Obesity in England is nearing epidemic proportions with one in five adults now dangerously overweight, costing the economy and NHS £2.6bn a year, the national audit office warns today.
More than 31,000 people a year are dying prematurely - 6% of all deaths - because of a lifestyle of fatty diets, over-reliance on the car and energy-saving devices such as lifts and escalators.
In a stark report sure to revive the spectre of the nanny state, the national audit office (NAO) warns that in 10 years obesity levels could reach those of the US, where a quarter of the population is obese, unless more action is taken by government, employers, the food industry and individuals.
In addition to the 21% of women and 17% of men in England regarded as obese, another 32% of women and 46% of men are overweight. This means nearly six in 10 adults - more than 20m people - should change their lifestyles, say the report's authors.
England, where obesity levels have tripled in 20 years, already has one of the worst records in Europe. Studies have also shown alarming rises in children's weight. As many as one in 10 children aged four or under is obese, while one in four is overweight, research in the British Medical Journal revealed last week.
Philip James, the professor who first persuaded Tony Blair to establish the food standards agency, and who now chairs the International Obesity Taskforce, suggested there should be a new public health lifestyle council, as exists in some Scandinavian countries, together with a cabinet-rank minister to tackle public health reforms "forgotten since the advent of the NHS."
He added: "We need to focus on transforming the diet of children and adults, even if the initiatives threaten some components of the food and soft drinks industries."
Obesity is measured using body mass index (BMI), which is the person's weight in kilograms divided by their height in metres squared. A BMI of 20 to 25 is normal, 25 to 30 is overweight and more than 30 is obese. A man of about 5ft 10in weighing more than 15 stone or a woman of 5ft 6in and 13.5 stone would be regarded as obese.
The report says treating obesity and related illnesses cost the NHS about £500m in 1998. The loss to the economy, through 18m days of sickness and 40m days of working life through early death of workers, was £2.1m. But this took no account of conditions where proportions due to obesity could not be calculated, including back pain, one of the most common causes of absences.
The report illustrates changing lifestyles by using earlier studies which suggested the number of 17-year-olds walking to school fell from 59% to 49% between 1986 and 1996 while car journeys to schools doubled. Average television watching in England doubled from 13 hours a week to 26 over 30 years to the mid-1990s and a recent government-funded study of the diet of 4 to 18-year-olds revealed average consumption of fruit, vegetables and fruit juice was 188 grams a day, less than half the 400g recommended for adults.
Life expectancy
The report says problems of obesity and excess weight increase with age, so that while less than 30% of 16 to 24-year-olds are above normal levels, seven in 10 over-65s have a problem. The prevalence of obesity grows among lower socio-economic groups. Obesity is reducing life expectancy by nine years on average, according to the report. But only one in seven health authorities has a plan to prevent or treat obesity and only 40% of GPs attempt to identify patients at highest risk of excessive weight gain.
The report calls on the government to build on existing cross-cutting Whitehall initiatives, including the NHS plan on nutrition, on increased participation in sport and on supporting healthier methods of transport. The NAO is particularly worried by inconsistency between certain food industry sponsorship of schools and initiatives designed to promote balanced diets. "Schools have participated with businesses in schemes to provide free books and maths equipment in return for tokens from crisps and biscuit packets. This type of commercial involvement, which has the effect of directly promoting sales of particular products, may encourage children and their families to buy more snack foods with a high fat, salt and sugar content."
James Robertson, director of health value for money at the NAO, said yesterday "It is a mistake to say there is a problem which cannot be tackled . There need not be a counsel of desperation. We are not seeking a nanny state." Suzi Leather, deputy chairman of the food standards agency, said: "We won't fight flab with only willpower. Consumers also need to be armed with information about the nutritional content of food. Improved labelling could do a great deal to help."
But the food industry, while cooperating with government and health bodies in attempting to reduce levels of ingredients such as salt in the public's diet and providing lifestyle advice, remains suspicious of state dictation. Martin Paterson, director of public affairs for the Food and Drink Federation, said: "Since the days of Edwina Currie, nannying is a busted flush. It may be well-meaning but never works. Education is the only key."
Fat facts
Main findings
• Obesity in England has tripled since 1980
• 1 in 5 adults is now obese, by 2010 it could be 1 in 4
• Two-thirds of men and over half of women are either obese or overweight
• Obesity costs the NHS at least £500m a year and the economy another £2bn a year
Trimming tips
• Take at least 30 mins of light to moderate exercise, such as a brisk walk, five times a week
• Eat a piece of fruit or drink fruit juice with every meal
• Eat two portions of salads or vegetables for main meals
• Rice, pasta or potatoes should take up about a third of your plate for main meals
• Eat fish 2-3 times a week
• Use semi-skimmed or skimmed milk
• Avoid salt
• Keep sweets, etc, for special occasions
Related story
'I liked feeling full. I thought about it all day'
Fat is fab
