By Leia Clifton, Policy Officer, Obesity Health Alliance
World Obesity Day is approaching on the 4th of March – on this day we are encouraged to think about and discuss practical solutions to help people achieve and maintain a healthy weight[1].
The day aims to raise awareness of the root causes of obesity which are incredibly complex, with genetics, psychological, sociocultural, and economic factors all having a part to play[1]. It is also an important platform to highlight the experiences of those living with overweight and obesity and the weight-based stigma they experience.
By far the biggest influence contributing to increasing rates of obesity, seen in the UK and internationally, is the world we live in. Often referred to as ‘obesogenic’, it describes an environment with surroundings, opportunities or conditions that promotes both individuals and society to be above a healthy weight[2]. In the UK, we are constantly bombarded by adverts and promotions for cheap, unhealthy food, making living a healthy life ever more difficult. As we are heavily influenced by our environment, addressing obesity is not the sole responsibility of individuals, and governments have a key part to play.
Over the years, governments around the world have started to understand their role in shaping health and are taking demonstrative action to make the environment healthier for their citizens. Chile and Singapore are two examples of countries that are receiving international interest in their very different approaches.
Chile’s Law of Food Labelling and Advertising
In 2016, levels of obesity across the population of Chile were rapidly increasing, having more than doubled since 1980. With one in four children, and a third of adults living with overweight and obesity, obesity and related conditions had become the largest cause of death in the country[3].
To address this, the Government took decisive action and introduced ‘Chile’s Law of Food Labelling and Advertising’ which aimed to create healthier food environment for children and families. This approach included banning the marketing of unhealthy foods to children and restricting the sales of unhealthy food in places children gather, such as schools.
Along with this, the ‘Chilean health warning label’[4] was introduced on packaged food products. It has since gained international attention for its simple approach to informing the public of the high amounts of sugar, saturated fat, salt or calories in what they eat.
Figure 1: Front‐of‐package (FOP) warning labels associated with the Chilean Law of Food Labelling and Advertising.
A recent evaluation[5] of the measures show they have been a success, with purchases of sugary drinks reduced by 23.7% during the first stage of implementation[6]. Evidence has also shown the black front of pack labels have improved public awareness of salt, sugar, saturated fat and calories in food products[7][8].
Singapore’s National Steps Challenge
In Singapore, the Government’s approach to addressing obesity and related conditions focused on increasing levels of physical activity in the population. This was part of a three strand approach to improve public health more broadly which also included an accessible and affordable medical system and extensive vaccination roll-out)[9].
In 2015, Singapore’s Health Promotion Board (HPB) introduced the National Steps Challenge. In the scheme, participants download an app with an in-built fitness tracker. Based on steps or other forms of physical activity, participants are able to build ‘healthpoints’ which they can redeem for a range of rewards. At the higher end, vouchers gained through points scheme can even go towards massage sofas, cruises, and international flights[10].
The popularity of the scheme alone tells of its success, with 156,000 of Singapore’s 5.7 million population joining at first launch in 2015. From then, popularity has only grown with 913,000 regular participants as of 20209.
Figure 2: Promotion material from Singapore’s Health Board – National Steps Challenge 2021.
What can the UK learn from these international approaches?
Governments around the world are waking up to the health impact of rising obesity rates and each country is likely to pursue a different approach based on their populations. Given the multiple drivers of obesity and key role of the environment, it’s important that governments consider a whole systems approach with a focus on structural changes that create a healthier environment for everyone.
In July 2020, the UK Government made a good start by announcing the 2020 Tackling Obesity Strategy[11] which outlined evidence-based measures targeting some of the key drivers of obesity. The proposals put forward action to address junk food marketing and promotions, whilst implementing clear front of pack food labelling and improving access to weight management services. On World Obesity Day 2021, we urge the Government to move ahead with full and swift implementation of the proposed measures to enable everyone in the UK to be a healthy weight.
[1] WHO (2020) World Obesity Day.
[2] Hobbs, M., Radley, D (2020). Obesogenic environments and obesity: a comment on ‘Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England’. Tallie. L (2020). Study suggests innovative Chilean food regulations are changing food perceptions, norms and behaviors. Gillings School of Public Health.
[3] Tallie. L (2020). Study suggests innovative Chilean food regulations are changing food perceptions, norms and behaviors. Gillings School of Public Health.
[4]Development of the Chilean Health Warning Label (2019). Accessible at: https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-7118-1
[5] Taillie LS, Reyes M, Colchero MA, Popkin B, Corvala´n C (2020) An evaluation of Chile’s Law of Food Labeling and Advertising on sugar sweetened beverage purchases from 2015 to 2017: A before-and-after study. PLoS Med 17(2).
[6] https://www.theguardian.com/world/2020/feb/11/chiles-drastic-anti-obesity-measures-cut-sugary-drink-sales-by-23
[7] Reyes, M., et al. (2020). Changes in the amount of nutrient of packaged foods and beverages after the initial implementation of the Chilean Law of Food Labelling and Advertising: A nonexperimental prospective study. PLoS medicine, 17(7), e1003220.
[8] Correa, T., Fierro, C., Reyes, M., Dillman Carpentier, F. R., Taillie, L. S., & Corvalan, C. (2019). “Responses to the Chilean law of food labeling and advertising: exploring knowledge, perceptions and behaviors of mothers of young children”. The international journal of behavioral nutrition and physical activity, 16(1), 21.
[9] https://www.straitstimes.com/singapore/health/incentives-work-to-keep-people-healthy-and-are-cheaper-than-treatment
[10] https://www.healthhub.sg/programmes/37/nsc
[11] Department of Health and Social Care (2020). Tackling obesity: government strategy. Accessible at: https://www.gov.uk/government/publications/tackling-obesity-government-strategy