Debate on food, diet and obesity, House of Lords, 28 March 2025

• Obesity continues to be a key public health challenge for both councils and wider public finances. It is estimated that the NHS spends £6.5 billion on obesity-related health care each year, whilst the cost to wider society is estimated to be £27bn per year. Under a backdrop of public health grant reductions, councils have spent over £1bn tackling child and adult obesity since responsibility for public health transferred to councils in 2013.
• Reversing long standing increases in child and adult obesity - and improving people’s physical activity levels and diets by making it easier for everyone to access opportunities to move more and to healthy food- would be hugely beneficial to the nation’s health and to society as a whole.
• Obesity is the result of interplay between many factors. The context in which councils operate – levels of deprivation, resources, urban and rural geography, and other competing priorities locally – influences the approaches that can be taken to prevent obesity. Supporting people to maintain a healthy weight requires action on many levels: individual, organisational, across whole systems, local and national.
• Affordability and the cost-of-living plays a significant role in determining food purchased and opportunities to exercise. The ability to afford a healthy diet is not only affected by food prices, but also income and the costs of other essentials, such as energy costs. The time available to purchase, prepare and cook food and the skills required to do so are also barriers to eating healthy diets. The most deprived fifth of the UK population would need to spend 50 per cent of their disposable income on food to meet the cost of the Government recommended healthy diet, and there is increasing reliance on cheap foods with low nutritional values.
• For councils, a ‘whole systems approach’ to obesity means using all the assets of the local area, supporting a community-centred approach to tackling health inequalities, and developing transferable workforce skills and capacity. Local and national government must take a long-term whole systems approach to promoting a healthy weight and reducing obesity.

• The National Child Measurement Programme (NCMP), delivered by council public health teams and overseen by the Office for Health Improvement and Disparities (OHID) measures the height and weight of children in mainstream state-maintained schools in England annually and provides data on the number of children in reception and year 6 who are underweight, a healthy weight, overweight, obese or severely obese.
• The NCMP provides robust public health surveillance data on child weight status, to understand obesity prevalence and trends at local and national levels, to inform obesity planning and commissioning and underpin the Public Health Outcomes Framework indicator on excess weight in 4- to 5- and 10- to 11-year-olds.
• Findings from the 2022/23 NCMP show an encouraging slight decline in the prevalence of overweight and obesity amongst children across both Reception and Year 6. The 2020/21 edition of the survey, which was carried out as a sample due to Covid-19, found large increases compared to previous years.
• The 2022/23 results show that the prevalence of obesity in Reception children decreased from 10.1 per cent in 2021/22 to 9.2 per cent in 2022/23. The decrease signals a return to pre-pandemic levels for this age group and is one of the lowest levels since 2006/07. The prevalence of obesity in Year 6 children decreased from 23.4 per cent in 2021/22 to 22.7 per cent in 2022/23. This is still higher than in 2018/19 and 2019/20.
• Obesity prevalence in boys is higher than girls for both age groups. For boys in reception, obesity prevalence was 9.3 per cent, compared with 9.0 per cent of girls. For boys in Year 6, obesity prevalence was 25.1 per cent, compared with 20.1 per cent of girls.
• The data shows a further widening of the inequalities gap in obesity prevalence across both deprivation, geography and ethnicity.
• Levels of obesity in reception-aged children living in the most deprived areas (12.4 per cent) were more than double those in the least deprived areas (5.8 per cent). The prevalence of severe obesity was more than three times higher in the most deprived areas (3.8 per cent) compared with those living in the least deprived areas (1.2 per cent).
• Similarly, the prevalence of obesity among year 6 children was 30.2 per cent in the most deprived areas, compared with 13.1 per cent in the least deprived areas. The prevalence of severe obesity was more than four times higher among year 6 children in the most deprived areas (9.2 per cent) compared with those living in the least deprived areas (2.1 per cent).
• Geographical disparities in obesity prevalence also exist. In reception-aged children, the prevalence of obesity was highest in the North East (11.3 per cent) and lowest in the South East (8.0 per cent), East of England (8.1 per cent) and South West (8.2 per cent). In year 6, the prevalence of obesity in 2022/23 was highest in the North East (25.8 per cent), the West Midlands (25.2 per cent) and London (24.8 per cent) and was lowest in the South West (19.4 per cent) and the South East (19.4 per cent).
• The proportion of children living with obesity in 2022/23 was highest for Black children in both reception (13.6 per cent) and year 6 (31.6 per cent). It was lowest for Chinese children in both reception (4.2 per cent) and year 6 (15.2 per cent).
• In 2022, the LGA produced a set of forecasts at local authority level for prevalence of obesity and overweight among children, at both reception and Year 6. LGA projections showed that child overweight and obesity at Reception might be expected to rise to almost 25 per cent by 2040, with the rate among Year 6 pupils expected to rise to over 40 per cent. Prevalence of obesity is projected to rise to almost 12 per cent of Reception pupils and almost 27 per cent of Year 6 Pupils.

• Obesity is a complex relapsing condition with multiple causes and significant implications for health and beyond. It has health implications at every stage across the life course, from pregnancy through to childhood and adulthood.
• Overweight children have increased chance of developing other health conditions, including heart disease, high blood pressure and diabetes.
• Obesity increases the risk of developing a range of health conditions in childhood and later life, including heart disease; stroke; high blood pressure; diabetes and some cancers. Obese children are much more likely to be obese adults, which may lead to significant health risks

• The National Child Measurement Programme (NCMP) indicates that 22 per cent of children under the age of five are overweight or living with obesity. This is often considered a ‘school problem’ but what happens in those nought to five years are crucial to understanding this statistic and moving the dial.
• Children’s food preferences and eating habits are formed early in life and the time that they spend in early years settings provides an ideal opportunity to shape healthy behaviours.
• It is evident that young children’s diets are providing more energy than they need, and consumption of fruit, vegetables, oily fish and fibre are still lower than recommendations.
• The value of good nutrition for the early years extends beyond physiological health – it contributes to establishing social behaviours, supports learning, and influences food preferences and eating habits. It underpins growth and development, can help to reduce childhood obesity and is a building block of the first 1,000 days of a child’s life.
• Little is known about what children are fed in early years settings. Guidance is voluntary. Monitoring and accountability are minimal.
• Close to 1.7 million under five year-olds are registered for either the 15- or 30-hour government entitlement. This means there are 1.7 million young children to feed with little oversight of what they are being fed. The mandatory school food standards don’t apply and the voluntary guidance, Eat Better Start Better (EBSB), was last updated over seven years ago. Questions have also been raised over EBSB’s relevance and applicability twelve years on and its cultural appropriateness.
• Some councils have highlighted to us that early years nutrition is often not on their agendas; it is often overshadowed by school food and that capacity for supporting early years settings with nutrition has in many places diminished due to funding challenges.

• The previous Government’s response to obesity was mainly been set out across three chapters of its childhood obesity plan, published in 2016, 2018, 2019, and a further obesity strategy published in 2020. Within these, the former Government has introduced several measures aimed at reducing the prevalence of childhood obesity, including the Soft Drink Industry Levy (2018), calorie labelling on menus of large restaurants/chains with more than 250 staff (2022) and restricting the placement of foods high in fat, salt and sugar (HFSS) in locations intended to encourage purchasing both instore and online (2022).
• In 2020, the former Government also committed to restricting promotions of HFSS foods such as “buy one get one free”, both online and in physical stores in England. The Government initially set out to implement these proposals in April 2022, but these have now been pushed back to October 2025 to allow the Government to continue to review the impact of the restrictions on the consumers and businesses in light of the unprecedented global economic situation.
• In March 2021, the Government announced an additional £100 million over the 2021/22 financial year to support people living with excess weight and obesity to lose weight and maintain healthier lifestyles, of which over £30 million was provided for councils to support the commissioning of adult behavioural (tier 2) weight management services. £4.2 million was provided to test the expansion of behavioural weight management services for children and families. The funding was initially announced as £100 million per year for three years to support healthy weight. In April 2022 the Government announced the funding would not be extended to 2022/233.
• Childhood obesity continues to be a key public health challenge for both councils and wider public finances. It is estimated that the NHS spends £6.5 billion on obesity-related health care each year, whilst the cost to wider society is estimated to be £27 billion per year. Under a backdrop of public health grant reductions, councils have spent over £1 billion tackling child and adult obesity since responsibility for public health transferred to councils in 2013.

Soft Drinks Industry Levy

The introduction of the Soft Drinks Industry Levy in 2018 has already had a positive impact on the reformulation by some soft drink manufacturers’, which is welcome.

• The levy may have reduced the number of under 18s having a tooth removed due to tooth decay by 12 per cent. Research published in the open access journal BMJ Nutrition, Prevention and Health suggests that the fall in hospital admissions may have saved more than 5,500 hospital admissions for tooth decay alone and the largest reductions were in children aged up to nine years old.
• However, it is disappointing that the proceeds from the levy which were earmarked as new money to invest in children’s sports and healthy eating programmes have since been diverted to address gaps in existing departmental funding.
• Public health teams in local government should be able to decide how the levy is spent. Councils are uniquely placed to work with schools, parents, businesses and the voluntary and community sector to ensure that funding goes to where it is needed most, and on the interventions that are proven to reduce child obesity.
• This includes targeting those areas with the greatest need, such as with oral health programmes, weight management services, exercise referral schemes and offering free or reduced-cost sport. This in turn will lead to less pressure on our already overstretched health and care services, saving the country much more from obesity-related treatment in future.
• Government could explore expanding the levy to include high-sugar milk-based drinks, such as milkshakes and certain coffees, and to explore a levy on other high-sugar products, where voluntary sugar reduction has seen limited success.

Additional funding for weight management services announced in 2021

• In March 2021, the Government announced an additional £100 million over the 2021-22 financial year to support people living with excess weight and obesity to lose weight and maintain healthier lifestyles, of which over £30 million was provided for councils to support the commissioning of adult behavioural (tier 2) weight management services. £4.2 million was provided to test the expansion of behavioural weight management services for children and families.
• The funding was initially announced as £100 million per year for three years to support healthy weight. In April 2022, the Government announced the funding would not be extended to 2022/23.
• The LGA was disappointed to learn of the Government’s decision to end £100 million of funding for council and NHS commissioned weight management services by not extending the grant to 2022/23. Over two-thirds of adults in England are currently overweight or obese, and council commissioned weight management services have been a vital way of tackling this issue in local communities.

Universal Infant Free School Meals (UIFSM) policy

• From September 2014, all infants in state-funded schools in England (comprising Reception, Year 1 and Year 2) have been entitled to receive a free school meal under the Universal Infant Free School Meals (UIFSM) policy.
• The Government’s introduction of a universal offer of FSM for all infants has on average reduced the chances of a child becoming obese by 0.7 percent, proving more effective in reducing obesity than policies focussing on food education or physical activity. FSMs have also been linked to helping improve children from disadvantaged backgrounds to improve their attention and academic performance.

Unhealthy food advertising ban announcement (December 2024)

• From October 2025, junk food adverts will be banned on TV before 9pm under government measures. Under the proposed laws, plans for which were included in Labour's election manifesto, television adverts for junk food products will not be allowed to air before the 9.00pm watershed from October 2025.

Revisions to the National Planning Policy Network (December 2024)

• The Government has included additional wording to the NPPF to provide greater direction and clarity to support local authorities in promoting healthy communities and tackling childhood obesity. Previously paragraph 96(c) of the NPPF has been amended to strengthen policy to promote good health and prevent ill health, especially where this would reduce health inequalities between the most and least deprived communities.
• Hot Food Takeaways: The Government has added new paragraph 97 of the NPPF stating that local planning authorities should refuse applications for hot food takeaways and fast-food outlets (within walking distance of schools and other locations where children and young people congregate) unless the location is within a designated town centre.

National policy tools

• National government must take a whole systems approach to promoting a healthy weight and reducing obesity across departments and through all policies. For example, greater funding of sustainable travel such as cycling and walking initiatives (subject to local consultation) can promote exercise which reduces obesity whilst also reducing car use, generating wider benefits around healthier living.
• We continue to call for the Government to reverse the real-terms reductions in public health grant funding since 2015/16. This is urgently needed to enable councils to develop long term strategies to prevent widening health inequalities, including developing long-term strategies to promote healthy weight.
• Government should update the Licensing Act to include a public health objective and allow councils to take action where premises fail to protect the health of their communities.
• Government should provide councils with new powers and funding to support more children and families to live healthier lives, including tackling the clustering of existing takeaways and restricting junk food advertising near schools.
• Giving councils more say on how the sugar industry levy is spent to better support local services which support healthy weight and a more targeted approach to investment.
• The Healthy Start scheme should be increased in line with inflation (and reviewed every 6 months) and expanded to include all those on Universal Credit and age up to 5 years old to support more young families on low incomes access nutritional support.

Examples of good practice from local government and partners

• Bristol City Council’s whole city approach to childhood obesity is long-term, cross-council and all-encompassing. Ambitious targets, set as part of the One City vision, include a halt in the rise of childhood obesity by 2026. By 2050, the aim is that obesity will no longer be a contributor to early death and that children will leave school knowing how to prepare a meal from fresh produce that is available throughout the city.
• London Borough of Brent's life-course perspective to tackle obesity highlights the importance of pre-natal and early-life factors in childhood obesity. Research shows that adult obesity is difficult to treat, emphasising how important it is to work with families to put in place early preventative measures.
• Luton Council is the first local authority in the East of England and among the first ten councils across the country to adopt a healthy food and drink advertising policy. The new policy restricts the advertising of products that are high in fact, salt or sugar (HFSS) on all council-owned assets to help protect children and adults.
• Nottinghamshire County Council has worked with partners and residents to improve access to affordable and healthy food. Families with young children in Nottinghamshire are being supported with the cost of living through a network of FOOD Clubs which provide more affordable access to healthy ingredients.
• Westminster City Council takes a whole-system approach in the early years – they involve the settings, partners and residents, but also look at wider systemic drivers of poor nutritional outcomes such as the food environment, food access and the cost of living crisis. Westminster provides information to parents, trains staff in healthy eating, uses a nutritionist to review food menus and suggest improvements. They also look at the early years through a wide lens, considering physical, mental and emotional health.
• North Somerset Council has launched programmes targeting issues such as nutrition, healthy weight and oral health for children. A range of different initiatives have been set up to support families of children under the age of five. There has been a focus on improving breastfeeding rates over recent years and that is now being built on by launching new programmes targeting issues such as nutrition, healthy weight and oral health.

Arian Nemati, Public Affairs and Campaigns Adviser

Email: [email protected]