Obesity

Dan Poulter Excerpts

Wednesday 9th November 2011 Westminster Hall

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I am grateful for the opportunity to contribute to this debate. I will not speak for very long, but it is worth highlighting some of the issues that have been raised in a comprehensive way. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this debate.

Obesity in the UK is a growing problem. In 1993, only 13% of men and 16% of women were obese, but in 2009, 22% of men—and 24% of women—were obese, which represents almost a doubling of the number of men with obesity. I am not talking about people with a body mass index of between 25 and 30, which means that they are overweight; I am talking about obesity. Almost a quarter of the UK population is obese and I am sure that we all find that unacceptable.

How can we deal with obesity effectively, because whatever previous Governments have done, obesity has not been addressed in a way that has worked or has been effective? First, I will briefly outline how Government policy is moving towards more community-based interventions on obesity, and I will explain how that approach, through the health and wellbeing boards that will be set up under the health care reforms, will be effective and work well. Secondly, I will talk a little about nudge theory, because I am more hopeful and optimistic about it than my medical colleague, my hon. Friend the Member for Totnes (Dr Wollaston). There is good evidence elsewhere, particularly in Iceland, that it has worked, and I hope it will also work effectively in relation to obesity.

[Jim Shannon]

While the hon. Gentleman is giving us his thoughts, and given his experience in his previous job, will he comment on gastric band operations? Just two weeks ago, I had occasion to visit the Northern Ireland Health Minister, Edwin Poots, with some of my constituents. These people had tried everything to lose weight; they had tried dieting and exercise—some of them were not able to exercise, which was the other problem—but they had clear medical and health problems. As a last resort—this really is the last chance saloon, or the last chance restaurant, perhaps—should regions and Health Ministers set aside money specifically for gastric band operations?

[Dr Poulter]

We certainly have to look at how the Government can help people to take more responsibility for their own health care. That is fundamental to obesity issues, and it is a particular challenge in more deprived areas. People often require gastric bands at the point where the medical problems associated with obesity—diabetes, the risk of heart attack or stroke, or high blood pressure—pose a potentially life-threatening risk. Such people may not have that long to live if a gastric band is not put in place, so it is the only feasible mechanism for dealing with obesity in such cases. Gastric bands have been shown to be an effective mechanism for looking after that part of the population, and there is good medical evidence to support their use. There is also good evidence in terms of the health care economics, as helping people to become slimmer will lessen the burden on the NHS.

The gastric band is good for the patient, because their health improves dramatically when it is used effectively, but the challenge with obesity is to bring about long-term lifestyle change, and the question with gastric bands is whether they necessarily deal with long-term lifestyle changes. In a medical sense, there needs to be greater emphasis on the education that goes with the bigger issues around obesity and lifestyle at the same time as the gastric band is fitted. I hope that that helps to answer the hon. Gentleman’s question.

[Andrew Bingham (High Peak) (Con)]

Does my hon. Friend share my concern that celebrities regularly have gastric bands fitted, with the result that the bands are now seen as a shortcut to losing weight? People think that celebrities have them, so we must all have them.

[Dr Poulter]

That is a good point. There is good evidence that the celebrity culture around dieting causes anorexia in young girls. It would be much better for us and for many of our constituents if celebrities sometimes showed greater responsibility in the way in which they behaved. Gastric bands are an effective way of dealing with severe obesity, but they should not be used as a general method of bringing about weight loss. Weight loss is about education and people taking responsibility for their own weight and lifestyle. It is also about putting support in place in communities to let people do that, particularly in more deprived areas.

[Mr Dodds]

I have heard constituents talk about the use of statins and polypills. These medications have enormously beneficial effects for many people, and many people need them, but people almost seem to think, “Well, we have this magic pill available. We can eat and drink as much as we like, and then we can go on this pill.” Does the hon. Gentleman share my concern that we need more education about the use of such medications? At the moment, people are under the impression that there is something out there that can solve all these problems without their having to do anything to change their lifestyle.

[Dr Poulter]

Yes, certainly. There is an issue about how physicians prescribe effectively. Statins are an effective way of controlling cholesterol, and there is good evidence that they benefit people with heart disease and high cholesterol and that they increase life expectancy. There has been a lot of research, and I believe that it has been shown that statins may have beneficial effects in reducing the risk of breast cancer, although the Minister will correct me if I am wrong.

The right hon. Gentleman touches on the wider point that the emphasis in this debate needs to be on effective community-led interventions that tackle obesity and health care, and my hon. Friend the Member for North Swindon (Justin Tomlinson) discussed that very effectively. However, we need to ask how we will make those community health care measures effective.

The Government are setting up health and wellbeing boards, which are a very useful part of their health care reforms, because they will, for the first time, bring together different organisations in a meaningful way. Local councils in certain towns may run good community initiatives that connect GPs with leisure centres, exercise and sport, and some schools may encourage sport and physical activity in an effective way or have good links with local sports clubs. However, that does not often happen in a co-ordinated way across whole counties or, indeed, across the country. Health and wellbeing boards will help to bring together different organisations to address key public health problems, and obesity is a key public health challenge in all our constituencies.

As part of the health care reforms, the health and wellbeing boards will be able to address issues such as obesity. For example, if we know that there is an issue with teenage pregnancy or obesity in certain schools or among certain schoolchildren in my constituency, targeted interventions can be put in place in a much more community-focused way by getting the local authority together with health care representatives at a much more strategic level. That must be a good thing, because it allows much more targeted interventions.

The second thing I want briefly to discuss—I do not want to speak for much longer—is nudge theory. My hon. Friend the Member for Totnes has a slightly different view of it. I have more faith in nudge theory than she does, and I say that because we have had debates about agriculture—some of the Opposition Members here today were present—in which we discussed the need for corporate firms and supermarkets to show greater corporate responsibility on issues such as food labelling. We have now seen active movement from some supermarkets on honest food labelling. For example, we talk about food in a store being labelled British only if it is actually farmed in Britain, and not if it is merely processed or sliced here. We are beginning to see such initiatives come through, with supermarkets supporting British farmers. Morrisons is a good example of a supermarket where the British food stamp actually means something, and that allows consumers to make an informed choice. Supermarkets are therefore able to show corporate responsibility when they are asked to do so, although things are not entirely perfect, as we all know.

In a similar vein, the Government have introduced a public health responsibility deal, and it is a good initiative. Almost 200 different companies have signed up to the deal, including supermarkets such as Asda, the Co-op, Morrisons, Marks and Spencer, Sainsbury’s, Tesco, Waitrose and many others. Fast-food outlets such as McDonald’s, Pizza Hut and KFC have pledged to remove trans fats and introduce calorie labelling as a result of this initiative. Those are all pleasing and beneficial steps in the right direction.

[Dr Wollaston]

Does my hon. Friend share my concern, however, that organisations such as Asda, which have signed up to the new responsibility deal, are in some ways undermining it by offering hugely discounted alcohol products?

[Dr Poulter]

There are areas of obvious concern, where supermarkets can go further. As I said earlier, when we were talking about the agricultural sector, even though several supermarkets are backing honest food labelling, and showing responsibility in food labelling and calorie counting to tackle obesity, it is right to highlight the areas in which they need to show greater corporate responsibility. Cut-price alcohol is one of those, and we will continue to monitor it carefully in our work on the Select Committee on Health, and as physicians. My hon. Friend makes a good point.

In preparing for the debate, although I do not normally take an active interest in children’s TV, I found out about an Icelandic TV show called “LazyTown”—the Minister may want to expand on the subject a little later. The show is watched by children all over the world, and we have it in Great Britain as well. There is a healthy sports superhero character, called Sportacus, who motivates children to eat healthily and be active. In Iceland several “LazyTown” initiatives have been run in partnership with the Government and the private sector. For example, children between four and seven years old were sent an energy contract, which they and their parents signed, in which they were rewarded for eating healthily, going to bed early and being active. In one supermarket chain, all the fruit and vegetables were branded “sports candy”, which is the “LazyTown” name for fruit and vegetables. That led to a 22% increase in sales at that supermarket, and improved health and reduced obesity levels in Iceland.

The fact that Iceland’s child obesity levels have started to fall as a result of initiatives of that kind is good evidence in support of such corporate responsibility. Those initiatives are designed to support supermarkets coming together with Government, to make effective use of the nudge theory of improving behaviour, and they can work—and have worked. For that reason, we must support what the Government are doing, because there is evidence that it can work. It is a good thing and the evidence from Iceland is that we need to do what works, with children and communities.

I understand, and I am sure that the Minister will confirm, that the Department of Health has set up a partnership with “LazyTown” and is interested in expanding that initiative in the United Kingdom. We need more such approaches. The reason supermarkets sign up to such deals and initiatives is that it is good not just for the children, who become healthier and less obese, but for the supermarket and its brand image. Supermarkets see that working with corporate responsibility—we see it in our constituencies with Tesco schools vouchers—can enhance their image and custom, and do real good, for example, by reducing obesity levels.

I have greater faith in the nudge theory than my hon. Friend the Member for Totnes, and we need to allow similar initiatives to take root in the future. What has been done in the past has not worked very well; obesity levels have been going up. We have good evidence, from examples of corporate responsibility, that things can be tackled, so let us give nudge theory a chance. Let us also look to those health and wellbeing boards to provide community-based interventions that will work. If we do not do something, things will get worse, and the boards are a good way to address the problem.

--- Later in debate ---

[Mr Burns]

I will give way in a moment. It is also important to say that, if we can get an agreement with commercial companies to change the way they behave and some of their practices, it will be far quicker to achieve that and put it in place than to wait for the heavy hand of Government legislation, which can take a minimum of a year and sometimes years. Why wait for the heavy hand of legislation that might take a long time, if we can get a voluntary agreement that will work quicker and more effectively to start dealing with the problem?

[Dr Poulter]

rose—

[Mr Burns]

I will give way to the hon. Member for Hackney North and Stoke Newington first, because I promised her, then my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), and then I will make progress.

--- Later in debate ---

[Mr Burns]

I understand the hon. Lady’s point, because the charge has been made on a number of occasions and I have considerable sympathy with it. The supermarket at which I shop each week—I shall not name it, because I do not want to advertise for it—does not do that any more. I think that the hon. Lady will find that, throughout the country, the responsible supermarkets have stopped that practice, for the very reasons that she has mentioned.

[Dr Poulter]

Does my right hon. Friend agree that we need to be careful about introducing regulation for alcohol and other relevant products? It could be a very crude measure and have unforeseen consequences. For example, on alcohol, we may be concerned about the cheap sale of white cider, but the bigger issue is that introducing legislation may impact on brands that market themselves responsibly to responsible drinkers. We have to be careful about that sort of thing.

[Mr Burns]

My hon. Friend makes a valid point.

I will address a number of issues that some of my hon. Friends have raised. My hon. Friend the Member for Totnes (Dr Wollaston) talked about the important issue of weighing and measuring children. I hope that she will be reassured by the national child measurement programme. It measures children in reception class—four to five-year-olds—and in year 6. Those measurements and weights are fed back to parents, so that they can not only know the information, but make informed choices about the lifestyles of their children.

My hon. Friend the Member for North Swindon (Justin Tomlinson) made some valid and good points about the planning regime and open spaces that enable parents and children to exercise. His points were well made and sensible. It would be worthwhile for local government, which has responsibility for the issue, to read what he has had to say, particularly, as the hon. Member for Hackney North and Stoke Newington has said, because certain inner-city areas do not have the advantages of some of the more rural and smaller town constituencies, which have far more access to open spaces.

As a Government, our general approach to tackling the problem is based on the latest scientific evidence on the underlying issues and causes of obesity, as well as what has worked best previously. Ultimately, there is a simple equation: people put on weight because they consume more calories than they need.