The carrot or the stick?

We are fat, and we are getting fatter. Ireland will be the fattest country in Europe by 2025 (2016). Projections from the World Health Organisation predict Ireland will become the world’s most obese nation in the world by 2030. By 2030, their model predicts that 47% of both men and women will be obese (WHO Global Health Observatory Data Repository). The healthcare expenditure due to the overweight and obese populations in 2009 was estimated at €437 million for the Republic of Ireland (ROI) and €127.41 million for Northern Ireland. Productivity lost due to overweight and obesity related health issues was up to €865 million for ROI and €362 million for NI (Dee et al., 2015). But don’t worry, the proposed new sugar tax will save Ireland; it will make us all thin and svelte!  It will limit the consumption of unhealthy foods and beverages surely, and take the pressure of an ailing health service, wont it?  The so-called ‘health-related food tax’…….. The “sugar tax” makes sense,   it is logical —it will make unhealthy foods more expensive and it will cause demand for them to fall.


Hungary was one of the first countries to introduce “A Public Health Food Tax” on packaged products with high sugar, saturated fat or salt levels in September 2011 and a tax on saturated fats was introduced in October 2011 in Denmark. 2011 also saw a re-introduction of a tax on sweets (including soft drinks and ice cream) in Finland and at the beginning of 2012, France introduced a tax on drinks with added sugar or sweetener. Mexico became the first country in Latin America to approve an excise tax on unhealthy food. To date, very few reports have materialized on whether these taxes have caused any changes in consumption. A report from Finland described the first year of the tax on sweets was a success, it raised more revenue than expected and the consumption of sweets dropped.  Similarly, preliminary figures from Denmark, Hungary and France suggested a reduction in the spending on sugar. However, the more recent figures reported sweet sales tend to return to previous levels meaning that the introduction of such a tax in Ireland may unfortunately only have a short term effect.


Rather than punish people financially for choosing unhealthy food, would it not be more effective to offer tax credits and incentives for people to be healthy. Would it be more beneficial to introduce measures that are positive incentives rather than negative ones? How about a tax credit for those with an appropriate body fat percentage and a body-mass index of less than 26? (A BMI of 30 or over is considered obese). Maybe a motivational tax credit rather than a punitive tax on sugar may work better. Positive financial incentives, e.g. subsidising the price of participation in activities, could potentially lead to an increase in quantity of physical activity in all populations regardless of age (Anokye et al., 2014). The best way for the Irish government to help the struggling health system is for fewer people to need its services! The reality is that the introduction of a sugar tax may result in an initial reduction in consumption of sweets and fizzy drinks but unless the “sugar taxes” raised are redirected to fund positive incentives to increase physical activity we will remain on target to be the one of the fattest nations in the world with a health system clogged with obesity related issues.







(2016). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 387, 1377-1396.


Anokye NK, Pokhrel S & Fox-Rushby J. (2014). Economic analysis of participation in physical activity in England: implications for health policy. Int J Behav Nutr Phys Act 11, 117.


Dee A, Callinan A, Doherty E, O’Neill C, McVeigh T, Sweeney MR, Staines A, Kearns K, Fitzgerald S, Sharp L, Kee F, Hughes J, Balanda K & Perry IJ. (2015). Overweight and obesity on the island of Ireland: an estimation of costs. BMJ Open 5, e006189.


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I qualified with an Honours degree in Physiotherapy from Trinity College Dublin in 2004. Since graduating I have worked in St. James Hospital Dublin and have worked in all the areas of speciality within the hospital including cardiorespiratory, orthopaedics, rheumatology, care of the elderly, neurology, burns and plastic surgery among others . I have also completed a post graduate certificate in acupuncture in UCD 2009. The Physiotherapy Department in SJH has strong links with Trinity College Dublin (TCD) and I have supervised undergraduate and postgraduate physiotherapy students on practice placements and also delivered lectures on the undergraduate academic programme in TCD. I have a keen interest in all sports and currently plays with Cill Dara RFC 1st team squad, and Milltown GAA. I have previously worked as Physiotherapist to Co. Carlow Senior GAA Team, Milltown GAA, Leinster Junior Rugby Team and Cill Dara RFC. I am an experienced runner and competed in the Dublin City Marathon in 2002. I continue to participate in running events and multisport disciplines such as Gaelforce West, Gaelforce North and the Motivate Challenge. I have a particular interest in strength and conditioning. I utilise this knowledge of resistance training in the treatment of his clients. I am committed to continuous learning and development in order to ensure the optimal level of care is offered to my clients, and with this in mind I am currently undertaking a certification in Strength and Conditioning (CSCS) with the NSCA.

One thought on “The carrot or the stick?

  1. Barry Keogh as always thought provoking ,& totally on the money. Positive/ financial incentives much more likely to impact on change & have better outcomes.

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