Looking south, west, and into the skies

Obesity Action Scotland focusses on the ways that it can influence action to prevent and reduce overweight and obesity in Scotland. But we We therefore closely track developments carefully across the world, we work closely with colleagues in London-based Obesity Health Alliance, we watch UK and wider developments in policy and evidence, and we cover ambitions that, in some cases, look to the skies. 

Let’s start with ambition and boldness from the UK Government. In summer, they launched their Health Plan Fit for the future: 10 Year Health Plan for England . On pages 62-66, they focus on prevention:  ‘From sickness to prevention: power to make the healthy choice  

‘People are living too long in ill health, the gap in healthy life expectancy between rich and poor is growing and nearly 1 in 5 children leave primary school with obesity. Our overall goal is to halve the gap in healthy life expectancy between the richest and poorest regions, while increasing it for everyone, and to raise the healthiest generation of children ever. This will boost our health, but also ensure the future sustainability of the NHS and support economic growth. We will achieve our goals by harnessing a huge cross-societal energy on prevention. We will work with businesses, employers, investors, local authorities and mayors to create a healthier country together.  

‘Specifically, we will: 

‘launch a moonshot to end the obesity epidemic. We will restrict junk food advertising targeted at children, ban the sale of high-caffeine energy drinks to under 16-year-olds, reform the soft drinks industry levy to drive reformulation; and - in a world first - introduce mandatory health food sales reporting for all large companies in the food sector. We will use that reporting to set new mandatory targets on the average healthiness of sales  

• restore the value of Healthy Start fromfinancial year2026 to 2027, expand free school meals so that all children with a parent in receipt of Universal Credit are eligible, and update school food standards to ensure all schools provide healthy, nutritious food.  
• harness recent breakthroughs in weight loss medication and expand access through the NHS. 
• encourage citizens to play their part.(3 July, later sections abridged) 

A moonshot  

The ambition is encouraging, although lunar exploration is a new venture for the Department of Health in Westminster, who have not previously been known for launching rockets into space. For younger readers unfamiliar with moonshots, help was at hand on the weekend following publication. 

‘The origins of the term moonshot lie with President Kennedy in 1961, after the US was overtaken in the space race by Sputnik (in 1957) and Yuri Gagarin (in 1961). The US would put a man on the moon – and they did. 

Apparently as this article goes on to argue, the moonshot is an appropriate aim for the UK as ‘We are a superintelligent nation’. ‘Britain cracked the Enigma code, figured out longitude, invented the web, the jet engine, the double helix and created the Curly Wurly.’ So now we know.  

Sunday Times, July 6th , Business section (page 6) 

Wes Streeting, The Secretary of State for Health and Social Care in England, is strong on the need for action. Reacting to a stalling of levels of obesity in the National (England) Child Measurement Programme on 5 November he said: ‘Obesity robs children of the best possible start in life, sets them up for a lifetime of health problems, and costs the NHS billions. 

Today's figures show the extent of the problem and the need to act now, which is exactly what we're doing – in schools, on sports pitches, and online – to make healthy choices the easy choices, support families, and turn the tide on childhood obesity. This is prevention, not punishment, and will help families and children across the country." 

The November ’25 budget widens and deepens the soft drinks industry levy (SDIL) incentive to reformulate and take sugar out of the food chain, chipping away at calorie dense food on offer. One more step along the way. 

Meantime the Health Foundation – London based with a UK remit, and investing in prevention research in Scotland through its SHERU programme – latest report is the 2025 Inequality Landscape - Scottish Health Equity Research Unit - produced a series of blogs on prevention and public health this autumn on its website. In September, Jennifer Dixon  & Sarah Woolnough, respectively CEOs of the Health Foundation and King’s Fund collaborated with, effectively, a songsheet for population health renewal: A prevention revolution – or another missed opportunity?   

One excerpt: 

‘Leadership means confronting vested interests – a commitment Wes Streeting has previously been only too happy to make, warning the food industry before Labour came to power, ‘You either get on board the steamroller or you’re going under it’. Polling shows he is right to have done so – there is strong public support for government intervention to improve the public’s health. And history shows that the public adapts rapidly once these measures are implemented.  

‘However, this steamroller appears to have been parked. While we welcome news of a proposed ban on the sale of high-caffeine energy drinks to children younger than 16 and that long-promised restrictions on advertising junk food will come into force in the new year, the government needs to go much further and faster on action to tackle the damage caused by unhealthy food.’ 

The statement ends : ‘The country desperately needs a prevention revolution, and this government should make good on its promise to deliver one.’ 

In a November blog, its Senior Fellow Samantha Field wrote  GLP-1 receptor agonists: a wake-up call for the food system, not a silver bullet for obesity - The Health Foundation . In it, she quotes US surveys and research: 12% of U.S adults have now tried weight loss drugs, mainly at their own expense. Their self-medication has started to shift food purchasing decisions – reducing the national food bill, perhaps even by $12 billion in the ‘unhealthy snack food category’ alone (presumably an annual sum). The major manufacturers are ‘launching smaller-portion, high-protein products labelled as suitable for people on these medications’; retailers like Walmart are having to respond to shoppers ‘spending less overall but maintaining purchases of healthier staples’. All this in a country that is now apparently intending to weigh its visa applicants - ‘Trump expands visa requirements to include diabetes and obesity’ BMJ report 13 November. There is an intriguing market adjustment, and yet more stigma dressed up as a bid to limit the risk to the US’s ballooning health and sickness bill. 

Back in the UK, near home, the Obesity Health Alliance  keeps us abreast of developments in England and liaises with OAS regularly. Currently they are advocating for going further and faster with the Food Strategy, and on restrictions proposed in the Energy Drinks consultation by the Government. 

What do we make of these developments? 

Effective policy interventions exist. As the September message from the Health Foundation and Kings Fund CEOs set out ‘… prevention works best through the cumulative combination of small actions, such as reducing the availability of junk food, increasing healthier options, and promoting physical activity and weight loss programmes.’ No one action will run the tide of this worrying epidemic; policy developments in England are building a portfolio of actions that augment and surpass Scotland’s own efforts, and rhetoric is bold. But the sum total of measures in place and proposed seems to fall well short – several satellites short of a full rocket payload, perhaps. Statistics stalling in child measurement in England suggest we have not turned the corner, far less show us heading in a trajectory that offers hope to future generations that overweight and obesity will not be the experience of the majority as it is now. Recent US trends, as Samantha Field wrote, also suggest that weight loss drugs are harming unhealthy food sales. We might see the various players in the food sector responding in a way that serves their customers’ longer-term interests - altering business models - but risks leaving people behind who can neither afford nor access the drugs or the good food. Fast food outlets and budget food chains will still want to market unhealthy food to many, many people with little choice, steepening the inequalities gradient. That’s why the market alone won’t help a whole population, only the wealthiest and best placed to take advantage of what’s good. Ambition and boldness in policy are what’s required to go further and faster, to create a fair and healthy weight future. If Mr Streeting wants to make a real difference, then he urgently needs to put some rocket fuel into his policy steamroller.  

Dr Andrew Fraser 

Chair 

Obesity Action Scotland Steering Group