The discussion over the ban on ads for HFSS products is a particularly unedifying example of eye-catching tactics over the difficult business of strategy.
On Monday, the prime minister revealed a suite of restrictions on the sale and promotion of foods high in fat, sugar, and salt (HFSS). Among the measures proposed would be a ban on pre-9pm advertising of such foods both on TV and online, the end to ‘buy one, get one free’ promotions, calorie and nutritional labelling, and then rather nebulously, “expanding NHS measures”.
Like the other proposed measures, that expansion lacks any tangible indication of what success might look like. Doctors will “be offered incentives”, care staff will have “the opportunity” to become weight coaches, and GPs will be “encouraged” to prescribe exercise. And, of course, there’s the promise of “more self-care apps and online tools”. Where in the past a report, an inquiry, or perhaps even a task force might have been assembled, the 2020 go-to answer, as we know, is to promise an app.
It’s all about galvanising a Better Health strategy. Boris Johnson, two buttons dandily undone, says the government “is just trying to help people a little bit” to bring their weight down - something the PM says he too has struggled with. The stakes: according to health secretary Matt “Tigger” Hancock, if everybody overweight lost just 5lbs (2.2 kg), it would save the NHS £100m. Headlines blared about the prescription of cycling - a very Johnsonian flourish. In the messaging, the government is, ultimately, making the point that this is about helping individuals to make choices.
However, it’s not that simple. “There is a risk that we once again fall into the trap of mainly focusing on individual responsibility”, said Andrew Goddard, president of the Royal College of Physicians, in comments reported by the Guardian and others. “We’ve been down this path before and it doesn’t work.
“We know the key to success in addressing obesity and other health inequalities lies in shared responsibility between individuals and the state.”
This isn’t to play down the importance of individual-level measures to tackle this problem, which has now come into the spotlight partly as a result of its increasingly clear links to severe COVID risks. The new campaign hints at that being the reason for the prime minister’s hospitalisation, which appears to have spurred his change of heart. This kind of “nanny state” measure was once the subject of his ire in his newspaper columns and part of his political persona. And back in the heady days of 2019, it was also – in the form of the sugar tax – ripe for undoing once the UK was out of the EU.
Is this not contrary to those same buccaneering instincts? An echo of that impulse saw the chancellor, Rishi Sunak, promise a discount scheme to get people eating out in the name of gastronomic stimulus must surely exist here. The whole point was to get the people to spend the economy out of recession. And get this: you can go and get half price McDonald's - or, to be fair to Maccie's, any number of robustly salted, luxuriously fatty comestibles - during the first half of the week, courtesy of this same government.
Obesity is a particular point of interest for the Conservative Party. And in more ways than one. Not only has its leader, Boris Johnson, launched the campaign with a video detailing his own struggles with the prime-ministerial heft, complete with slow-motion dog walking; it has consistently featured as an almost-policy going on five years. Under all three Tory prime ministers since 2015, plans have emerged, receded, and then re-emerged. So why the attraction?
Usually focused on obesity among children, it’s a relatively uncontroversial good in the eyes of the public: to help children lose weight. Think how as First Lady, Michelle Obama was limited to the Let's Move initiative, to witness the extent of its apolitical nature. Nobody is for making children overweight.
Helping adults lose weight is a logical and important extension of this. The problem is this isn’t a state that feels ultimately responsible for public health as much as a state that feels its place is to encourage better choices, but isn’t willing to accept that a proper strategy must go deeper: obesity is an complicated issue whose roots are social, environmental, economic, educational, and genetic.
Look, for instance, at the APG Gold-Award-winning Change4Life, a decade-long campaign by Public Health England (along with agency M&C Saatchi) that acknowledges the psychological, political, emotional factors that affect obesity. If that campaign says anything, it's that the hard yards lie in the understanding and engagement. This isn't to say that this was a perfect example of health provision, but it indicates what is important: some kind of commitment to dealing with complexity.
As a condition, obesity exists in all socioeconomic brackets, which has the effect of disguising its complexity in ubiquity. The way this can be ignored is to make it about personal choice rather than addressing the deeper, underlying issues.
But the price of this is worth considering too. With the advertising and publishing industries certain to shoulder much of the strain of such a ban, the alphabet soup of trade associations have been vocal in opposition. As usual, this has led to slightly bizarre defences from the industry that say advertising has only a small influence on childhood obesity, and is not actually as effective as is often believed.
Nobody wins from this particular kind of contest, even if – as those in the industry are all too aware – advertising is no magic bullet either for getting people to buy things or for getting people to stop doing something.
To be fair, as the AA, IPA, ISBA, and IAB all point out, the government is taking a position that isn’t supported by its own evidence. “The Government’s very own research has shown that a 9pm watershed ban on HFSS advertising will reduce a child’s calorie intake by a miniscule 1.7 calories per day – the equivalent of half a Smartie,” says the Advertising Association’s director of public affairs, Sue Eustace, who goes on to stick the boot in:
“These proposed bans on HFSS advertising will not solve the structural inequalities linked to deprivation that cause higher rates of obesity among people, just as attention-grabbing new regulations will not undo decades of under-investment in targeted and community-based health initiatives.”
Because, ultimately, the measures that the industry criticises are more of a stunt than a considered strategy to tackle the problem of obesity. And that’s because dealing with public health is the kind of difficult, long-term matter that requires, most of all, a measure of what success looks like, not to mention the resources to make it happen. You can’t will them into existence, even with an 80-seat majority.
Instead, these tactics have picked villains in search of short-term points rather than embarking on a serious programme of long-term public engagement. Anything less is a kind of public health theatre. But that's hardly a surprise: it’s likely we’ll be told there’s an app for that.