Obesity and Fatty Liver Disease

Clive Efford Excerpts

Tuesday 28th October 2025 Westminster Hall

[Dr Cooper]

I thank my hon. Friend for that excellent point and agree absolutely. In our society, we focus on how people look for many reasons, cultural and commercial, but this is purely about health. This is about keeping people healthy on the inside and allowing them to live good quality lives. My hon. Friend is absolutely right in that sense.

Poor diet is now the leading risk factor for death and disability. It is responsible for millions of preventable deaths each year. In the UK, almost two thirds of adults are overweight or are living with obesity, increasing the risk of fatty liver disease, cardiovascular disease and a multitude of cancers. In my job as a public health consultant, I see a lot of data and read many papers, but this statistic shocked me: four in 10 children with obesity may already have fatty liver disease. That demonstrates the urgent need to act now to prevent an even greater epidemic of disease in future.

That has not happened by accident; it is the result of a broken food system, which has made the UK Europe’s third most obese country and one of the world’s biggest consumers of ultra-processed food. We have a system that makes the unhealthy choice the cheapest, easiest and most available choice. Healthier food now costs more than twice as much per calorie as unhealthy food. That is £10.24 per 1,000 kilocalories compared with £4.50. For fruit and vegetables, the cost is even more at £11.90 per 1,000 kilocalories.

For the lowest income households, following a recommended healthy diet would swallow half or more of their disposable income. It is no surprise that obesity and fatty liver disease hit hardest in poorer communities. As I said at the beginning, this is not about personal failure. As hon. Members have said, sometimes people feel that that they are failing to lose weight and failing to keep themselves healthy. This is not about personal failure; it is a political failure. It is our collective failure to create a food environment that protects rather than undermines public health. If we are serious about prevention, we must be serious about reform—the right type—with stronger fiscal and regulatory measures to reduce the availability and marketing of foods that are high in fat, salt and sugar, and to rebuild a food system that serves public health and not profit.

Why have we not addressed this yet? Weighted against the commercial gain of the food and drink industry, our obesogenic environment is killing our population and costing the taxpayer billions. Economic analysis last year suggests that excess weight costs the economy £126 billion a year. A Budget is coming up next month; I am fairly sure that our Chancellor would like £126 billion a year. That figure takes in wider factors, such as lost productivity, care costs and lost years of healthy life. The direct NHS cost of obesity is projected to rise from £6.5 billion to £9.7 billion by 2050. We cannot separate our health and our wealth, and we cannot hope to achieve economic growth without tackling issues such as obesity and fatty liver disease.

Since 1990, there have been nearly 700 policies proposed by Government to reduce obesity. Imagine having 700 policies about your life! Past strategies fell short because they targeted behaviour change—individual choice—rather than the structural and commercial drivers of diet. Many lacked delivery plans, timelines or evaluation frameworks, leading to fragmented progress and limited long-term impact.

What can we do now to ensure that this public health emergency is addressed? My key asks for our Health Minister, who is kindly listening here today, are as follows. First, there is a clear need for a national liver strategy, ensuring increased public awareness, early liver checks and primary care pathways. As stated earlier, every integrated care board should have a pathway for the early detection of liver disease.

Secondly, we need strong planning and co-ordination to be ready to deliver the next generation of medication for liver disease. Thirdly, if we truly mean to deliver the left shift to prevention, promised in the 10-year health plan for England, then we have to change the environment that is driving poor health. There is strong consensus about the necessity of upstream interventions to regulate the unhealthy food and drink environment. We can build on that strong consensus to extend the levy model to high-sugar and high-salt foods; to enforce the 9 pm watershed for high fat, salt and sugar advertising, closing brand mark loopholes; to provide stable funding for local food partnerships, so that councils can act on local needs; to reinstate the full childhood obesity plan; and to address food affordability via fiscal reform.

None of this is easy or it would have been done already, but right now our environment is draining our health service of billions each year and weighing heavily on the nation’s health—no pun intended. Let us not keep repeating our mistakes, but rather embed food policy as a national health priority. Through our work on preventing obesity and fatty liver disease, let us support and finally see the long-discussed and essential shift towards prevention and a healthier, wealthier country.

[Clive Efford (in the Chair)]

I remind Members to bob in their places if they intend to speak.

[Several hon. Members rose—]

[Clive Efford (in the Chair)]

Right, that gives me a better idea. We will bring in the Front Benchers at 10.28 am, so that gives an idea of how much time there is for the six or seven Members who wish to speak.

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper), who is co-chair of the all-party parliamentary group on liver disease and liver cancer, for setting the scene incredibly well. I thank her for the detail and for her requests to the Minister. It is, as always, a pleasure to see the Minister in her place. I wish her well and I look forward to her answers. I also thank the British Liver Trust and the Foundation for Liver Research, which supplied me with a briefing that made clear the excellent work at the Roger Williams Institute of Liver Studies, which continues to drive world-leading research into metabolic liver disease to shape how it is diagnosed and treated.

Liver disease is a growing cause of premature mortality and lost years of working life in all four nations of the United Kingdom. It has been estimated that some 4,878 potential years of life were lost due to chronic liver disease in Northern Ireland. It is clear that the UK is in the midst of a liver disease crisis, to which the hon. Lady referred. It is as serious as that, and we should all take note. While premature mortality rates from other major diseases have fallen over the past two generations, deaths from liver disease have risen 400% since the 1970s. There are more than 18,000 deaths from liver disease and liver cancer each year in the United Kingdom.

[Clive Efford (in the Chair)]

Order. Members are asking that you speak into the microphone, Mr Shannon, so that they can hear you.

[Jim Shannon]

That has never been a problem in the past, Mr Efford. Do I need to lift it up to my mouth? I thought it was good enough to carry my voice; apologies if it is not. This would be the first time it has not worked.

Two thirds of adults are overweight or living with obesity, and one in three children are classified as overweight or obese when they leave primary school. Sadly, four in 10 children with obesity may already have liver disease. One in five people are affected by liver disease and liver cancer in the UK, and as many as 12% of those—more than 1 million people—go on to develop the more severe form of fatty liver disease.

The stats for Northern Ireland are unreal. That is not the Minister’s responsibility, but it gives a flavour for the debate. Some 64% of adults in Northern Ireland were overweight or obese, a marked increase from 23% in 2010-11. My goodness me—if ever we needed a reality check, that is one for us. Shockingly, Northern Ireland has the highest rate of overweight or obese primary 1 children in the UK, with 25.3% of children fitting that category. In my constituency of Strangford, 27% of year 8 children were overweight or obese. It is estimated that 70% of adults and 40% of children who are overweight or obese have fatty liver disease, so urgent work must be done to prevent this health crisis in the making.

Shockingly, 37 million extra sick days are estimated to be taken by people living with obesity, harming economic output on a massive scale—a figure of 1% to 2% of UK GDP as estimated by the Institute for Government. The NHS alone is expected to shoulder an estimated £10 billion per year obesity bill by 2050, with obese patients costing twice as much as those of a healthy weight. Reducing obesity prevalence by 10% could save £6 billion per year in the UK economy.

Let me tell a personal story. I am a type 2 diabetic. Some 16 or 17 years ago, I realised that I needed to drastically change my eating habits. I was 17 stone. To be honest, to put it very starkly, I was a big fat pudding. I realised that if I did not lose weight for my diabetes, I was going to be in trouble, so I reduced my weight quite substantially, by 4 stone. I have managed, by and large, to keep at that reduced level. First, it was down to stress but, secondly, it was down to Chinese takeaways five nights a week with two bottles of Coca Cola. That just does not work; when it is added up, you just get fatter and fatter. I took that away and tried to reduce my chocolate intake.

My hon. Friend the Member for East Londonderry (Mr Campbell) has said that he is reducing his sugar intake—well done to him; he does not need to, but it is definitely a good purpose to have. The point I am making is that not everyone can. For those who cannot, it is important to look towards the weight-reduction injections, to which I will refer in a moment. I have been able to control my diabetes for the last 10 years by tablets. I take nine tablets in the morning and five at night to keep everything under control.

Newly released weight-management drugs such as Ozempic and Mounjaro have been shown to reduce the weight of patients by an average of 5%, reducing the risk of a variety of health effects, including fatty liver disease. However, although those drugs are available for those who obesity and type 2 diabetes, they are not for those with fatty liver disease. Making that happen would be my one request of the Minister. If someone has a body mass index of over 40, and does not yet have those comorbidities, unfortunately they will not qualify.

There is a new generation of drugs targeting advanced fatty liver disease. Resmetirom has recently been approved by the US Food and Drug Administration and is expected to be approved in the UK within 12 to 18 months. Could the Minister give us an indication of where those drugs are in the system? Those new drugs—some of which improve liver function and some of which enable weight loss—can reverse fatty liver disease and must be made available in a timely fashion to save lives. The NHS needs to ensure that services are ready to support that, as previously no treatment has been available for those patients.

The UK faces a very challenging commercial environment for drug pricing. Lilly recently announced that it will increase the price of Mounjaro by as much as 170% in response to pressure from the US Government and historic pricing inconsistencies. My second question to the Minister is about what has been done to ensure that the price of drugs is reduced or kept controlled in a way that can make a difference.

Thirdly, I say to the Minister that ICBs must have an effective pathway for the early detection of liver disease. A new nationally endorsed pathology pathway to improve early diagnosis of liver disease is essential. Every community diagnostic centre should also have a fibroscan to assess fibrosis.

Finally, I say to the Minister that patients with advanced liver disease and cancer need access to weight management services in line with access for people with type 2 diabetes. This is a ticking timebomb, but there are scientific breakthroughs there to address it. I believe in my heart that the Government need to cut that wire and stop that timebomb now.