Today we launch our manifesto for the upcoming parliamentary elections in Scotland. In it, we call on all parties and candidates to recognise the significant challenge Scotland's high prevalence of overweight and obesity poses for public health and health inequalities. In this blog, we reflect on obesity prevalence in Scotland, exploring the causes and contributory factors, and explain why we believe the next Scottish Parliament and Government should take strong and urgent actions to improve the food environment in Scotland.
Obesity rates are not reducing
The majority (66%) of adults in Scotland now have a BMI which falls into the overweight or obesity category, while 1 in 4 of adults in Scotland (29%) have obesity1. Children in Scotland don’t fare much better: almost a third of children aged 2-15 are at risk of overweight or obesity, with 16% at risk of obesity alone1. This high prevalence poses a significant challenge to public health and health inequalities. With obesity shortening life expectancy, and increasing the risk of type 2 diabetes, 13 types of cancer, cardiovascular disease and many other non-communicable diseases2, we must not accept a lack of strong, combined policy actions to prevent and reduce obesity.
The obesity inequalities gap continues to widen
Worryingly, over recent years, Scotland has seen a widening gap in childhood overweight and obesity3. In 2019, this gap reached 12% in prevalence between children from the most and the least deprived areas of society1. This is not acceptable, and shows that we are not getting it right for every child.
Unfortunately, the widening inequalities in obesity prevalence amongst Scotland’s children is also reflected in progress towards the Scottish Government’s target of halving childhood obesity by 2030. Since the commitment was announced, over 18,000 more children have fallen into the ‘at risk of obesity’ category, meaning that it is not currently on track to be achieved4.
Read more about widening inequalities in childhood obesity in our blog ‘Protecting Scotland’s Children: is tackling childhood obesity more vital than ever?’
COVID-19 has highlighted the urgency of taking action
With the coronavirus pandemic hitting the world with force in 2020, children in Scotland have seen a massive upheaval to their everyday lives. Schools have closed, school meals have changed, and some activities stopped. Adults have also been affected by the halt in activities and gym closures, alongside limited access to services, such as weight management clinics.
We have seen some of our habits change, particularly in relation to our diets and the way we exercise.
It is now also clear that obesity is a risk factor for the severity of COVID-19, leading to poorer outcomes5. The Scottish Government has been clear in its desire to build a ‘wellbeing economy’, recognising population health and wellbeing as incumbent to building back a robust, resilient economy. It is vital that the impact and link between COVID-19 and obesity is recognised, and that real steps are taken to improve the resilience of the population of Scotland.
We must take urgent preventative action to achieve healthy weight in the Scottish population
It is well established that obesity is a complex condition influenced by many factors, including: food consumption, food production, individual psychology, societal influences, physiology, individual activity and the physical activity environment6. Action is therefore required across all of these domains in order to address the rising prevalence of obesity. The fact that we have been missing dietary targets for nearly 20 years in Scotland is unsurprising due to the wide availability and heavy promotion of food and drink which is high in fat, salt and/or sugar7.
To achieve healthy weight in the Scottish population, we must take urgent, preventative action by improving the food environment, ensuring that the healthy choice is the easy choice for everyone. Obesity Action Scotland therefore makes the following asks of the next Scottish Parliament:
Promotions: The Scottish Parliament and Government should seek to pass a Bill to restrict the use of promotions on food and drink high in fat, sugar and/or salt urgently in the next session.
Advertising: The Scottish Parliament and Government should restrict the advertising of food and drink high in fat, sugar and/or salt in Scotland where they can. This should include outdoor advertising such as billboards, public transport, digital media advertising, and sponsorship of professional sports and events.
Out of Home: The Scottish Government should ensure that the adaptation and recovery of the food and catering out-of-home sector from the Covid-19 pandemic happens in a way that supports and enables improved healthier food options and a shift to healthier, more sustainable foods.
The Scottish Parliament and Government should also improve planning and registration arrangements for the out-of-home sector, to limit access to unhealthy foods.
Finally, the Scottish Parliament and Government should introduce mandatory calorie labelling and control of portion size.