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SAMJ: South African Medical Journal

On-line version ISSN 2078-5135
Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.107 n.11 Pretoria Nov. 2017 



Promoting obesity



Recently I paid my annual visit to the cinema, to see the new 'Blade Runner' on the big screen (I usually prefer a DVD and the comfort of my own home). Before I went, my mother remarked that I must be sure to get myself one of the enormous boxes of popcorn and huge cups of sweetened fizzy drinks that she had seen on one of her rare trips to the cinema last year. Sure enough - while my husband and I waited to get into the show - we saw countless people, children and adults alike, with boxes of popcorn ranging from what to me looked like large to gigantic, but are probably marketed as small to extra-large, and 750 mL cartons of drinks. And with few exceptions the people consuming this junk food were extra-large themselves, including the children. Earlier that day I had happened to be standing in line in Clicks, and noticed that not only did they have the usual assortment of sweets, crisps and fizzy drinks for sale in the pay-point aisles, but they were promoting a 'meal deal', which was made up of a packet of crisps, a sweet and a drink - the cheapest being free. Even more remarkable, one of the most utilised medical aid companies in the country offers popcorn and sweetened, fizzy drinks at a local cinema chain as 'rewards' for hitting exercise point targets each week! It is no wonder that a recent report in The Lancet shows that a staggering 30% of the world's population are obese or overweight.

At the same time, this week's BMJ carries a story showing that in the UK spending on junk food advertising is nearly 30 times what government spends on promoting healthy eating.[1] The analysis used data from The Grocer magazine's top 100 list of advertising spending on fast-moving consumer brands, which identifies brands commonly associated with crisps, sweets and sugary drinks. The analysis showed that companies producing the top 18 UK brands spent more than GBP143 million (USD190 million) on advertising their products last year. This was about 27.5 times the GBP5.2 million annual spending by the UK government's flagship healthy eating campaign, run by Public Health England. On top of this, the UK's National Health Service is spending around GBP38 million a year on weight-loss surgery and about GBP5.1 billion a year on treating obesity-related conditions.

Locally, South Africa (SA) records the highest obesity rates on the continent, with almost 70% of women either overweight or obese according to the latest South African Demographic and Health Survey.[2] Our local Advertising Code of Practice was amended in 2008 to limit the marketing of unhealthy foods to children aged under 12. But a National Department of Health policy to increase this to all school-age children has been stalled for several years. And there is plenty of evidence to suggest that junk foods are cheaper than healthy alternatives. A recent article in the Daily Maverick quotes Prof. Vishwas Satgar, chair of the board of the Co-operative Policy Alternative Centre (COPAC), as saying that people sometimes eat junk food out of necessity, as it is cheap (and easily available).[3]

However, people and organisations like COPAC, who are advocating changes in food policy and trying to promote accessible, locally produced, fresh, nutritious and culturally appropriate food, are up against the food industry giants. Junk food advertising follows that of tobacco (now banned in SA) and alcohol (the advertising of which probably should be banned) in that it plays on people's social aspirations, promoting drinking Coca Cola, for example, as being 'cool'. In sub-Saharan Africa in 2016 alone, Coca Cola spent over ZAR518 million on advertising, according to Nielsen.[4]

Various local public health experts say that measures such as the proposed tax on sugary drinks and any future tax on unhealthy foods are a start, but educating people on how sugary and processed foods affect their health is also important. We also need to look at food production and distribution, which have a major effect on how people eat. We cannot expect the food industry to regulate itself. We know that all too well from the tobacco and alcohol industry. The food giants are just as dangerous to people's health.



Bridget Farham




1. O'Dowd A. Spending on junk food advertising is nearly 30 times what government spends on promoting healthy eating. BMJ 2017;359:j4677.        [ Links ]

2. South African Demographic and Health Survey 2016. Key Indicator Report. (accessed 16 October 2017).         [ Links ]

3. Green A. Health-e News: 'Ban junk food adverts. Daily Maverick 2017. (accessed 16 October 2017).         [ Links ]

4. Nielsen Sub-Saharan Africa. Africa's Prospects. 2017. (accessed 16 October 2017).         [ Links ]

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