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Letter to the Prime Minister regarding Child Obesity

sent on behalf of London's Child Obesity Taskforce

I sent this letter to the Prime Minister on 17 July 2020, ahead of his welcomed and anticipated-to-be-significant review of the National Obesity Strategy:

Dear Prime Minister,


I hope this letter finds you and your family well - indeed, many congratulations on the recent birth of your son.


Obesity and Covid-19

I am writing in my role as Chair of London's Child Obesity Taskforce, as I was interested to hear that we have both been considering the emerging evidence on the detrimental impact obesity has on those suffering from Covid-19. Of course, we have known for some time that being overweight or obese has a devastating impact on an individual's physical and mental health; with 11,117 directly related hospital admissions recorded in 2018/19. In 2018, in England 28% of adults were obese and 3% were morbidly obese.


This emerging evidence means that there could be real additional benefit in providing extra support for those adults who are struggling to maintain a healthy weight, including through proper funding for local weight management services, if we are going to improve resilience and protect against Covid-19 infection.


Resilient future generations

The emerging evidence also reaffirms the vital nature of the focus of our Taskforce; in supporting children's health right from their earliest years. Through my role, I have seen that too many children face the risk of lifelong poor health; reducing their life chances, increasing their risk of bullying and stigma and preventing them from flourishing. This puts a huge strain, now and throughout their lives, on each individual, their families, communities, the NHS and our economy.


While young people may be less vulnerable to Covid-19 infection, they have been disproportionally affected by the wider impacts of the pandemic. Black and minority ethnic groups, young carers, young people leaving care and those with pre-existing mental health conditions have been hardest hit of all. Worryingly, the National Child Measurement Programme (NCMP) shows that inequalities are widening in obesity, excess weight, and severe obesity across all age and sex groups with the largest increases seen in the most deprived areas. We cannot ignore that we are failing to give future generations the opportunity to live healthy lives and flourish.


The impact of lockdown will also have been significant; with the long period of inactivity meaning that physical fitness may have rapidly decreased, children have been unable to play and undertake activities such as the Daily Mile in nurseries and schools. In addition, for the many children experiencing food poverty, the usual daily struggle to maintain a healthy diet will have been more difficult than ever and in this regard, your decision to extend the Free School Meal voucher system through the upcoming summer holidays is most welcome and applauded.


In London nearly 40% of all London's children are affected by overweight or obesity, and the highest rates occur in the areas of greatest deprivation. The Food Foundation reports that since the lockdown; food insecurity has risen 25% with 1,700,000 children living in households without access to sufficient food. We also know that households of Black, Asian and Minority Ethnic (BAME) communities will be disproportionally affected by the health and financial impact of Covid-19. Tackling these fundamental inequalities will be crucial to making progress.


The opportunity

London's Child Obesity Taskforce was convened in 2018 by the Mayor of London. We are an independent taskforce, tasked with producing a step change in a citywide response to the child obesity crisis and health inequalities visible in the city.


In September 2019, we published our call to action 'Every Child a Healthy Weight'; which outlines ten key ambitions for London. We feel that these ambitions must be realised in order to ensure every child, regardless of their background, has the best chance to enjoy a healthy weight and enter adulthood free from disease. This means creating environments for children to grown up in that enables them to access good quality healthy diets, take adequate physical activity and drink plenty of water; from their early years and right through their lives.


Our unique actions

Our ambitions are about transforming ten aspects of the daily lives of children and their parents/carers. We selected these ambitions and actions after engaging extensively with partners and leaders throughout London and assessing the evidence base. Most importantly, we sought to better understand the lives of children living in poverty and those who care for them.


We wanted to be brave, impactful and innovative in the way we crafted our ambitions and looked outside of the usual remit of what is possible. Understanding the reality of children and young people's everyday lives - i.e. lack of money, poor housing conditions and the working lives of their parents and caregivers, helped us to do this.


We heard how families struggle; when all around them there are temptations to consume foods and drinks that are cheap and bad for their health. This is why, for example, our Ambition 9 focuses on transforming fast-food business. With the total number of takeaway outlets in the UK increasing by over one third since 2010, we want to work with food businesses to improve their offer to children and families.  To start with, we want to see the unhealthy foods and drinks most commonly consumed by young people, and promotions for them, off the menu at times when they are most likely to visit, and healthier options and promotions offered instead.


We understand the importance of creating healthy food environments for families and call for funding for good-food innovation under Ambition 10. We want to see the power on investment harnessed and support responsible investment, in order to make a difference to children's lives. Under Ambition 8, we have called for an extension to wider settings of the ban on HFSS advertising which has been implemented successfully on the TfL Estate, leading brands to switch to healthier products without impacting advertising revenues. We would urge you to support the introduction of a 9pm watershed on junk food advertising both on TV and online.


In regard to sugary drinks, we know these products contribute to dental caries and excess calorie intake. We want water to be the norm, with everyone choosing to refill their water bottle rather than purchasing an alternative drink. This is why, through our Ambition 6, we have worked with Public Health England London to develop a Water Only Schools Toolkit which has been launched in London. We want schools to adopt their own water only policies and take the lead in promoting child health and creating healthy behaviours.


Our ask and offer

We need these changes, and our other recommendations, implemented coherently and consistently while taking a whole-system approach. We must target the root causes of obesity; placing the reality of life for children and their families at the heart of everything we do, ensuring that action is effective and equitable.


We were much encouraged by your recent comments and commitments to tackling obesity, as the root cause of many challenges to a healthy British society.  We are asking that the government work to implement the Child Obesity Plan, published by the Department of Health and Social Care. The Taskforce wants to see the focus on obesogenic environments, as outlined in the plan, made real and pushed further and faster. The existing plan provides a good foundation to tackle obesity in both adults and children, we feel that the work of the Taskforce can support the implementation of this plan by creating a radical difference in how people live, with a fundamental shift in norms, values and attitudes to diet, hydration and activity.  We need to encourage positive behaviour change, encouraging and enabling families to make the healthy choice regardless of their income or where they live. Given your recent experience, and the immense power of this lived experience, and the authority of your office, we ask that you lead this plan personally.


I also ask that we have an opportunity to meet with you soon to share our experience and offer to help in shaping policy that will help all our children reach a healthy weight by increasing the impact of your child obesity plan. By doing this we will be investing in a healthier country of the future. There is a real opportunity to learn from the past and build a better future for children and their families.


I wanted to share a copy of 'Every Child a Healthy Weight' so that you can see the unique way we have approached our task and to allow us to begin this conversation. There is still so much to be done and there is no better time to act than now.


Keep smiling!


Paul Lindley

Chair, London's Child Obesity Taskforce