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Last Updated: Wednesday, 23 January 2008, 02:11 GMT
Beating the bulge (again)
By Nick Triggle
Health reporter, BBC News

Overweight men
Projects to tackle obesity have been scrapped
Everyone is agreed that obesity is one of the greatest challenges facing the country.

Nearly a quarter of adults are obese after rates rose by 50% in the last decade.

The increases among children have been even worse.

The government has recognised that the problem needs to be tackled by drawing up an obesity strategy, which will be published on Wednesday.

But this is far from the first time ministers have tried to tackle the nation's expanding waistlines. So what has gone wrong?

Back in 1992, the Tories published a white paper, Health of the Nation, which set a number of targets to tackle obesity.

These were subsequently dropped by Labour after it came into power in 1997.

But the Blair government was back worrying about eating habits with its own public health white paper in 2004.


Choosing Health set out a range of measures, including food labelling, a crackdown on TV junk food advertising and school-based campaigns to get children exercising and eating healthily.

But the key problem, according to public health experts who warmly welcomed the proposals at the time, was that the government has not kept promises over money.

The 2004 white paper said public health chiefs would get an extra 300m over the following two years.

A snapshot survey by the Faculty of Public Health, which represents public health specialists, has shown that as little as 40% of this money actually reached the front line.

Responding to the challenge requires the whole of government to work together
Dr Tim Crayford, of the Association of Directors of Public Health

Professor Chris Drinkwater, a public health expert at the NHS Alliance, which represents health professionals working outside hospitals, said: "The problem is that the funds were not ring-fenced and became a soft option when the NHS was having problems with deficits."

The result has been that much of what was envisaged at the time has not materialised.

Promised improvements to the cycle network have not been carried out, while the sale of school playing fields has continued.

The effect is that the government will almost certainly miss its target to halt the year-on-year rise in childhood obesity by 2010.

In fact, ministers are facing an uphill struggle to even encourage the public to adopt healthier lifestyles.


Despite gradual improvements in recent years, over two thirds of adults are not doing the recommended five 30-minute sessions of exercise a week.

Meanwhile, the five-a-day fruit and vegetable intake is more like three-a-day for most.

And even where targets were set and hit, in the case of health trainers, it has required outside investment.

The aim was to appoint 1,200 of the lifestyle coaches by March last year, but figures show nearly half of them have been employed by the army and prison service.

Professor Alan Maryon-Davis, president of the Faculty of Public Health, said the problems are being worsened by cuts in the number of public health specialists.

In the last four years the number of consultant and director posts in the NHS has been reduced by over a quarter, he said.

"These are the people who would be co-ordinating local approaches - the schools sports programmes, the organised walks.

"It is things such as this that are essential to tackling obesity, but without the public health specialists in place they end up being cut."

Dr Tim Crayford, president of the Association of Directors of Public Health, agrees. "Responding to the challenge requires the whole of government to work together. It involves transport, education and health. But unfortunately it has been losing out to other priorities."

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