Of all the policy solutions the public wished for under a Labour government, it’s a safe guess that “drug the unemployed with appetite suppressants until they’re thin enough to work” wasn’t top of the list. And yet here we are, apparently: writing in the Telegraph yesterday morning the Health Secretary, Wes Streeting, announced that, in collaboration with Zepbound manufacturer, Eli Lilly, weight-loss drugs will be trialled as a cure for not just obesity but worklessness.
Obesity, the Health Secretary wrote, costs the NHS £11bn a year – a significant rise on the £6.5bn a year estimated by the previous government this February – but in fact it costs still more, because it is “holding back our economy”. Obese people take an extra four sick days a year on average, and “many people” are excluded from work altogether by their weight.
Previous governments have “ducked” this issue, Streeting wrote, because they feared being accused of being see as the “nanny state”. Doubtless this fear was exacerbated by articles such as this New Statesman op-ed, which described the Labour Party’s decision to ban McDonald’s from exhibiting at its conference in 2016 as “gesture politics” and “virtue signalling of the worst kind”. The author, one Wes Streeting, warmly remembered the teenage years he spent working beneath the Golden Arches.
No one would dispute that obesity is a very significant public health issue, one that may have something to do with the business model of multinational fast food chains. One in every nine adults in the UK – more than five million people – is affected by pre-diabetes, according to the Office for National Statistics. It’s also true that a number of studies have shown a correlation between unemployment and being overweight or obese. These include two longitudinal studies of several thousand adults each that demonstrated “strong associations between job-loss and excess weight gain”.
What these studies show is that job loss can cause people to gain weight. Most would probably accept that this is intuitively true, and that work is – in a very general sense – good for people’s health.
The logic suggested by the Lilly trial is the opposite, however. It proposes that being overweight is a primary cause of unemployment, and that if you can cure people of being fat, you can cure them of not working.
This is not the first time that politicians have proposed intervening in people’s weight for the benefit of our two national gods, the economy and the NHS. In 2012 the Conservative-led Westminster Council proposed cutting benefits of obese people if they didn’t take exercise classes. In 2015, David Cameron agreed that obese people who refused treatment for obesity should have their benefits cut.
To a certain kind of technological solutionist, the weight-loss jabs make perfect sense: the most deprived areas of the UK have the highest rates of obesity, so if we stop them being obese, we’ll stop them being deprived.
It is highly unlikely that the complex economic problems of deprived areas would be fixed by a jab. Economists who specialise in worklessness describe a concerning mixture of general ill health that includes obesity, musculoskeletal problems and mental health issues. Together these long-term conditions are keeping 2.8 million people out of work.
These people are over-represented in areas that have been deprived of transport, investment, skills and opportunities by government policy. The choices about what to eat for people in areas of economic deprivation are often more limited to the kind of foods most associated with obesity, such as ultra-processed foods, or drinks that are very high in sugar. A government that addressed the sharp regional inequality in this country and a health ministry that regulated unhealthy foods might well find that they could have a positive impact on economic growth and therefore employment. A country that just suppresses the appetites of its unemployed risks ending up with a group of thinner people who are still too ill to work.
[See also: Wes Streeting: “I don’t want to be the fun police”]
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