HC Deb 22 March 1996 vol 274 cc668-82

Order for Second Reading read.

1.33 pm
Mrs. Alice Mahon (Halifax)

I beg to move, That the Bill be now read a Second time.

This is the second year that I have moved the Second Reading of my Bill. It is moderate, but it would ensure that all medicines claiming to aid would-be dieters be registered under the Medicines Act 1968. All products or treatment would contain a warning that rapid weight loss may cause serious health problems. The qualifications of all providers—including personnel of weight-loss centres such as Weight Watchers—would be listed. The recommended duration of a weight-loss programme would have to be shown on all products and in all advertising.

Information about the potential health risks of any programme, its nutritional content and the psychological support and educational components must be made available on request. Customers should know the price of the treatment, including the price of any extra products, services, supplements or laboratory tests. A notice containing that information should be conspicuously posted in every room in which weight-loss people treat customers. The notice should also be prominently displayed on all products advertised and sold.

At present, the diet industry can claim almost anything it likes about its products. When those products fail, as they invariably do, the woman—it is usually a woman—blames herself and moves on to the next useless and usually expensive product.

The Bill is long overdue and very necessary. As any examination of this multi-million pound industry reveals, it is completely unregulated. It fails to warn potential clients of the health risks and adverse side effects associated with rapid weight-loss programmes. The customer is often not given information on the qualifications of staff, the details of research carried out into the weight-loss programme, if any, or the costs of the programme if it is prolonged for any length of time.

The Bill is intended to support the aims of Diet Breakers—an excellent organisation founded by Mary Evans Young, which is now international. On No Diet Day on 5 May, women throughout the world will celebrate from Helsinki to Australia to Canada. [Interruption.] The hon. Gentleman who is making remarks from a sedentary position could easily find out for himself that it is a growing movement.

Mr. Michael Fabricant (Mid-Staffordshire)

For all the people who will supposedly celebrate No Diet Day, how many will be dying because they are wildly obese? There are enough obese people in the House of Commons. All one has to do is look around the streets of the United Kingdom or Australia to see that more people will be dying than celebrating No Diet Day.

Mrs. Mahon

I shall make that into a more serious point. I imagine that more people die in the third world because they do not get enough to eat and they are literally starving to death. That includes thousands and thousands of children every year.

When it celebrates No Diet Day, Diet Breakers will draw attention to the perils and futility of dieting other than for medical reasons such as diabetes. It will encourage a healthier way of living and point out that dieting undermines women's emotional and physical well-being, and is often the first step to far more serious eating disorders.

The truth is that, if one wishes to lose weight, there is no safe alternative to exercise and healthy eating. We all come in different shapes and sizes. It is not written on tablets of stone that we should all conform to a certain size. Yet the fashion industry and the image-makers put enormous pressures on women, girls and, increasingly, young men. One has only to look at the advertisements for jeans, where we see a requirement to have a certain sized bottom. The image-makers put enormous pressure on women and girls to be unhealthily thin. [Interruption.] I know that it causes great amusement on Conservative Benches, but there is a serious health problem. I never expect anything serious from the hon. Member for Mid-Staffordshire (Mr. Fabricant), so I am not surprised that I am not getting anything serious now.

Dieting has reached epidemic levels in the west. The figures show that 90 per cent. of women will diet at some time in their lives, and that, at any given time, 50 per cent. of women are dieting, including children as young as nine and women as old as 75. It is tragic that powerful image-makers are encouraging western women and girls to starve themselves by dieting, when, in other parts of the world, people are genuinely starving.

We in the west are being bombarded and subjected to what 1 call a tyranny of thinness. We see all the subliminal messages on billboards and television screens and in magazines—not forgetting the catwalks—trying to tell us that we cannot look nice unless we imitate models who are too thin anyway. These messages also imply that we are valued for our looks alone—a distressing idea. There seems to be a cult encouraging the oppression of fat people and disseminating wrong information about healthy eating and exercise.

An article in the local press recently brought home to me just how much this cult has influenced our way of thinking. Under the headline "You're too fat", there followed a story about a woman called Sharon Lynch, who was turned down for a job at the Royal Halifax infirmary because, she was told, she was too fat. She had sailed through her interview for the post of nursing auxiliary. She had passed a medical, and knew that she was quite fit, and she had already worked as a nursing auxiliary in a private nursing home. She said that being told she was too fat left her feeling angry and humiliated, and she suffered a loss of confidence. The doctor told her that he could do nothing and that, if she really wanted the job, she had better do as she had been advised and lose weight. That is gross discrimination against someone whom the manager of the trust deemed too fat. It was personally insulting, and bore no relation to the woman's fitness.

We know that obesity can cause health risks, but the answer is to visit a doctor and go on a properly controlled diet. It is no answer to go for one of the "miracle cures" available from quacks or for any of the useless products that are on display just about everywhere.

For most people, these diets do not work. We know, in fact, that 96 per cent. of them are not effective. Dieting can cause other serious problems. The Select Committee on Health is carrying out a major inquiry into the health of children, so I asked the Department of Health for some information about eating disorders, which are predominantly diseases of young females between the ages of 14 and 25. It is now becoming apparent, however, that a growing number of children suffer from serious slimming disorders such as bulimia and anorexia nervosa. Moreover, women sufferers outnumber their male counterparts by 10:1.

I have always believed that the epidemic of dieting in western society is responsible for the increase in slimming illnesses. Many people will rightly claim that some eating disorders are a result of a combination of factors; so they are, but social influences that encourage dieting and suggest an equation between beauty and slimness play an important part in the fact that women succumb to these illnesses.

Dr. Bridget Dolan, of St. George's medical school and the European Council on Eating Disorders, recently said: Dieting causes more problems than it solves and can lead to serious eating disorders. Anyone embarking on a diet should consider the long-term consequences. A proportion of sufferers need psychiatric care. The services offered by the NHS in this respect are poor. According to the Department of Health, in 1992 the Royal College of Psychiatrists identified only 21 specialist centres, of which only 11 had in-patient beds. There were no NHS specialist centres for children. It is typical of the Government that the private sector is moving in to fill the gap.

I draw the attention of the House to an excellent organisation, the Eating Disorders Association, which includes people whose relatives—daughters, sisters, mothers and so on—suffer from these serious illnesses. It believes that the pressure on women to be thin causes them to diet, and that that leads to slimming illnesses and serious results. It is a voluntary organisation, giving information and advice about anorexia and bulimia, and has a huge database of knowledge on what has happened to sufferers of eating disorders. We should listen to people who have grass roots knowledge.

One important regulation that my Bill hopes to introduce is that pills, potions, patches—anything of that nature—should be included under the Medicines Act 1968. Something needs to be done about the scurrilous misuse of amphetamines and amphetamine-type drugs. The use of such drugs for slimming purposes can and does have devastating effects. In some cases, it has led to serious illness and deaths in young females.

Last year, in a similar debate at about this time, I asked about the progress of a study by the Medicines Control Agency—an executive agency of the Department of Health—into the use of these drugs. It has been consulting for some time with a view to restricting the use of certain amphetamines and amphetamine-type drugs and to banning them from being used for slimming purposes.

Yesterday, I had a reply from the Minister for Health. I asked about 10 days ago when he expected to make an announcement on the use of amphetamines for slimming purposes. We have waited more than a year now. The reply that I received said: An announcement is expected to be made shortly concerning the availability for slimming purposes of a range of medicinal products known as anorectic agents."—[Official Report, 21 March 1996; Vol. 274, c. 318.] We have waited a long time. I am not sure how much longer we have to wait. While we wait, the misuse of these drugs continues to wreck lives. Slimming clinics and others continue to dish them out like Smarties. Last year, when the Minister for Health spoke in the debate, he appeared to be convinced that something needed to be done. I quote exactly what he said in a press release. These drugs are ruining people's lives. We know families that have broken up because of personality changes in people taking these pills. We know that it is worse than that: people have died or have been made seriously ill. But still there has been no action. It is a coincidence that today in the Daily Mail is a major article, by Edward Verity and Jenny Hope, on the use of these pills by a well-known member of the royal family who has risked her health by taking pills to lose weight. I quote from what Jenny Hope has to say about the use of slimming pills: The use of slimming pills to generate quick weight loss is being reviewed by the Government following fears they are being abused. Amphetamine and amphetamine-type drugs such as phentermine and fenfluramine are widely prescribed by private slimming clubs. But a clampdown was announced last May by the Government"— that is not true— which said some doctors were acting unethically by giving them to women who did not have a 'clear medical need'. Action has not yet been taken.

The article continues: The death of Christine Malik, 31, in 1994 was attributed to her use of slimming drugs. She died five days after being prescribed a cocktail of diuretics, appetite suppressants and hormone drugs at a private London clinic. An inquest was told that she died from multi-system failure, which a medical expert said on the 'balance of probabilities' was brought on by the drugs. The General Medical Council has warned doctors not to prescribe the drugs except in rare cases where patients need to lose weight quickly. Today, 12 months since the last time that I brought such a Bill before the House, we are still talking about "considering" the use of those drugs. It is time we stopped considering and started doing something about it.

I put on record my thanks to the National Food Alliance working party on advertising, for publishing a report of its survey of slimming advertising, entitled "Slim Hopes". That is an excellent document, and I am really pleased that someone has taken seriously the role that advertising plays in that multi-million pound industry.

In fairness to the Advertising Standards Authority, it too has recognised that slimming advertising is a problem area, and its own survey found that a high percentage of advertisements for slimming products were in breach of the British code of advertising.

I shall summarise quickly what "Slim Hopes" found. The researchers examined 89 advertisements for 49 slimming products or services. Of those, 36 appeared in slimming magazines, 30 in women's monthly magazines, 14 in the popular press, and 18 in women's weekly magazines. Only one was found in a teen magazine, because slimming advertising is not allowed to be directed at the under-18s.

The advertised products and services included pills, creams, slimming clubs, food supplements, exercise equipment, body wraps, slimming belts, books, videos, alternative treatments, slimming courses, foods making slimming or calorie-control claims, and cosmetic surgery. So the survey took a thorough look at what the advertising industry goes in for.

Of the 89 advertisements, only 11–12 per cent.—were considered acceptable. Seventy-eight advertisements—88 per cent.—were considered to be in breach of the code. That is the scale of the difference between the claims that products and services can do something for people who are worried about their weight, and the truth of the matter.

Mr. Charles Hendry (High Peak)

I have been following the hon. Lady's argument with great care. Does she think that the people placing the advertisements and the professionals involved in the dieting industry are deliberately misleading customers, or is it naivety on the customer's part? Does she not believe that more could be done by tightening a voluntary code, rather than by legislation?

Mrs. Mahon

I believe that a deliberate con trick is being foisted on women, after they have been led to believe that they are ugly if they are not incredibly thin. An awful lot of money is being made out of people's miseries and fears, as they lose confidence in themselves. I think that that is deliberate. People must know. Major multinational companies have every resource at their disposal, and they could soon find out whether a product that they were selling and advertising did what they claimed.

The largest number of advertisements considered to be in breach of the rules—33 advertisements for 21 products—were found in the four slimming magazines examined—Health and Fitness, Slimmer, Slimming and Weight Watchers Magazine. That is trading on people's vulnerabilities and misery.

In the 10 women's monthly magazines examined, 27 of the 30 advertisements were considered unacceptable. The 10 women's weekly magazines examined included only eight slimming advertisements, which were all considered to be in breach of the code. Six national tabloid newspapers and four Sunday newspapers were examined and found to contain 14 advertisements, of which 71 per cent. were considered to be in breach of the code. It is true that the majority of miracle weight-loss claims appeared in newspapers and not in magazines.

The "Slim Hopes" report says: The single largest category of advertised products in the survey were foods making slimming or calorie-control claims (37 such advertisements) of which only 6 advertisements for three products were considered acceptable. Virtually all were considered to be in breach because they failed to state that they cannot aid slimming except as part of a diet in which the total calorie intake is controlled. That aspect was common to all the advertisements. Advertisers failed to say in the small print that a near-starvation diet is necessary to achieve what they claim.

The report goes on: Problem areas identified by the survey included 'miracle' claims, excessive weight loss claims, claims that failed to state the time period over which weight was lost, creams that claimed to have a physiological effect and exercise equipment and wraps which claimed weight loss. The report clearly confirms that compliance with the code remains unacceptably low.

"Slim Hopes" made superb recommendations; I may have to change my Bill to catch up with them. "Slim Hopes" recommends that the Advertising Standards Authority should fully investigate all advertisements considered by this report to be in breach of the rules and to take effective action against all transgressors of the Code. Some of us are putting pressure on the ASA to do just that.

On the vetting of advertisements, "Slim Hopes" recommends that Publishers should be instructed not to accept adverts for slimming products unless they have a certificate of pre-clearance from the ASA", which seems to be common sense.

On effective enforcement, which is where we always encounter difficulties with a code of practice, "Slim Hopes" recommends that the ASA should implement more effective sanctions. There have recently been one or two instances of fines being imposed on some of the more extreme elements of the industry, but they have been too low. The sanctions have not been sufficiently effective when they have been applied to transgressors, and I would certainly support making them more effective.

"Slim Hopes" also recommends that the ASA should undertake an annual review of slimming advertising to assess whether current measures are adequate to deal with the problem. The review should be undertaken in such a way that statistical comparisons can be made between years over time. If there is no significant improvement", it should develop with independent experts and public interest groups, additional measures to tackle the problem. I think that the Government should be involved in that matter.

On the specific claims that cause the worst and most worrying effects on health, as a consequence of the speed of weight loss, "Slim Hopes" recommends: The code should be amended to include a requirement that no advertising for a slimming product shall make any reference to the amount or speed of weight loss, or to a reduction in the sense of hunger or an increase in the sense of satiety. This should cover not only claims but also product names, testimonials and any other words or images associated with the product. On dieting and people who are underweight, the final recommendation is: The Code should be amended to include a requirement that no advertisement for any kind of product should suggest that underweight is desirable or attractive or in any other way encourage individuals to become unnecessarily concerned about their weight. This should preclude the use of underweight models in advertisements. We often see unhealthily skinny models, who are very young people and whom children sometimes regard as role models for how to be beautiful, which causes all kinds of health problems. Even if children and young people do not go to the extreme of suffering from anorexia or bulimia, they suffer from constipation and develop gallstones because they do not have the right diet, because they are worrying too much about their image and believe that they have to look unhealthily thin.

The United Kingdom's slimming industry is estimated to have an annual turnover of approximately £1 billion a year, yet the number of overweight and obese people is increasing. By the year 2005, it is estimated that 18 per cent. of men and 24 per cent. of women will be obese. At the same time, there has been a rise in the incidence of eating disorders such as anorexia and bulimia.

What is shocking about "Slim Hopes" is the number of well-known companies, almost household names, that it has caught out conning the public into believing that some miracle cure is available for those who have been led to believe that they are overweight.

I should like to give Sue Dibb, Claudia Grillo and Jenny Smith, the authors of "Slim Hopes", the last word. They say in their introduction: the dream that a physical ideal can be achieved through the latest diet fad retains its appeal despite the fact that the majority of people who embark upon diets to lose weight fail to do so in the long term. The medical and scientific consensus that has now emerged is that the way to maintain a healthy weight is to ensure that calorie intake does not exceed calorie expenditure; that is by eating a healthy balanced diet and by being physically active throughout life. Advertising plays an important role in maintaining the myth of `miracle' or easy weight loss and thus undermining the important health message. There we have it. The dieting industry and the advertising industry are contributing to the increasingly bad health of our nation. The Government have a duty to look into those matters seriously.

2.1 pm

Mr. Kevin Barron (Rother Valley)

First, I congratulate my hon. Friend the Member for Halifax (Mrs. Mahon) on her excellent speech and on promoting the Bill. I know that it is second time around, and I hope that if the Bill goes into Committee and then completes its passage this year, my hon. Friend will not give up hope that we should look again at the industry.

As my hon. Friend said, her Bill would regulate aspects of the diet industry, or perhaps it would be more useful to refer to it as the slimming industry. First, the Bill would require slimming centres to display warnings about the damaging effects of rapid weight loss. She also advocates that those risks should be outlined in those centres' literature. Those are straightforward and sensible proposals. Regardless of the eventual fate of the Bill, I hope that the people responsible for such centres, who promote such weight-loss programmes, would want to inform potential customers of the risks. I am therefore disappointed that the slimming industry has not yet volunteered to do so.

Secondly, my hon. Friend suggested that dieting preparations and treatments should come under the Medicines Act 1968. That could be done almost immediately. Her proposal that the charges involved in an entire course of treatment should be detailed may cause some problems, but it is not an insurmountable hurdle. My hon. Friend is not asking for a massive new regulatory framework for the slimming industry, but she is calling for proper and reasonable regulations designed to offer protection to consumers from misleading or inaccurate information. She is also calling for decent levels of product safety. I am sure that all hon. Members would agree that such protection should be offered to consumers.

There is nothing in the Bill on which a sensible Government could take offence. I am sure that the House will be convinced by my hon. Friend's arguments that the slimming industry is in need of control. It is not feasible to leave an industry with an annual turnover of £1 billion largely unregulated, and the scope for it to abuse its position is obvious. Concerns are already being expressed about the number of women and young girls who are suffering as a result of the enormous pressures that they face to be thin, from the fashion industry, the media and the slimming industry. I highlight the case of women and girls, because the overwhelming majority of dieters are female—about 90 per cent. of them diet at some time in their lives. The intense industry pressures also affect men and boys, growing numbers of whom are taking up the slimming craze.

We must be clear about the damage that a badly regulated slimming industry can cause. I shall deal later with the medical effects but first, I shall consider the advertising pressures. It is clear that the Advertising Standards Authority does not have the remit to cover all aspects of regulations necessary for the slimming industry. Its scope for action is limited to printed advertisements and does not cover the practices of so-called dieting experts in their clinics. The Bill would help to complete the regulatory framework for that. Given the findings of the survey that my hon. Friend the Member for Halifax mentioned, does the Minister agree that the ASA should investigate the advertisements that the survey found to be untoward in respect of its code?

The Bill seeks to address the medical aspects of slimming and the diet industry. We must make distinctions between the extremes of clinical obesity and thinning eating disorders, and healthy eating and frequent dieting. Obesity is a problem. I hope that the Minister will say a few words about the Government's progress towards securing "The Health of the Nation" targets for the reduction of obesity and associated complaints.

To feel a little overweight, especially when the feeling is deliberately heightened by the effects of the industry's advertising campaigns, is far from clinical obesity. Few people who diet, especially those who diet obsessively, are clinically obese. Clinical obesity is the cause of many illnesses. Stroke and coronary heart disease are real dangers and the risks of diabetes, gallstones and arthritis are also increased. Many of those who diet do not need to. More importantly, in some cases the preoccupation of obsessive dieters with unnatural slimness may be a cause of other physical and psychological illnesses. Not everyone who starts dieting ends up with an eating disorder, but everyone with an eating disorder started by dieting.

Both groups are a call on national health service resources, and we should do all that we can to reduce that resource usage and to put such resources, where they are available, to other uses. The Bill would help to regulate some of the excesses of the diet industry and reduce that pull on national health service resources. The Minister should tell us what other measures he is taking to counter the effect of the diet industry and to reduce the incidence of eating disorders.

In particular, I hope that the Minister will say something about the role of healthy eating as opposed to dieting. The Bill makes it clear that dieting and healthy eating are not the same and I hope that he does so, too. I welcome the initiative of the Minister's colleague, Baroness Cumberlege, to encourage people to take more exercise and to fund a campaign to get that message across. What similar initiatives has the Minister planned to teach the public more about healthy eating? I put that question because I believe that the slimming industry does not want people to hear the healthy eating message, that the best way to maintain reasonable weight and keep weight down is to eat properly and healthily and to exercise regularly. The other message that the industry insists on keeping quiet is about the real effects of dieting and rapid weight loss.

The House may wish to hear what the doctor's bible, the British National Formulary, says about appetite suppressants, which are a mainstay of the slimming industry. Of bulk-forming drugs—preparations that claim to make people feel full, so reducing their food intake—the British National Formulary says: The most commonly-used drug is Methylcellulose. It is claimed to reduce intake by producing feelings of satiety but there is little evidence to support this claim. It states that centrally acting appetite suppressants are of no real value in the treatment of obesity since they do not improve the long-term outlook. Most have a pronounced stimulant effect on the central nervous system. Use of the amphetamine-like drug Phentermine is not justified as any possible benefits are outweighed by the risks involved. Abuse may be a problem. The British National Formulary continues: Fenfluramine is also related to amphetamine but in standard doses it has a sedative rather than a stimulant effect. Nevertheless, abuse has occurred and abrupt withdrawal may induce depression. The pills and drugs used by the slimming industry could effectively be called uppers and downers—the term used in the drug culture. They are prescribed in private clinics throughout the country.

The British National Formulary states that an appetite suppressant should not be given to patients with a past history of epilepsy, drug abuse or psychiatric illness and is not recommended for periods of treatment beyond three months. It should not be used for cosmetic reasons. Last year, the Minister's predecessor announced that he was seriously considering a ban on amphetamine-type slimming pills under the Medicines Act 1968 and that the Department intended to consult on the issue. He said: We are considering action because we know that many qualified practitioners are prescribing inappropriately, although legally, slimming pills which were not designed for people who are, or who believe themselves to be, slightly overweight."—[Official Report, 31 March 1995; Vol. 257, c. 1359.] There are clearly clinical grounds for prescribing such drugs, but many of the people who currently receive them do not fall into that category.

The newspaper report from which my hon. Friend the Member for Halifax quoted seemed to suggest that the practice of prescribing slimming pills continues unchecked. The end of the article by Jenny Hope in today's Daily Mail states: The Department of Health said proposals for restricting the use of slimming pills were 'with Ministers'. The Minister has plenty of time, so perhaps he will tell the House whether the proposals are with him and what he and his colleagues intend to do about them. When his predecessor announced a review a year ago, was it a serious suggestion or was it made merely to divert attention from my hon. Friend's Bill?

The loosely regulated diet industry sells us rapid weight-loss products that have no real benefit over time. It makes claims for its products that cannot be properly challenged and, in many cases, it has an open-ended charging policy. The diet industry thrives on its own failure to make us thin and it profits from promoting an unrealistic ideal. Those are matters on which the House should take a considered view. My hon. Friend the Member for Halifax has brought before the House a Bill that intends to regulate those matters. Her Bill deserves a Second Reading today and detailed consideration in Committee.

2.13 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Horam)

The hon. Member for Halifax (Mrs. Mahon) has introduced a Bill that seeks to regulate the diet industry. I should first, like the hon. Member for Rother Valley (Mr. Barron), like to congratulate the hon. Lady on her persistence. I think that this is not merely the second time, but the third time—

Mrs. Mahon

Second time, Second Reading.

Mr. Horam

As the hon. Lady says, second time, Second Reading. She originally introduced the measure as a ten-minute Bill, so this is technically the third time that she has had a go. The Government congratulate her on her persistence, and they share many of her concerns. The question is: how do we deal with these legitimate concerns which, from time to time, have divided us?

For most people, deciding whether to diet is a matter of personal choice—a choice in which they probably will not want the Government to interfere. However, the fact is that sometimes being overweight is serious enough to put health at risk. In Britain and in other developed countries, the proportion of obese men and women is increasing. The health implications include raised plasma cholesterol levels and raised blood pressure. In other words, obesity increases the risk of coronary heart disease and stroke which, together, are Britain's biggest killers.

Being overweight and obesity are the result, in simple terms, of taking more energy from food and from drink than is used up—in physical activity, for instance. The solution is simple: eat less and be more active. The hon. Lady spelt that out in her speech, and she is entirely right. However, it is easier said than done. Many slimming diets help people to lose weight and have been successful—the problems start when they try to keep the weight off in the longer term.

I shall outline what the Government are doing on the subject, in reply to the concerns of the hon. Lady and of the hon. Member for Rother Valley. We have consulted widely with experts on how to encourage effective, long-term weight loss. The hon. Lady will be aware of a report that was published in October last year, entitled "Obesity—Reversing the Increasing Problems of Obesity in England". We are considering future courses of action based on the report. For example, as a first step, we have commissioned a review of effective interventions, to identify what works to help people maintain a healthy weight in the long term.

We already have a major programme to promote healthy eating and to increase physical activity—the Eat Well programme is part of that. As part of the nutrition task force programme to achieve diet and nutrition targets, discussion set in train with the food industry on further reductions in fat and saturated fat content of foods will continue.

Hon. Members may have seen the new Active for Life campaign, to which the hon. Member for Rother Valley referred, which my noble Friend Baroness Cumberlege announced last week. During the last Health Question Time, I encouraged hon. Members to participate in the campaign and said that I was disappointed by the number of Members of Parliament who attend the Westminster gym and the Boothroyd studio. Nevertheless, one does not need to do that—one needs only a regular amount of modest exercise, which will do the trick. Exercise releases endorphins and stimulates people—it is of huge advantage to everyone.

All those things are a part of a structured programme to help with the problem. The hon. Lady and the hon. Gentleman raised the question of what we are doing about anorectic agents. The then Under-Secretary of State, my hon. Friend the Member for Bolton, West (Mr. Sackville), announced in the equivalent debate last year that he was setting up a process to look into the matter. I inform hon. Members that that is going well and that an announcement will be made shortly. It has taken a long time, but as the hon. Lady will recognise, there has been a huge amount of public interest in the matter. The number of people who wanted to be consulted was greater than we expected, and she will understand that it is important to get it right.

The Bill applies to any person, other than a doctor, who gives advice on diet or on weight loss. That will be a restriction on many other professionals who are not doctors, but who may be qualified to advise. At the same time, medicine is a broad church and we cannot assume that every doctor is an expert in every field. Treating obese people appropriately requires specialist knowledge, and weight loss is only part of the management.

Mrs. Mahon

I take the point that the Minister is making about the wider number of people who treat those who are deemed to be overweight. However, they have nothing to fear from the Bill. If they are not doing anything wrong—if they are just promoting healthy eating, calorie control and exercise—they have nothing to worry about. It is the diet industry—which is selling all the rubbish, selling poisons and promising medical cures—that the Bill intends to get at, not the genuine practitioner.

Mr. Horam

I understand that, but I believe that it is better to promote higher standards of knowledge and good practice among all relevant professionals. That is one of the ways to proceed. That is why the Government's nutrition task force has developed a core curriculum for nutrition in education for health professionals. That is a central element in the way in which we should proceed, and that applies not only to doctors, but to nurses, pharmacists and so on, who often say that slimming devices should be used.

Finally, it is essential to distinguish between good and bad advice. Although we well understand the thoughts giving rise to the Bill, we are worried that it is too general and too vague. We must consider specific products and work out which we can give advice on in a sensible way, leading to proper public education. Although the Government are sympathetic to the hon. Lady's concerns, the problem is the general, and I am afraid rather vague, outlines of the Bill. We prefer to work through the existing methods, which we believe are more specific.

2.20 pm
Mr. Michael Fabricant (Mid-Staffordshire)

Again I find myself opposing the hon. Member for Halifax (Mrs. Mahon). I opposed her when she spoke against Sunday trading, and in the end she had to—

Mrs. Mahon

Sunday trading? No.

Mr. Fabricant

The hon. Lady says that she did not oppose Sunday trading. I certainly opposed her, though, when this Bill was introduced as a ten-minute Bill, and I stand again to oppose her again. I shall be brief because I do not intend to talk out the Bill.

The Bill would introduce costly, and in my view cumbersome, new regulation to prevent 18 million adults from taking responsible steps to improve their own health.

I have not, this year or any other year, had an axe to grind on behalf of the slimming industry—indeed, the occupational health therapist told me that it was time I put on weight—and I certainly do not receive any moneys or have any such connection with the diet industry.

The trouble is that the hon. Member for Halifax keeps getting confused about what the problem is. She is convinced that the British public are surrounded by a conspiracy—in fact, I believe she used the word "conspiracy" today—of unscrupulous people who are trying to con them out of their hard-earned cash by persuading them that they are fat when they are not.

The hon. Lady's Bill, however well intentioned, is doomed to failure for three reasons. First, it will do nothing to curb the activities of the unscrupulous people who cash in on overweight people by selling ineffective or dangerous products, because it lacks the necessary sanctions to do so. Secondly, the only businesses on which it is likely to have an impact are the reputable organisations on which the medical profession increasingly relies to provide safe, effective, long-term solutions to the problem of weight control. Thirdly, this cumbersome legislation will only heap greater burdens on the national health service, especially hard-pressed general practitioners.

Yes, there are unscrupulous people cashing in on overweight people and they need to be stopped, but the hon. Lady's Bill will not do anything to stop them. I shall explain why later.

In any event, that is not the real problem. The problem is that nearly half the adults in this country are overweight. One person in seven—nearly 6 million people—is so fat that his health is in danger. The problem is getting worse, not better. Throughout the 1980s, the number of women suffering from clinical obesity shot up by 50 per cent. That is clinical obesity—not fashion.

Last year, the Department of Health threw up its hands in despair and admitted that obesity was one of only two of the list of "The Health of the Nation" targets that had stubbornly refused to respond to measures to tackle them.

The hon. Member for Halifax thinks—or perhaps she has been made to think—that being fat does not matter. Some 50 per cent. of us are already too heavy for our height and one in four people will be clinically obese by 2000—heaven knows how many by 2010. Any doctor will tell her that that is not okay. Dozens of obesity experts will say the same thing, if only the hon. Lady would listen to them. Being fat can kill. Obesity puts people at risk from heart disease, strokes, diabetes, breast cancer, bowel cancer, ovarian cancer, bladder cancer, infertility, respiratory problems and painful joints—shall I continue?

Mr. John Carlisle (Luton, North)

Yes.

Mr. Fabricant

Perhaps I should refer also to a Minister mentioned in the tabloids. They reported a lady as saying that making love with him was like having a double wardrobe fall on her with its little key sticking out.

Mr. Carlisle

Name him.

Mr. Fabricant

No, I will not—but it is a serious point. Fat people know that their obesity is often concentrated in their torsos: their guts become like pots of foie gras. That may seem an odd analogy—the Minister may laugh—but it is a serious problem because their organs are packed in fat.

Mr. Carlisle

I hate to stop my hon. Friend during his catalogue of disasters and descriptions, but he is depicting only the British people. Does he agree that one has only to travel across what is popularly known as the pond to see a far worse situation? The Americans are much more obese than British people. I am sure that some of their elected representatives would fit the description of the Minister whom my hon. Friend quite rightly chose not to name in the House this afternoon.

Mr. Fabricant

My hon. Friend is absolutely right: obesity is an even more serious problem in the United States. However, it is a problem here also.

Six million people in this country cannot run for a bus. They cannot sit in the same seats that we sit in, they cannot walk properly and they cannot get comfortable. More seriously, they are refused operations until they lose weight, because obese people cannot be stitched easily. Hip replacements will not work because of the excess pressure and the anaesthetic risk is too great in patients whose breathing and cardiac function are impaired by excess weight. We are not talking about a small minority: we are talking about 6 million people in this country alone.

My hon. Friend referred to the United States example. The most recent research in that country, based on a study of several hundred thousand people, has proved without doubt that the fatter one becomes, the more likely one is to die early. We should think about that: the fatter one is, the more likely one is to die before one's time. It is as simple as that.

Perhaps the hon. Member for Halifax does not care about the nation's health, because she thinks that it is not nice to tell people that they should not be fat. However, she may care a little about how much obesity is costing the nation. It has been estimated that the cost to the national health service of trying to treat obesity and the things that happen to people's bodies as a result amounts to at least £200 million a year—money that could be spent providing other, perhaps more urgent, operations. The awful truth is that most of that money is spent on firefighting: treating the painful, disabling symptoms of the numerous health problems that are caused by excess flab. Those problems range from the merely unpleasant to the fatal.

The consequences of being overweight and obesity are among the most serious public health issues that face us today. It amazes me that we have a health problem of such enormous scale, which calls for urgent action, yet along comes the hon. Member for Halifax with a Bill that not only misses the point, but is completely ineffective against the problem that she hopes to remedy. It also fundamentally threatens some of the lifelines that are achieving results for many obese people. What is more, it is totally unnecessary.

What exactly is the hon. Member for Halifax hoping to achieve with the Bill? She has said that she wants to stop overweight people being exploited by businesses that try to cash in by selling them ineffective products. That is true, but who are the unscrupulous people running those businesses and how will her Bill affect them? We know that it is possible for people to buy powerful and dangerous amphetamines with only the most cursory of medical—

It being half-past Two o'clock, the debate stood adjourned.

Debate to be resumed upon Friday 19 April.