COMMENT: Tackling obesity requires proper planning

The growth of US fast food chains in the UK market suggests policies to curb the proliferation of hot food takeaways need rebooting, says Nick Hughes.

Last week health secretary Steve Barclay unveiled plans to fast-track “cutting-edge obesity treatments and technologies”. The government claims a new £20m fund could lead to promising medicines and digital technologies, such as apps and online portals, being made available to patients to encourage lifestyle changes.

The initiative marks a further retreat from the prevention-led, interventionist obesity strategy launched by Boris Johnson in 2020 – and since largely jettisoned – to a more comfortable Conservative position focused on treatment, technical fixes and personal responsibility.

This past year has already seen backsliding on promotions and advertising bans and the latest announcement offers further evidence that attempts to reshape the food environment to support healthy consumption died along with Johnson’s own premiership.

Cast your mind back even further to 2018 and the planning system was being identified as a key lever the government could pull to tackle obesity. Part two of Theresa May’s childhood obesity plan for action included a commitment to develop resources that support local authorities who want to use their powers to create a healthy food environment by, for example, limiting the over-concentration of fast food takeaways, particularly around schools. The government noted how it was possible within the existing planning system to restrict access to unhealthy food but said in practice local leaders found it difficult to put these powers into practice; one reason being that the evidence needed to support their planning decisions and make them resilient to appeals could be difficult and expensive to obtain.

Public Health England subsequently published guidance in 2020 for using the powers of the planning system to promote healthy weight environments. Later that year the government also changed the use class order for hot food takeaways to ‘sui generis’, a term used for premises that do not fall within a defined class meaning they don’t benefit from any permitted development rights. In theory this allows local authorities to have greater control over preventing the proliferation of hot food takeaways because every change of use needs to be locally approved.

US expansion

I was reminded of these planning policies while reading a recent article in The Guardian detailing the rapid expansion of American fast food restaurants in the UK market. The likes of Popeyes, Wendy’s, Taco Bell and Tim Hortons have all identified the UK as a growth opportunity – chicken chain Popeyes only opened its first branch in November last year and is targeting 350 branches in the UK within a decade.

The article explained that the growth of these chains is attributable to a few things: cultural similarities between the UK and US markets; the strength of the dollar against the pound; and a need among cash-strapped councils to fill vacant property sites and so generate vital revenue from business rates.

It’s easy to understand why this kind of growth has happened but it still feels like a failure of policy. Fast food outlets tend to cluster in areas of deprivation and poverty. Research by the now defunct Public Health England from 2018 found England’s poorest areas are fast-food hotspots, with five times more outlets found in these communities than in the most affluent. Children exposed to these outlets, whether out with friends or on their way home from school, may find it more difficult to choose healthier options, PHE said.

Success story

Some councils have successfully managed to curb the proliferation of fast food chains. In 2015, Gateshead developed a planning policy that restricted the locations of hot food takeaways. The Guardian article explained that since it was adopted, all planning applications for hot food takeaways have been refused, and the council has been successful on every single one of the appeals. Moreover, Gateshead’s senior planning officer Lucy Greenfield told the paper that property vacancy rates have actually fallen since the policy was adopted. “We desire local businesses to thrive and not have an influx of massive multinationals taking over,” she said.

Local authorities could also implement policies that don’t lock out food-to-go businesses entirely but do incentivise operators to put more healthy products on their menus. In a report published last year the food and farming alliance Sustain urged councils to look beyond planning policies and use the range of powers they already have to help create a healthier food environment. This could include requiring licenses to sell food high in fat, sugar and/or salt (HFSS) that would fail the government’s nutrient profiling model; limiting opening times; and restricting what can be sold to children within certain hours. 

Striking a balance

Councils clearly have to balance the need to generate revenue with a desire to create healthy communities and in so doing reduce the pressure on local public health services. Fast food takeaways have their place in the food-to-go ecosystem but not at the expense of diversity in the local food offer.

Policy makers shouldn’t be afraid of taking actions that avoid creating obesogenic environments, but there’s little sign of that happening at a national level. (A government spokesperson says: “The government takes tackling obesity seriously. Having a fit and healthy population is essential for a thriving economy and we remain committed to helping people live healthier lives. We will continue to work closely with industry to make it easier for people to make healthier choices so that everyone can access healthy, affordable and high-quality food.”)

In its latest announcement the government noted how it costs the NHS £6bn a year treating obesity-related ill health, a figure that is set to rise to over £9.7bn each year by 2050. In this context, splurging £20m on a few lifestyle apps feels a bit like taking a kitchen knife to a gunfight.

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