Written Evidence Submitted by Mr Martin Fidock at Oviva (FWM0090)

Food and Weight Management Inquiry

August 2025

Executive Summary 

• In response to question 1 - Policies fail by focusing on individuals rather than environments. Success needs structural change and ongoing support.
• In response to question 2 - Mandatory measures like ad restrictions work best, paired with subsidies and service access.
• In response to question 3 - Disparities reduce when care is flexible, culturally tailored and community led, with barriers faced tackled early.
• In response to question 4 - Affordable healthy food requires stronger government action, industry availability and behavioral support.
• In response to question 5 - New medications are effective, but risk widening inequalities. They must be paired with structured support.
• In response to question 6 - Services are underfunded. Long term investment in a national pathway is essential. 

Executive Summary

Reducing obesity disparities requires weight management services that are accessible through the NHS, flexible in terms of delivery modes, culturally tailored and community-led, supported by wider action on the social determinants of health. New weight-loss medications such as Wegovy and Mounjaro offer significant opportunities to improve outcomes, but their success depends on being delivered alongside structured behavioural support to ensure effectiveness and equity.

The NHS 10-Year Health Plan sets out a strong ambition to tackle obesity and reduce health inequalities, yet Oviva’s experience highlights a disconnect between this rhetoric and the reality on the ground. Current provision is deeply uneven, with access to newer treatment varying significantly between regions due to Integrated Care Board decisions. In some areas, only a handful of patients can access GLP-1 therapies, while many others face restrictions or long delays, creating a postcode lottery of provision. 

This inconsistency underscores the urgent need for government support to establish a consistent national pathway, provide long-term funding, and integrate innovative treatments into a fair and sustainable system that improves population health while reducing long-term NHS costs.

Introduction to Oviva

Oviva is a leading provider of NHS commissioned weight management services, specialising in digital and blended care models. Our programmes combine nutritional guidance, behavioural therapy and one-to-one coaching, with the flexibility of face-to-face, telephone and digital delivery. Oviva’s experience shows that when services are accessible and tailored to individual and community needs, engagement and health outcomes improve significantly, particularly among underserved groups. 

Question 1: Why are existing policies relating to food and diet seemingly not succeeding in reducing rates of obesity, and what should the Government learn from this, or do differently, when designing and implementing policy in future?

Existing policies on food and diet have struggled to reduce obesity rates because they often focus on individual behaviour change rather than addressing the broader environmental and social factors that shape eating habits and physical movement. Policies emphasising education of food labelling alone do not fully account for structural barriers such as the affordability and availability of healthy food, marketing of high calorie products, psychological drivers or access to open space for physical activity. 

Oviva’s experience delivering digital and blended weight management programmes shows that sustainable change requires interventions that are supported by ongoing guidance. Without personalised and context sensitive support, initiatives are unlikely to reach those most at risk.

To improve future policy the government should:

• Integrate behavioural support with environmental measures. Education and dietary guidance are more effective when paired with interventions that make healthy choices easier such as subsidies, reformulation or restrictions on marketing of unhealthy foods.
• Invest in innovation and evaluation, piloting and evaluating novel approaches, including digital interventions and new therapeutic options can identify the most effective and scalable strategies.

The Government must move from isolated measures toward coordinated and evidence based strategies that combine structural change, ensuring policies are practical, inclusive and capable of achieving measurable reductions in obesity.

Question 2: Which public health interventions have been the most effective, either domestically or internationally, at reducing obesity or consumption of less healthy foods? What should the Government learn from them?

• Where should the balance lie between voluntary and mandatory policies, and between tax and incentive?

What works:

• Limiting child-directed advertising and curbing impulse-promoting placement reduces exposure.
• Clear front of pack labels make healthier choices easier.
• Produce vouchers/subsidies for low-income households increase purchase and intake, especially when paired with tailored guidance. 
• Working with local councils to map local food access / provision to ensure populations are able to access healthy foods and to avoid over-provision of unhealthy food outlets.

The Government should adopt several lessons from the most effective interventions to date. Mandates move markets in a way that voluntary measures alone do not, and when national measures prompt individuals to seek help, rapid access weight management services and support through blended digital and in person programmes must be available to sustain progress and reach lasting outcomes.

Question 3: What action could be the most effective in reducing ethnic and social disparities relating to rates of obesity, and how could any barriers to implementation be addressed?

Reducing ethnic and social disparities in obesity care requires moving beyond the one-size-fits-all approach that currently exists. The NHS must embed accessible and community led models of care into weight management services, with wraparound programmes for weight loss medication plans. The most effective way to reduce ethnic and social disparities in obesity is to deliver weight management support that is flexible, culturally appropriate and co-designed with communities, and at the same time addressing structural barriers to healthy living. 

Oviva’s experience in delivering digital and blended care models shows that when programmes are tailored and accessible, engagement and outcomes among underserved groups significantly improve. 

• Tailored, appropriate support
• Programmes should be designed to reflect cultural dietary practices, family dynamics and health beliefs of all communities.
• Accessible delivery models
• Flexible delivery, including options for face to face, telephone and online engagement, reduces barriers that are linked to work, childcare, transport, and importantly - stigma. 
• Services should be provided in multiple languages and materials must be accessible for individuals with different levels of health awareness.
• Early intervention in deprived areas
• Proactively providing and expanding services in communities with higher deprivation where obesity rates are highest, can reduce widening health inequalities.
• Integration with primary care and community organisations (e.g. faith groups, housing providers) ensures services are viable and trusted.
• Addressing wider determinants of health
• Supporting individuals with behaviour change is essential, but progress is undermined if access to affordable health food or spaces to be active are lacking. Partnership with local government, public health and community groups to address these structural barriers is critical.

Question 4: What more should the Government and/or the food industry do to address disparities and delivery on the Government’s Food Strategy aim of improving “access to affordable healthy food”?

Disparities in access to affordable and healthy food remain one of the biggest barriers to tackling obesity and diet-related disease. Families in deprived areas are more likely to face higher prices for produce and greater exposure to the marketing of high-calorie foods. These structural barriers mean that education and awareness alone are not enough to change outcomes. 

What is needed:

• Government action on affordability and availability, including work with local councils on food mapping
• Industry accountability
• Behavioural support

To meet the aims of the Food Strategy, government and industry must work together to ensure that healthier food is not only more affordable and accessible but also supported by services that empower individuals to make lasting changes. Without tackling both the structural and personal barriers simultaneously progress on obesity and health inequalities will remain limited.

Question 5: What challenges and opportunities do weight loss medications like Wegovy and Mounjaro present to the NHS and to individuals?

• Are weight loss injections cost-effective to the NHS and how does this compare with other treatments?

Opportunities

Enhanced treatment efficacy

• GLP-1 jabs such as Wegovy (semaglutide) and Mounjaro (tirzepatide) have demonstrated clinically significant weight loss in adults with obesity, often exceeding results achievable with lifestyle interventions alone.
• For individuals who have struggled with traditional behaviour interventions, these medications offer a new tool to achieve meaningful weight reduction, improve metabolic health, and reduce obesity related comorbidities such as type 2 diabetes and cardiovascular disease

Complementary to digital and behavioural programmes

• Integrating therapy with structured weight management programmes, including digital coaching, dietary support and behavioural therapy can amplify and prolong outcomes. Evidence suggests approaches like this improve both short and long term adherence and thus sustained weight loss.

Potential to reduce health inequalities

• If made available through the NHS, these therapies could benefit populations disproportionately affected by obesity, particularly those in more high-risk groups who may have more difficulty achieving sufficient weight loss with lifestyle interventions alone.

Challenges

Equitable access and health inequalities

• If access is limited by cost, supply or prescribing criteria, there is a risk of widening health inequalities, with more affluent patients disproportionately benefiting. 

Cost-effectiveness

Early modelling suggests that GLP1s are cost effective for individuals with severe obesity-related comorbidities when considering reductions in diabetes, cardiovascular issues and other obesity-related complications. Combining therapy with specialist, structured behavioural support is likely the most clinically and effective model, as it improvises adherence and so maximises long-term health benefits per cost.

Weight loss medications such as Wegovy and Mounjaro present significant opportunities for individuals and the NHS by enabling greater weight reduction and improving metabolic outcomes, particularly when combined with structured behavioral programmes. 

Investment in research and development of new weight management medications could help address these challenges by producing more cost-effective treatments with simpler storage requirements and broader accessibility in the long term, this would allow the highest-cost, high-efficacy therapies to be targeted more effectively to patients with the greatest clinical need, improving outcomes while optimising NHS resources.

Question 6: How well are weight management services functioning in the NHS and are they providing equitable access to treatment?

• What changes might be needed to services, or additional support from Government, to ensure they are able to provide equitable access and take advantage of innovations in treatment?

NHS weight management services in the NHS provide vital support but are inconsistent across the country. Provision depends on local ICB decisions, meaning some areas offer a full pathway of services while others have very limited access. This creates a postcode lottery for patients. Demand also far outstrips supply, with long waiting times common. 

Challenges for equitable access include:

• Regional variation: patients in some areas have access to structured services while others are left with very limited or no support.
• Limited capacity: even when services exist, numbers are capped and waiting lists are too long.
• Unequal impact: the communities most affected by obesity are the least likely to be able to access timely, appropriate care.

Opportunity for change:

• Government should ensure all regions provide a core pathway of services so patients are not disadvantaged by where they live. 
• Services need long-term funding to expand capacity and reduce waiting times. 
• Combining digital, telephone and face-to-face options helps reach more people and fit support around work and family commitments.
• Weight loss medications should be embedded into structured support programmes, rather than offered in isolation.
• Not all patients need the same level of care support - allowing flexibility in care pathways with some patients having much more digital journeys, could drive cost efficiencies, enabling more of the eligible population to receive care.

Conclusion

Obesity remains one of the most pressing health challenges of our time, driving widening health inequalities and placing unsustainable pressure on the NHS. While recent advances in pharmacological treatments such as GLP-1 therapies represent a major breakthrough, they cannot be seen as a silver bullet. Their long-term success depends on being embedded within person centred weight management plans that also acknowledge the wider determinants of health.

Oviva’s experience demonstrates that when services are accessible and delivered through flexible digital and blended care models, individuals from all backgrounds are able to achieve meaningful and sustained improvements in their health. The current system is fragmented and underfunded, with too many people being unable to access consistent support. This has created a postcode lottery of provision at the moment we should be scaling up and tackling these disparities.

The Government has a critical opportunity to transform weight management services on a national level that truly reflects the 10 Year Health Plan. Achieving this will require a pathway that integrates lifestyle and behavioural interventions and ensures no one is left behind. If these changes are delivered, weight management services can improve outcomes for individuals, reduce long-term costs to the NHS and help build a healthy and more resilient population. Oviva stands ready to work with Government, the NHS and ICBs to make this vision a reality, and we would be ready to submit oral evidence upon request.