Hilary Sutcliffe explores why processed food firms are free to peddle poison and how mother can actually know best.

Rumour has it that the Labour Party is set to take on the food industry by implementing the main recommendations of Henry Dimbleby’s National Food Strategy  to “break the junk food cycle this interaction between our appetite and the commercial incentives of companies”.  The headline recommendation was a sugar and salt reformulation tax as a stimulus for industry innovation, an incentive that did have some effect with the previous sugary drinks tax. 

Our new research shows Dimbleby was right; that structural policy interventions like these are the key to changing social norms and eliminating the harms caused by the financialisation of the food industry. 

Figure 1 – Revenue and costs to society

These measures are long overdue. The cost to UK society of obesity caused by the consumption of unhealthy foods is now greater than that caused by alcohol and gambling and is eclipsed only by cigarettes in its cost to the NHS, social, informal and unmet care costs, loss of productivity and Quality Adjusted Life Years calculations (see figure 1 Revenue and costs to society).

How did it happen that our everyday food went from being what keeps us alive, to one of the  biggest causes of ill health and preventable death in the UK?  We set up our project: The Addiction Economy and Unhealthy and Ultra-Processed Food to find out. 

The starting point for this research was a question from my son, and now colleague, Joe. “Mum” he asked, “how are cigarette companies allowed to still exist?”.  As so often these days, I looked him in the eye and mumbled, “err, good point.  I don’t know. I’m sorry we screwed this up too.”

How have we allowed killing one’s customers to be normal?

But it set us thinking. How in an industry that kills half of its long-term users, around eight million a year globally, and is the biggest cause of preventable death ever known, allowed not just to exist, but to flourish, in plain sight? The greatest number of preventable deaths come not from war, guns, or car accidents, but from mainstream consumer products. How have we allowed killing one’s customers to be normal? 

Our research put eight sectors under the microscope: cigarettes, alcohol, unhealthy and ultra-processed foods, opioids, gambling, social media, computer games and vapes. 

There was one aspect that they all had in common – they were addictive by design. But that wasn’t necessarily the most important factor. We also saw a surprising coherence in the mainstream yet mundane corporate actions that create and perpetuate markets for harmful products and the political inaction that allows it to happen.

We distilled these into five economic drivers of addiction which are common across all sectors. And we now propose that they are considered an important component of academic addiction modelling; of policy responses to addiction; and of consumer product design regulation (see figure 2).

Figure 2 – five economic drivers of addiction

Addiction is defined by the UK National Health Service as “not having control over doing, taking or using something to the point where it could be harmful to you”. The Addiction Economy is a term we created to describe those industries whose business models deliberately erode our ability to control our usage of their products so we go beyond the point at which it harms us.

A growing body of research demonstrates that it is the addictive nature of unhealthy and ultra-processed products which leads us to eat too much of them, at the expense of ordinary nutritious food. The result is obesity, leading to a variety of damaging health effects, including cancer, high blood pressure and heart attacks, as well as mental health problems and loss of quality of life.

The five economic drivers of addiction that clearly apply to unhealthy and ultra-processed foods are: addictive product design; inescapable availability; predatory marketing; disinformation; and undermining political action.

Addictive Product Design

These products use ingredients which are known to interfere with our ability to regulate our usage – these are sugar; combinations of addictive ingredients, particularly sugar, fat and salt;  product formulations designed for hyper-palatability but with negligible nutritional content and other synthetic ingredients such as some emulsifiers, sweeteners and additives which optimise the enjoyment of the food but have negative effects in the body when consumed as designed..

Inescapable availability

Limitless access makes products unavoidable.  Areas where access to nutritious food is limited and fast and unhealthy food outlets dominate have been dubbed “food swamps”. It’s hard to avoid unhealthy foods if that is all there is to eat where you live.

Figure 3 – 9 frames of disinformation

Predatory marketing

The design of advertising, marketing, pricing and promotion can encourage use and overuse. Examples include: association with positive emotions or situations; promotion by celebrities; ubiquitous advertising, low pricing, targeting of vulnerable people such as poor communities or young people; green-washing or CSR-washing of their activities as part of marketing.

Disinformation

Addiction peddlers put out information or frame others’ information to confuse, distract, and mislead citizens, media, policymakers and the law (see figure 3).

 

Undermining political action

This comprises lobbying, subversion of political processes through donations, litigation, subverting existing regulation, preventing or influencing planned regulation.  

Creating pretty frameworks for corporate responsibility is just what companies want, and mainly a waste of time.

It has taken me 35 years of work for the penny to finally drop that activists like me focusing on company behaviour and creating pretty frameworks for corporate responsibility is just what companies want, and mainly a waste of time. Why? Because these frameworks divert our focus and energy from what works – political action and regulation that constrains the design, availability and marketing of harmful products and prevents their producers from promoting disinformation and undermining political action (See box Nanny or negligent).

Nanny or negligent
Curtailing the harms from Addiction Economy industries challenges certain values and ideologies and is often resisted. Here are the Addiction Economy’s common ideological counters and how they are expressed.

  • The nanny state – we don’t want the “big state” interfering in our personal lives.
  • The right to choose – we should be free to choose to use these products even if it harms us and others.
  • The market will go underground – the illegal market will step in and more dangerous unregulated products will be the result.
  • They don’t work – these policies are ineffective and a waste of public money.
  • Market forces– the market is the best way to regulate society, if people didn’t want them they wouldn’t buy them.
  • Fiscal – these companies contribute to society, give us jobs, and pay taxes, they should be allowed to flourish for the economic good of the country.

We have an alternative perspective, which we believe has increasing support:

  • The neglectful state – citizens increasingly consider that governments are not doing their job properly if they don’t protect the public from harm by predatory companies.
  • Public health – the public interest should override the individual’s right to choose products which harm themselves, or other individuals and society.
  • The rule of law – while prohibition can lead to more dangerous products it is not impossible to create effective laws and enforcement to change social norms around products (cigarette usage has fallen dramatically in countries where the 5 drivers are curtailed, without a huge illegal sector).
  • Effectiveness – regulation has been proven to work best.
  • Ideology – as a society, we must prioritise the public interest, we cannot afford to subsidise the social costs of the harms caused by any companies.
  • Financial – these industries are a net drain on society and should be incentivised to ditch harmful products and innovate in ways which nourish people, not damage them.

Companies don’t change unless the incentives designed into policy and regulation override the incentives of the market. And even then they will take every opportunity to exploit any loopholes like cereal companies in Mexico making their packs double-sided when mandatory traffic-light labelling was introduced, and then paying supermarkets to display the back of the pack on shelf.

Capitalism, like water, finds a way. Some are concerned about the economic damage of constraining food businesses producing harmful foods. But government actions and regulation don’t just prevent bad things happening, they also stimulate innovation and creativity.  When constraining the market for unhealthy and ultra-processed foods, regulation can also, if well designed, liberate the market for nutritious food. As well as preventing harmful products from flourishing, regulators should focus on ways to support innovations which nourish not harm.

 

Hilary Sutcliffe

Hilary Sutcliffe is the Director of UK not-for-profit SocietyInside and co-leader, with Joe Woof, of The Addiction Economy Project SocietyInside has for over 20 years been dedicated to putting people …

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