Issue: 2015, Vol 1, No 2, Pages 41–79

David Cameron for Obesity Czar

Tam Fry

Tam Fry
Spokesperson for the National Obesity Forum

By the time you get to this page, David Cameron may have unexpectedly announced that he, personally, is to lead the UK’s fight against obesity, and childhood obesity in particular. The promise that his Government, if elected, would address the problem emerged in the run-up to the May election, but without any hint that he might make obesity his “mission”. The scuttlebutt around Westminster at the end of June was that a surprise announcement would be made before Parliament’s recess – or earlier – but one never knows with Westminster.

If Mr Cameron genuinely wants to champion what is arguably the most urgent health issue of the day, it will be the most welcome news since Tony Blair ordered up a blueprint to tackle obesity in 1997 (although he then chickened out of doing anything with it!). Cameron, on the other hand, can and must do better than Blair, and he is undeniably the only person in the country with the chance of getting a radical strategy up and running. And radical it must be. He’ll need a team of people to make it happen, but his authority will ensure that it doesn’t get blown off course by roadblocks and rivalries in lower levels of Government and elsewhere. The sound of departmental and industry heads being banged together after 20 years of collectively obfuscating every proposed obesity plan will be pure music.

When and where the Prime Minister’s “light bulb moment” came to him may become known in due course, but it might have been after some plain talking by Simon Stevens, the new head of the NHS. Stevens has made the assertion more than once that, unless there is a revolution in our attitude towards obesity, the health of millions of children and the financial sustainability of the health service itself will be at risk (Boseley, 2014). Clearly, Stevens won’t want to be labelled as the man in charge when the NHS sinks below the waves, and neither will the PM. Following admissions that the Tories’ worst decision in the last administration was to allow Andrew Lansley to screw up the NHS (Smyth et al, 2014), a decision to rescue it with dramatic action on obesity could be a no-brainer. Although, on the face of it, reshuffling either Jeremy Hunt or Jane Ellison out of ministerial duties in the Department of Health is unlikely, a new face in Richmond House to give Stevens political backing would have logic to it. Hunt and Ellison must be considered responsible for the scant activity regarding obesity in the last administration, and a new broom wouldn’t go amiss.

There is also a theory going the rounds in Westminster that Mr Cameron could have been shamed into action by Jamie Oliver, the master of “revolution” in modern times. Here is a man who is passionate about childhood obesity, and his recent announcement that he is to charge a tax, or “child health levy”, on all customers who order sugary drinks in his restaurant chains from September (Templeton, 2015) is not a million miles away from the salvo he lobbed at Tony Blair to remove Turkey Twizzlers from school meals a decade ago. Hunt, Ellison and Cameron himself have, so far, flatly rejected the idea of a sugar tax, but they have done so in the face of an avalanche of specialists who know about the effects of sugar on obesity and who think that such a tax is a “must”. The most up-to-date meta-analysis has linked 184 000 adult deaths annually to sugary drinks (Singh et al, 2015), and someone needs to send a signal to the food and beverage industries that shovelling excessive quantities into their products is no longer acceptable. A degree of sugar may be required in manufactured foodstuffs but, as Oliver knows, the levels are quite superfluous in the majority of soft drinks. For good measure, the tax should also apply to indulgence foods that are not essential shopping items. If people want to eat cake, let them eat cake, but put a high price tag on it to remind them that it should be a treat and not their basic diet.

Mr Cameron must publish his strategy as soon as possible if he is to see any chance of success in this parliamentary term. It is not for this news item to outline what the strategy might be – indeed, you could probably list its bullet points on your next coffee break – but it is essential that it be workable and pass public scrutiny in front of the Commons Health Select Committee. The Committee’s Chair and MP for Totnes, Dr Sarah Wollaston, has already set out her stall and made it quite plain that anything substantive and to do with health will not escape the Committee’s attention on her watch. One should assume a PM’s strategy will not be exempt. When once asked why she, a former GP, had not been offered junior minister rank in the Coalition’s last reshuffle, her response was that her parliamentary record may have been a touch “rebellious”. Now the rebel is “on-side”. With her June election to a second spell as Chair assured by a thumping majority in the House of Commons, she should relish her mandate to give the strategy a serious once-over.

Just who Cameron will recruit to his implementation team may not be revealed with the announcement, but Westminster’s bookies are laying odds on one member who isn’t yet a household name. He is Richard Dobbs, first author of the McKinsey Global Institute report that is frequently cited in this Journal’s pages (Dobbs et al, 2014). This made the headlines in November and listed the bullet points that any obesity specialist would sign up to. Furthermore, it highlighted 44 interventions that had been assessed for impact and cost-effectiveness. Finally, it predicted that, put together in a cohesive strategy, these could help bring 20% of overweight people back to normal weight within 5–10 years. That kind of language might make Cameron’s 2020 target not so impossible to hit. Getting UK obesity down to an “acceptable” level will certainly take years more, but 20% is a start and nothing to sneeze at.

Boseley S (2014) Obesity could bankrupt NHS if left unchecked. The Guardian, London. Available at: (accessed 29.06.15)

Dobbs R, Sawers C, Thompson F et al (2014) Overcoming Obesity: An Initial Economic Analysis. McKinsey Global Institute, London. Available at: (accessed 29.06.15)

Singh GM, Micha R, Katibzadeh S et al (2015) Estimated global, regional, and national disease burdens related to sugarsweetened beverage consumption in 2010. Circulation 29 Jun [Epub ahead of print]

Smyth C, Sylvester R, Thomson A (2014) NHS reforms our worst mistake, Tories admit. The Times, London. Available at: (accessed 29.06.15)

Templeton S (2015) Jamie’s 10p “sugar tax” on fizzy drinks. The Sunday Times, London.