fall under unhealthy sugars. Will the Minister provide information on that? Has she made an assessment of the Conservative Government’s step of informing people by adding calories to menus? What effect has that had on consumption and food portion sizes in the restaurant sector?

Exercise is also important. We know that physical exercise strengthens joints, increases weight loss and helps in the reduction of diabetes, depression and dementia. The previous Government gave £1 billion to support the sports and leisure industry during the pandemic so that it could continue, and had a school sports action plan, guaranteeing at least two hours of PE and supporting after-school clubs.

The current Government have pledged £400 million for new sports facilities, but delivery of that money seems to be at a standstill. Will the Minister update us on that? Many grassroots sports facilities need that money. Will she also update the House on what the Government are doing to improve girls’ attendance in sports? We know that teenage girls in particular are not taking the advised amount of exercise.

In summary, we need an NHS pathway to detect liver disease in the early stages so that it can be treated; an NHS that is ready to deliver the new treatments that are becoming available; and action to tackle obesity to prevent liver disease in the first place. There has been an emphasis throughout the debate on what the Government can do to prevent obesity and on state culpability in that regard. It is important that people recognise that they have agency and do not need to wait for the Government to do something about this. People do not need to wait for the soft drinks industry levy or for changes to regulations. They have the agency to help themselves; they can do that.

[Ben Coleman]

Will the hon. Member accept that there is now a general body of opinion that it is time to stop blaming people for not having the willpower not to eat bad food when they are constantly bombarded with advertising and marketing? Some £6.4 billion a year will be spent by the food industry on advertising and marketing to people, and in many areas it is very difficult to get food that is both affordable and healthy. Is it not time to stop blaming people for being fat and to support them to tackle obesity in the ways that I and many of my hon. Friends here have described? Is it not time to stop sticking up for the food industry and to start sticking up for ordinary people?

[Dr Johnson]

I do not think it is sticking up for the food industry to suggest that people have agency over what they eat. I will give an example. I saw a very small patient—about five years old—who was very obese. I asked the mum what sort of things the child was being fed, and the answer was, “Well, Doctor, he eats lots of crisps all the time.” But there is a simple point there: where was he getting those crisps from? He was getting the crisps from the cupboard without asking, but the crisps did not get in the cupboard because the five-year-old put them there. It is a question of making sure that what is available is healthy and what is being fed to children is healthy.

I have seen even in the last few weeks patients who have low vitamin D levels, critically low vitamin B12 levels and critically low iron levels as a result of the diet that they are getting. It is not just a case of, “It’s all the Government’s fault. The state must make sure that everyone eats healthily.” People have a responsibility of their own as well. This is about working together.

There are wider policy impacts as well. The hon. Member for Chelsea and Fulham (Ben Coleman) talked about food pricing and food security. This Government want to cover Lincolnshire—the breadbasket of the UK, where a third of the country’s fruit and vegetables are produced—in glass solar panels. That is what his Government want to do, so there is a wider policy framework about food affordability. Food inflation is going up hugely under this Government, so they need to look in the mirror and see what they are doing to reduce food prices for people. We need to work together: it is a combination of what the Government can do and what the individual can do.