Madam Deputy Speaker (Caroline Nokes)
We now come to the Select Committee statement on behalf of the Health and Social Care Committee. Layla Moran will speak for up to 10 minutes, during which there will be no interventions. At the conclusion of the statement, Members may ask questions on the subject of the statement; those contributions must be questions, not speeches.
Layla Moran (Oxford West and Abingdon) (LD)
On behalf of the Health and Social Care Committee, it is a pleasure to present to the House our report on the obesity moonshot, our sixth report of this Parliament. It is also the final report in a series from our inquiry on food and weight management, drawing together our two previous reports on the food environment and obesity treatment.
What if I said that there was a life-limiting condition that affects a third of adults in this country—one that costs the Government at least £74 billion a year, and for which they have no coherent plan? I am afraid to say that this is the case for the relapsing, remitting condition that is obesity—a condition that, if left untreated, is associated with dozens of others, from cancer to diabetes to heart disease and fertility problems. Why have we got here? In short, it has happened because of an enduring underlying stigma that that condition is in some way a personal failing of individuals, rather than a largely preventable and demonstrably treatable disease that society and the Government need to take as seriously as any other.
In July last year, we launched our inquiry into food and weight management to better understand the public health challenge of rising rates of obesity. We asked why, despite there being at least 14 Government strategies and nearly 700 individual policies since 1992, efforts to reverse the tide of the country’s obesity crisis have failed spectacularly. The latest Government policy—the so-called moonshot—was announced in the Government’s 10-year health plan, with an ambition to “end the obesity epidemic.” That is certainly a laudable aim, but it faces the unfortunate pitfall of lacking any real substance, and our concern is that, without significant work, it is doomed to fail. We want this to succeed. If we are going to call it a moonshot, let us look at its destination, at its flight path and at who is in command. Can you tell that I am a Star Trek geek, Madam Deputy Speaker?
Obesity is a crisis. Among reception-age children, it has now reached a level of 10.5%. That is the highest it has ever been. It is a shocking figure. When we asked Ministers what they expected from the trajectory of the moonshot—do we expect the rise to stop, level off or go down, and over what period and with what targets?—we did not get any coherent answers. That is just not good enough. How do we know if we are reaching where we want to go if we have not even defined the destination?
Next, let us look at how we might get there: the flight plan. We found a muddled relationship between prevention and treatment in conversations about obesity. I hear this all the time. If someone is living with obesity, immediately the conversations about it turn to the food system. However, the fact of the matter is—and this is the bit that I think most people do not understand—if someone has lived with obesity for a long-enough period of time, their underlying physiology changes. It is no longer enough simply to point to lifestyle changes or to ask for changes in the wider environment. There must also be a clinical pathway that those people can follow, and that is simply not what happens.
Let us take another example that is not dissimilar. A bariatric surgeon told us,
“I still see lung cancer every day in my clinical practice, and I have to treat it…Nobody questions whether those patients should get chemotherapy”.
But if someone presents with obesity, that is exactly what happens. We do not tell someone living with cancer to stop smoking—it is too late by that point. Yes, ideally, we stop them in the first place, but we also need to be able to treat the problem in front of us. One reason we have not turned the tide on obesity so far is the failure to treat prevention and treatment as distinct but interoperable.
Let us take each in turn. On prevention, our report on “Fixing the food environment” focused on the action that the Government must take to prevent people from living with obesity in the first place, bearing in mind that two thirds of the British population are either living with overweight or living with obesity. The food environment has significantly changed—certainly since I was a child in the ’80s—towards an environment of more heavily marketed ultra-processed food. These changes have coincided with increasing levels of children and adults living with obesity. Current food policy regulations lag woefully behind, and that hardly comes as a surprise given that the model underpinning our food regulation is nearly 22 years old. The 2018 replacement still has not been implemented. The regulation of our food industry is built on out-of-date scientific advice, so we urge the Government to introduce the 2018 nutrient profiling model as soon as possible and no later than the end of 2027.
Some of our other recommendations from the report include: launching healthy sales reporting as soon as possible so that supermarkets must declare the number of healthy products they sell; introducing mandatory front-of-pack labelling by January 2028 so that customers can make their own choices about a product’s nutritional value; banning outdoor advertising of foods high in fat, sugar and salt by July 2027, and consulting on extending that to social media; updating the national planning policy framework to better support councils to challenge fast food outlets, particularly those that want to open near schools; and, critically, excluding food businesses that derive a certain proportion of their profits from the foods causing this harm.
We also recognise that cost is a factor. In our inquiry, we heard that healthier food costs more than twice as much per calorie as unhealthy alternatives, and the fact is people living with obesity are disproportionately from low-income backgrounds. In 2024, only 8% of those aged between 11 and 15 in the least deprived areas were living with obesity compared with—this is staggering—30% in the most deprived areas. For too many families, a healthy diet is simply out of reach, and the Government should do more to support them. While the Healthy Start scheme is a great start, it need to be reviewed regularly, especially to keep pace with food inflation. Community projects do great work, but they need stable funding to succeed.
On treatment, our second report, “Modernising obesity treatment” turned to the millions of people already living with obesity; I do not have any shame in saying that I am one of them. When I was in my 20s, I had a life-changing bariatric operation that saw me lose 60 kg, but to say it is over is far from true. People living with obesity know that it is a lifelong battle. The emergence of GLP-1s could help many more people much sooner, but it is no silver bullet. We also know that just 6% of those eligible are currently on it. Those who can pay go private, but those who cannot are either left behind or turn to a dangerous—and it is dangerous—black market. Access to treatment is increasingly decided by ability to pay and not clinical need. Last time I checked, that was not something that the NHS claimed it did.
But GLP-1s are not the only treatment for many people. In 2024-2025, 6,500 people in England had bariatric surgery. France, by contrast, has lower rates of obesity and yet carried out 60,000 operations—as I said, they are life-changing. We recommend that the Government publish a modern service framework for obesity as soon as possible. They need to name it publicly as the lifelong, relapsing condition that it is and focus on expanding capacity across all treatment options, creating an improved, simplified and person-centred pathway of care and improving training for healthcare professionals.
Finally, who is in charge? Fellow parliamentarians will have noted that this issue lies not just in the Department of Health and Social Care; it is also across the Department for Digital, Culture, Media and Sport and local government. It needs gripping from the top. If there is another reason why tackling obesity has failed, it is simply that who pays and who is accountable is too dispersed across government. We recommend a cross-Cabinet Committee chaired by the Prime Minister himself because this should be a national priority. I appreciate that he has given himself a lot to do, but I urge him to look at this issue, which affects two thirds of our population and the most deprived parts of our society. The Committee wills the Government to succeed on this, although I am afraid to say that, from where we sit, we think the mission might be not just doomed to fail but not even launched yet.
Josh Fenton-Glynn (Calder Valley) (Lab)
Taking part in this inquiry was eye-opening. It was interesting to see the Public Health Minister’s predecessor tell the Committee that we would treat obesity in future as a relapsing-remitting condition. I hope the current Minister will undertake to follow through on that so that we can update all our guidance. Does the hon. Member agree that central to the problem of how we treat obesity is that we see it as a one-time thing? Like a broken leg, it is treated once, the people lose the weight and then we let them go, with the result that too many people get GLP-1s without the support on diet and lifestyle that comes along with them, and they are not followed up on. Would it not make a lot more sense if the health service treated people in a person-centred way and helped them recover from this relapsing-remitting condition of obesity?
Layla Moran
I am extremely grateful to the Committee member for his question—he is absolutely right. We had a roundtable with lived experience witnesses and they all said the same thing. Even though many had had aspects of treatment over the years and had tried every conceivable diet, what was disheartening was that they would go to their GP and face that wider stigma from the GP themselves, who would tell them that they just needed to tweak things in their modern life. It just does not work that way. Naming it as a relapsing-remitting condition, putting it up there as the public health challenge it is and focusing in on it in the way that we are so good at doing when we want to in this House is the answer—I completely agree with him.
Tom Gordon (Harrogate and Knaresborough) (LD)
I was pleased to see the wealth of experience that the Select Committee drew upon, including from organisations such as Diabetes UK and Yorkshire Cancer Research. The report asks for a target to cut obesity. That is welcome, but does my hon. Friend the Chair of the Select Committee agree that we need to have additional sub-targets and metrics to ensure that progress is equal across all our regions, because we know a north-south divide still exists and there are persistent issues when it comes to health inequalities, including obesity?
Layla Moran
I am grateful to my hon. Friend for his point. He is exactly right that there is a huge disparity. We know that healthy food is too often out of reach for those on the poorest incomes, especially so when it comes to children, and that is not reflected currently. That is what we hope the modern service framework might start from—how we close that patchwork of services across the country and make inequality one of the core missions of this Government through this policy.
Alex McIntyre (Gloucester) (Lab)
I thank the Chair of the Select Committee for her statement. Most of the House will know—I have spoken about this publicly—that I have had a lifelong battle with obesity. It was only when I was diagnosed with type 2 diabetes at 33 years old last year that the NHS stepped in to help. Since then, I have lost seven and a half stone through the diabetes path to remission programme. My plea to the Minister for Public Health and Patient Safety, who I know is listening intently, is that those of us with lived experience of obesity and overweight are included in the conversation about how we tackle this, because for too long people who have not experienced it have dictated to those of us who have, about how best to go forward.
The path to remission programme for type 2 diabetes is referenced in the report and its conclusions because it is a proven weight loss intervention, but it is currently only available to a small subset of people with type 2 diabetes. Does she agree that this cost-effective and efficient way to help people like me to lose weight should be rolled out to people living with obesity nationally?
Layla Moran
I pay enormous tribute to the former member of the Committee. I can entirely understand why he was elevated to other things, but he was very much my right-hand man through the obesity side of this inquiry. I completely agree with him—it was stark. We know what works, and the path for how we do this is clear, but what was missing was a joined-up approach, not just across Departments but within the NHS itself. He is completely right that there are things that work and we know what we need to do, but at the moment we are not seeing that joined-up approach that we need Government to take to achieve it.
Ian Roome (North Devon) (LD)
Given that child obesity is at record levels, what single intervention does my hon. Friend believe would make the greatest difference to preventing children from developing obesity in the first place?
Layla Moran
I am extremely grateful to my hon. Friend for his question. The rising rates of obesity among reception-age children should give us real pause for thought. If we ever wanted proof that obesity is not an individual failing, it is the fact that it seems to be most acute among that population. There is no silver bullet—that is the trap we fall into—despite the lobbying not to do this or that, whether that is about the food industry or advertising. It will never be one thing. It will be a suite of measures that we put around children: stopping fast food joints being on their walk to school; supporting their families with sustained funding, so that they can have healthy food at home; and bans on advertising, which we know works on children, because otherwise, why would the companies do it?
Jim Shannon (Strangford) (DUP)
Many moons ago, in 2009, long before I had the pleasure of meeting you, Madam Deputy Speaker, or anybody in this Chamber, I used to be 17 stone. I was a big fat pudding—I am calling myself that. I was eating Chinese food five nights a week with two bottles of Coca-Cola. It was the wrong recipe, with lots of stress. When I became a type 2 diabetic, I realised I had to lose weight. I lost 4 stone, and I have kept it off. I tell that story because sometimes we do not know things are happening until the doctor tells us.
I think of the children in school. I am very fortunate to have six grandchildren. The wee ones especially—the six-year-old and the four-year-old—eat their fruit and veg every day, all day, which is really good. My question is, does the hon. Lady agree that if we want to change habits, we must engage and educate our young people about eating fruit and veg, and if they cannot have it at home, they need to have it at school, starting at primary level?
Layla Moran
All credit to the hon. Gentleman. As I said, I have faced a similar journey, and it is hard to keep the weight off, because once we have lived with it for a long while, our underlying endocrinology changes. People need to appreciate that if we allow young people to live with obesity, it affects their whole life. With any luck, we can avoid the point where they end up with diabetes, which can be reversible, as we know. He is completely right: this needs to happen in school, but it is not just about school. We need to recognise that when those children are at home, their families need help. We need to drive down the prices of healthy fruit and veg, and that needs a joined-up strategy with the Department for Environment, Food and Rural Affairs. That is why we are calling for a cross-Cabinet Committee—because if any one Department tries to do this on its own, it will continue to fail.
Madam Deputy Speaker (Caroline Nokes)
I thank the Select Committee Chair for her statement and all Members who shared their stories.