Britons Tip Europe's Scale
With Most Obesity Cases

LONDON -- West London's Hobbayne Primary School hands out fruit to its 462 students every morning. It provides a "healthy burst of energy in the morning, not through sweets and biscuits," principal Bob Fletcher says.

It is part of a new program, started this month, that dispenses fruit to a million British students a day, aimed at reversing an alarming trend toward obesity. A 2002 national health survey estimated one-third of all British children between two and 15 years old are overweight or obese, defined as 20% or more over the weight recommended for a person's height and sex. That is 50% from the mid-1990s and, according to the Organization for Economic Cooperation and Development, ranks Britain's obesity problem as the worst in Europe and the third-worst in the world, behind Mexico and the U.S.

TIPPING THE SCALES • Taxpayers Foot More Than Half of Obesity-Related Medical Bills1

Experts warn, though, that it is going to take far more than free apples and bananas to solve a problem that has been building since the early 1970s. "It's great if children are learning to eat fruit, but if they then spend of the rest of the day eating junk food and being inactive, it's not going to make much difference," says Helen Johnson, an officer for the National Obesity Forum, an independent U.K. group formed to raise awareness of the impact of obesity.

Ms. Johnson's group and others are urging a unified effort by the government and private sector -- plus a radical change in lifestyle -- to address a problem now on a par with alcoholism in its financial burden on the U.K.'s health-care system.

In addition to endangering Britons' health, the country's weight problem threatens its cradle-to-grave system of free health care. "There is a time lag between the onset of obesity and increases in chronic disease, so the large increase in obesity since 1980 will have substantial implications for future incidence of health problems and related spending," the OECD said in a 2003 report.

A Health-Care Headache

In 2001, the last year for which figures are available, the U.K.'s National Audit Office said the National Health Service spent around £500 million ($913.3 million or €723.5 million) a year treating obesity-related illnesses, including diabetes, hypertension, cardiovascular diseases, asthma and arthritis. That compares with between £1.4 billion and £1.7 billion spent to treat alcohol abuse last year.

But the audit office expects an additional cost of £2 billion to the economy from lost working days and lower productivity due to obesity. The total cost of obesity to the U.K. economy is expected to rise to £3.6 billion a year by 2010, according to the U.K.'s Department of Health.

British doctors say they are starting to see more cases of illnesses with known connections to obesity -- and they are seeing them striking patients at younger ages. "Put simply, this is due to children eating too much and exercising too little," says Ian Campbell, chairman of the National Obesity Forum.

Broader trends also are to blame. Cities and neighborhoods for years have been laid out in ways that discourage walking and encourage sedentary lifestyles. Britons are increasingly eating out, often feasting on aggressively marketed foods high in fat, salt or sugar. The U.K. market for fast food and home-delivery food grew 5% to £6.8 billion in 2002 from a year earlier and will rise to nearly £7.6 billion a year by 2007, according to market-analysis company Euromonitor International.

Troubling Habits Stew

"We're seeing a generation growing up who simply don't know how to cook healthy meals, as they've been weaned on a diet of burgers," says Angus Armstrong, a general practitioner in the northern England village of Rothbury.

Government officials say they are trying to address the problem through programs such as the fruit giveaway. Public Health Minister Melanie Johnson has also announced a £2 million "Food in Schools program" to create healthier campus food shops and vending machines that dispense less-sugary food and drinks. Vending machines have sprouted on school campuses over the past decade because they can bring in as much as £15,000 a machine a year for schools' coffers; income from two such machines could pay the annual salary of an experienced classroom teacher.

The U.K. Department of Transport is promoting national cycling and walking campaigns, encouraging local governments to make walking in towns easier and safer by improving pavements and crossings and cleaning litter from the streets.

But the National Obesity Forum says both government and business leaders need to do more. Dr. Campbell says the government needs a "unified body or 'Fat Czar' to take overall charge" of the country's obesity problem, as Scotland did two years ago, naming a national food and health coordinator.

The forum's Ms. Johnson says the private sector has a strong incentive to promote better health among employees. The U.K.'s National Audit Office said 18 million sick days were lost in 2001 due to health problems connected to people being overweight, more than the estimated 11 million to 17 million days lost every year from alcohol-related sickness.

A Helping Hand

More companies also need to offer subsidized or free gym memberships, like London law firm Slaughter & May, which gives staff £12 a month toward gym membership. "It's a valued employee benefit, which people appreciate having, and it's important to keep employees healthy," says Martin Havelock, head of personnel. Banking groups HSBC Holdings PLC and Deutsche Bank AG each have subsidized gyms in their buildings here. HSBC gives staff £18 a month toward gym membership and Deutsche Bank £30.

"The food industry also needs to get more involved, says Tim Lobstein, director of the Food Commission, the U.K.'s independent food watchdog. "The food industry should be looking for opportunities to develop new food ranges that meet the needs of the next decade" and advertisers should feel more responsible for what they are selling, he says.

U.K. supermarket chain J. Sainsbury PLC and Swiss pharmaceutical company Roche Holding AG last year expanded a healthier diet program to include the overweight. The program offers doctors the option of sending overweight patients who want to eat more healthily to visit a Sainsbury's supermarket, take a tour and talk with a food adviser. Roche, which markets an antiobesity drug, takes the doctors' referrals and arranges the visits. A J. Sainsbury representative says the 100 food advisers come from a range of backgrounds but are trained by certified nutritionists who work for the grocer. The program was originally put in place by Sainsbury to offer dietary suggestions to diabetics and people suffering from high blood pressure. "Roche is very much involved in supporting healthy-eating messages," says a spokesman for Roche in London.

Last week, Anglo-Dutch food group Unilever Group launched a line of low-carbohydrate foods called "Carb Options," a range of sauces, marinades, salad dressings, peanut spread, bars and shakes, in the U.S., though the company doesn't have plans at the moment to roll out the program in the U.K. "The low-carbohydrate diet in the U.K. isn't as popular here as in the U.S., but Unilever will keep a watchful eye on the situation," says Mike Haines, a Unilever spokesman in London.

But even with healthier diet choices, no one expects Britain's obesity trend to reverse anytime soon. "It's taken the country 30 years to become overweight," says the National Obesity Forum's Ms. Johnson, "so it's clearly a long-term problem."

Write to Susanna Howard at susanna.howard@dowjones.com⁵

Updated January 22, 2004