Sugar taxes clearly work - but we must tackle the root cause of obesity too

Sugar taxes have been increasingly deployed by governments looking to combat the obesity crisis but, as Professor Mike Trenell, co-founder and chief scientific officer at Changing Health, explains, they are failing to address the root causes of obesity.

Objections to sugar taxes are always the same: they place a financial burden on the hardest off, we should be encouraging exercise instead, they’ll damage the economy, and so on. Yet there’s one inescapable truth about these kinds of levies: they result in the reformulation of some seriously unhealthy products.

In Malaysia, where a similar number of people live with Type 2 diabetes as in the UK, a recently introduced tax prompted one of the country’s biggest drinks manufacturers to reduce the sugar in 70% of its products. Malaysian consumers keen to continue enjoying their favourite flavours needn’t worry; in the manufacturer’s own words, they “have done sufficient research to ensure the same great flavour, without compromising taste”. 

In France, meanwhile, a flat rate tax on sugary drinks was introduced in 2012 and - in the face of fierce opposition from industry - tiered by sugar content in July 2018. By September 2018, Schweppes and Lipton Ice Tea had reduced the sugar content of their French marketed products by 40%, while sugar in Seven Up and Fanta was down by 30%

Taxation as an effective means of effecting change

Evidently, widespread reformulation of unhealthy products is feasible. Unless manufacturers sense an imminent threat to their margins, however, it simply doesn’t happen. In the UK, the 2010-15 coalition government agreed a ‘Public Health Responsibility Deal’ with food manufacturers in Britain, in which the latter pledged to make their products healthier en masse. 

Three years later, independent studies showed that the deal had had almost no effect on public health whatsoever. While many firms signed up to the deal and agreed to reformulate, few made good on their promise. Of those that did, 37% only made changes they would have done anyway.

But then we changed tack: mandating through taxes. Results were immediate. According to Treasury analysis, manufacturers removed 45 million kg of sugar from the nation’s diet on day one. And the revenue speaks for itself; the government initially forecast £520m in additional income in the first year of tax. Actual revenue was £153.8m. The numbers don’t reflect lower sales; it means manufacturers at last took action on sugar. 

Mandating alone doesn’t address the root cause of the obesity crisis

What’s more, the tax on drinks has given more clout to Public Health England’s warning to food manufacturers to reformulate their own products; as a result, some are now doing so voluntarily as the prospect of a further tax on sugary foods hangs in the air. 

Taxation has, therefore, proved an effective means of enacting change. Yet mandating alone doesn’t address the root cause of the obesity crisis: unhealthy lifestyle behaviours and a widespread lack of understanding of how to change them in a way that’s sustainable and long term. 

What many of us really struggle with in managing our weight is translating an intention to make a change (motivation) into concrete action (volition). In other words: we know full well we need to eat less and move more. What we don’t know is how to fit what may seem like a seismic shift in behaviour into our own unique circumstances. The solution? To make healthy living simple. That can be broken down into two priorities: giving people the knowledge to make a change, and then giving them the psychological skills to sustain it. 

Empowering healthier lifestyles 

The need for knowledge is in helping people eat healthy foods they may well enjoy, but don’t realise it - “little swaps”, as the Changing Health coaches put it. One recent Changing Health user, for example, had slipped into long term unhealthy habits and was living with severe Type 2 diabetes. In the space of just six months, she successfully put the condition into remission by replacing pasta with cauliflower rice, beer with sparkling water (or slimline G&T at the weekends), chicken balti takeaways with homemade veggie curries, and so on. Transforming her health had always been possible - she just hadn’t known she likes these things. She’s by no means alone in that regard.

Empowering people with knowledge also means giving them clearer information about the food they’re eating. For example, ensuring manufacturers make clear when a key ingredient is “sugar”, not dextrose, barley malt, agave nectar, ethyl maltol or any of the 56 other commonly used by-words for the same thing, could go a long way. The traffic light system of displaying nutrition information has, in fairness, made things clearer - but there’s more that could be done. 

The obesity crisis is bigger than too much sugar in our drinks

Giving people the skills to sustain a lifestyle change, meanwhile, is about targeting the psychological drivers of behaviour, showing them how to set practical, long term diet and exercise goals (think S.M.A.R.T: specific, measurable, achievable, relevant, time-bound), respond positively to social influences (moderating alcohol consumption on a night out, for example), and manage relapses (getting back on track after slipping up). 

The obesity crisis is bigger than too much sugar in our drinks. Without addressing the root causes of poor health behaviours, turning the tide on our national weight gain will be impossible. But by empowering the nation with a more comprehensive understanding of diet, nutrition and metabolism, and the ability to act on that understanding, we can bring about lifestyle change that lasts. 

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