The pledge by a number of large food producers and retailers to reduce the levels of saturated fat in the food that they sell, has been met with a foray of criticism by food policy experts. The argument goes that it is such a small step that the impact on the health of the nation will be minute, if that. What followed were calls for tighter regulation and binding laws on the make-up of food.
It comes down to the age old argument on how far should the state intervene? Is a pledge enough? Should it come down to regulation from the top down or should it be about changing people’s behaviour from the bottom up? Should it be a mix of both?
These core arguments (the Libertarian Paternalist Vs. Hard Paternalist) underpin the obesity debate and the recent furore around the saturated fat pledge has opened the old war wounds many of us in The Campaign Company’s office bear from our own internal debate on the matter.
The Libertarian Paternalist believes in the role of ‘nudging’ in order to make it easier for people to make healthier choices, whilst the Hard Paternalist believes citizens have the right to regulate and remove the choices available to limit that behaviour for the greater good.
We managed a childhood obesity project in Camden which looked at these very arguments. Camden tested a number of childhood obesity initiatives; on one hand we had the Hard Paternalist policy of banning every drink apart from water on school premises, and on the other hand we had the Libertarian Paternalist in the context of the Healthy Food Commitment by businesses electing to make manageable changes in the make-up of their food (such as reducing salt, reducing oil, changing oils and single frying chips).
Our research for the childhood obesity project revealed that businesses were instinctively suspicious of state intrusion but were receptive to a policy like the Healthy Catering Commitment which allowed them to make manageable but meaningful changes. Moreover a core recommendation that came from our research with businesses was the need for a conciliatory two way dialogue with business owners to involve them in the change process.
For me, the hard paternalists have crowded the media ground around the saturated fat pledge, and that this attitude, to criticise and impose instead of involving is dangerous. For Nestle – a food giant that has built itself on high saturated fat products like chocolate – to actually commit to changing the make-up of one of their most loved products, KitKats, cannot be underestimated.
In the same way that people need to change their behaviour, nudged here and there, we should of course have the same expectation of businesses – but it is unrealistic to expect sudden and dramatic changes, an expectation that we do not have on the public.
Prochaska and Di Clemente wrote a Transtheoretical model of change which has been used for developing effective interventions to promote health behaviour change. In their work they identify 5 stages of change that people move through in trying to change their behaviour. “Stages and processes of self-change of smoking: Toward an integrative model of change.” The stages describe a person’s motivational readiness or progress towards modifying the problem behavior. The stages are as follows:
1/ Pre contemplation (aware of need to change but not interested)
2/ Contemplation (considering change but undecided)
3/ Preparation (ready to start taking action, taking small steps towards changing behaviour)
4/ Action (behaviour has changed and action is taken to strengthen their commitment to change)
5/ Maintenance (change is now integrated into their being)
Can’t the same stages of change be applied to businesses? Don’t businesses need to go through similar stages in order to change their own behaviour? I would argue that at this point, businesses are in the ‘preparation’ stage – trying to put in place measures to change behaviour. We as behaviour change professionals, have a responsibility to put the same emphasis on engaging with businesses just as we put emphasis on engaging with the public as being key to any behaviour change model for obesity and heart disease. By involving them in the process we can hopefully support businesses through the remaining stages of change.
So why not celebrate the saturated fat pledge for what it signifies in the cycle of behaviour change for businesses?
Rosanna Post is a Project Officer for The Campaign Company.