In the past two decades, the number of people who are overweight and obese in Ireland has doubled. Only four in 10 of us now have a healthy weight. And the problem is much more prevalent in disadvantaged groups.
The negative effects of being overweight are well documented and include many diseases.
But, obesity is not a simple linear equation – either in its causes or its solutions. Changes to the environment and transport infrastructure can be as influential as the types of food we like.
Solutions, too, are complex and extend well beyond the health system.
Behavioural change
So, what does A Healthy Weight for Ireland, Obesity Policy and Action Plan 2016-2025 bring to the table? It is well researched and based on multiple layers of consultation.
It acknowledges the risk of stigma in tackling obesity. Crucially, it contains timelines for priority actions. Its 10-year lifespan recognises the slow pace of behavioural change.
But there is no mention of funding for the myriad proposals. Without dedicated money there is a real danger the new policy will not be implemented.
Although the plan is much more than a single-issue document, inevitably attention will focus on the topic of a sugar tax.
“Develop proposals relating to the rollout of evidence-based fiscal measures, including a levy on sugar-sweetened drinks, in support of healthy eating” is the plan’s stated ambition.
Although disappointing for some public health advocates, the effective postponement of a sugar tax (until 2018 at least) is probably a wise decision.
There simply isn’t a sufficiently robust evidence base to implement such fundamental change.
Yes, Mexico increased tax on fizzy drinks by about 10 per cent in 2014 with a resultant fall of 6 per cent in sales: but this is very different from showing a link between increased taxation and a drop in overweight/obesity levels in the population.
No guarantee
Denmark
had an unhappy experience with “fat tax” and was forced to reverse fiscal policy.
Individual US states have had mixed outcomes from taxation measures.
Human behaviour in response to tax increases is unpredictable; for example, doubling tax doesn’t mean a twofold drop in the consumption of sugary drinks.
And we know that a flat rate increase in food tax impacts disproportionately on those in lower socioeconomic groups.
Irish nutrition expert Prof Michael Gibney has questioned the assumption that taxing carbonated soft drinks is a solution to obesity.
He notes about half the Irish population consume sugary drinks, with an average intake from the drinks of about 35 calories a day.
But there is no guarantee that reducing intake by 35 calories a day will produce a concomitant weight loss, because of the complex way the body defends itself against nutritional change.
Overall, the obesity strategy has much to recommend it. Whether it can meet its stated targets is, however, open to question.