Nearly two years on from publication of the Obesity Health Alliance’s ‘Turning the Tide – a 10 year Healthy Weight Strategy’, former OHA director Caroline Cerny (now Director of Policy and Engagement at Bite Back 2030) reflects on the process and where we are now.
In the public health policy world we often talk about the ‘playbook’ of commercial giants and increasingly how big food companies use the tried and tested tactics of the tobacco industry. Well that playbook works both ways – the same policies that have reduced the sales of tobacco (advertising regulations, fiscal measures) are also the tools needed to improve population dietary-related health. But also, as NGOs, we can learn a lot from the tobacco advocacy journey and the success of an evidence-based long-term blueprint to bring together campaigners and successfully influence government policy as exemplified by ASH’s Smoking Kills series.
So in 2019 OHA set out on an ambitious project – to bring together the public health and academic communities to review evidence, utilise the collective expertise and wisdom of OHA members and map out the pathway and policies needed to turn the tide on population level excess weight. And finally debunk the failed government approaches of education and awareness campaigns that had characterised the last 20 years.
We had reason to feel reasonably optimistic. We’d successfully secured one of OHA’s three initial policy priorities with the introduction of the soft drinks industry levy in 2018, a (albeit voluntary) reformulation programme was underway and stronger food marketing restrictions were back on the political agenda, with the Government consulting on options. So it seemed to be the right time to turn our attention to what next.
The unwelcome appearance of Covid-19 certainly slowed the process down, as the public health expertise of many of our expert advisors, including our independent chair Professor Anne Johnson and academic lead Professor Linda Bauld, was rightly diverted to the acute public health emergency unfolding. But it also brought opportunity, with renewed momentum to address dietary health politically, due to the emerging evidence linking excess weight with poorer outcomes from covid.
Finally in 2021, Turning the Tide was born. With the input and support of all 50 OHA members, along with 15 external expert advisors, the strategy sets out 30 recommendations spanning actions across the food system along with action needed to address weight stigma and overhaul service provision.
With such a high number of recommendations (each one needed to address the multifactorial influences of obesity) we needed a system to order them – hence the KIND framework. This organised recommendations into policies already committed to (KEEP), those that build on successful approaches (INTENSIFY), NEW proposals plus promising ideas that need further DEVELOPMENT. At the time we were hopeful we didn’t need to include the KEEP policies but erred on the side of caution, given the unpredictable nature of politics. A wise decision, given the stalling, delays and row backs we have seen on vital restrictions to take unhealthy food and drink out of the marketing spotlight.
Nearly two years after launch, it can sometimes feel like we haven’t made much progress along the carefully planned map to turning the tide on obesity. But the systemic change needed is a long journey, with many twists, turns and storms along the way. Against the might of a powerful food industry, entrenched stigma and prevailing misconceptions about the causes of obesity, our most powerful weapon as NGOs is the ability to come together to speak with one voice and Turning the Tide is that consensus brought to life.
Prime Ministers change. Health Ministers will come and go. What’s certain is that they all eventually wake-up to the fact that to improve everyone’s health and reduce the pressures on the NHS, they need to address the root causes of ill health*. When we next find ourselves in a supportive political environment, we now have an evidence-informed, oven ready plan for implementation. In the meantime we all need to stick together and hold fast to the rallying cry (incidentally first shared with me by a tobacco campaigner) of another tenacious, and ultimately victorious campaigner** and Keep B*ggering On.
*Unfortunately some take longer than others to reach that conclusion
** As a dedicated free marketer, Churchill would probably have been dismayed to have his phrase appropriated in this way. Not sorry.