Your Secret Midnight Snack Costs the NHS (And Your Future Self)

 Ever find yourself at 2 am, scrolling through Deliveroo, torn between a £7.99 "detox salad" and that indulging cheese fries? It’s not just a moment of hunger – your choice could be quietly shaping the future of the NHS.

The Sneaky Economics of Guilty Pleasure

Economists refer to 'externalities' as costs incurred by third parties, not reflected in the product's price. Negative externalities are the social costs (like healthcare) that go beyond the private costs (such as the price of a sugary drink). These unhealthy eating habits cause obesity, diabetes, cardiovascular diseases, which burden the NHS.

When you order that £3 boba tea, the price tag doesn’t reflect its true cost. It doesn’t include the £30 blood sugar test you’ll need in 5 years, the £300 meds for that prediabetes diagnosis and the £3,000 hospital bed when things go south. The NHS ends up paying the price, costing £6.1 billion a year on diet-related treatments alone (Department of Health and Social Care, 2020).

Beyond the burden on NHS, sugar-related obesity puts a lot of pressure on healthcare system, leading to more people needing medical care and costing taxpayers more money. In 2018-19, nearly 900,000 hospital admissions were obesity-related, leaving doctors with less time to treat their other patients (Department of Health and Social Care, 2020).

Why Your Brain is the Ultimate Cheat Code

Supermarkets are strategically designed to take advantage of human psychology, making unhealthy choices more tempting. Research shows that product placement such as candy bars at eye level and the perfectly crispy snacks engineered by food encourages impulse purchasing and overconsumption. (Cohen & Babey, 2012). Despite public health efforts, global consumption of animal and vegetable fats continues to increase. In fact, the energy density of Western diets is now increased with dietary fats accounting for 33% - 47% of dietary energy in the UK, France, and the US (Drewnowski et al., 2010).

Pigouvian Economics: A 1920s Solution to Modern Health Crises

Arthur Pigou – a leading economist from the 1920s was among the first to address these issues. His solutions are surprisingly straightforward. He introduced the concept of sin taxes which are financial penalties imposed on unhealthy products. He also recommended health subsidies, including incentives such as tax breaks for gym memberships, to encourage healthier lifestyle choices. In addition to this, Pigou advocated for pollution charges, where companies would pay for the environmental harm they cause, (clean air fines). His idea is to make prices reflect the real cost of our choices so both individuals and society feel the impact.

Imagine if every sugary drink had two prices. £3 at checkout, and an additional £1.20 NHS tax to offset future healthcare costs. Suddenly, what seems like a harmless £3 soda becomes a £4.20 reality check with an added NHS tax. That’s Pigou’s magic – forcing prices to tell the whole truth.

However, these taxes can be hard to get right, may unfairly impact lower-income people, and might lead to businesses finding ways around them.

Real-World Rollercoaster

London has already started testing this by charging £12.50 a day for car pollution requiring drivers to contribute to air quality costs. Scotland is trying bottle deposits where you return a bottle for cash to help fund healthier initiatives. However, these strategies don’t always work as intended.  When France taxed sugary drinks, everyone just switched to artificial sweeteners (usage jumped 23%). In Australia, cutting smoking led to a rise in vaping-related ER visits. Our brains are excellent at finding loopholes, leading to unintended consequences.

London's ban on junk food ads in buses and tube stations worked. It helped cut obesity cases by nearly 5%, stopped about 3,000 people from getting diabetes and 2,000 from heart disease in just three years, and saved the NHS £218 million. The best part is that it helped poorer communities 37% more than richer areas - proving health policies can fight inequality (Thomas et al., 2022).

​We often find ourselves skipping gym sessions despite active memberships, a behaviour influenced by psychological patterns like the sunk cost fallacy and moral licensing.  Our tendency to reward healthy choices with unhealthy pleasures "I ate a salad yesterday, so I deserve a donut today!", slows down our long-term progress.

The NHS Fights Back (With Tech!)

Bristol is trailing an app that scans groceries to show their contribution to NHS expenses. By showing how a product, like a frozen pizza, contributes to NHS expenses, and rewarding healthier choices like quinoa with perks (e.g., priority GP access), it gives consumers a clear financial incentive to make healthier decisions. Early results show a 38% drop in processed food purchases, with one user admitting: "I’m not being healthy – I just want faster wisdom tooth removal."

The Path Forward: From Awareness to Action

It’s time to stop ignoring the impact of our choices. Every time you indulge in that midnight snack, it puts more strain on the NHS. While food companies capitalize on our biological cravings—using carefully designed, highly addictive snacks—the NHS is left to manage the long-term health consequences.

What if food delivery apps made us confront this reality? Imagine your cart flashing a message like: "This burger = 2 MRI scans the NHS can’t fund." Would you still click "order"? For many of us, convenience wins over healthcare concerns.

This isn’t about blame—it’s about redesigning the system. Should prices reflect NHS costs? Could gym memberships be treated like tax-deductible investments? Perhaps Bristol’s app is onto something, showing how personal gains (like faster dental care) could motivate healthier decisions. But no policy is flawless; for every success story, there are loopholes. The question remains - how can we collectively redesign an environment that makes healthy choices the easier choices?

Your Move

Next time you’re hit with a midnight craving, ask yourself: "Am I actually hungry – or just being caught in an economic trap?" The conversation starts here—should prices show true NHS costs? Could tax breaks make fitness more appealing? How else can we shift the system to promote better health?

References

Cohen, D.A. and Babey, S.H., 2012. Candy at the cash register—a risk factor for obesity and chronic disease. New England Journal of Medicine, 367(15), pp.1381-1383.

Department of Health and Social Care (2020) Tackling Obesity: Empowering Adults and Children to Live Healthier Lives. London: GOV.UK. Available at: https://www.gov.uk/government/publications/tackling-obesity-government-strategy/tackling-obesity-empowering-adults-and-children-to-live-healthier-lives (Last accessed on: 3 April 2025).

Drewnowski, A. and Almiron-Roig, E., 2011. Human perceptions and preferences for fat-rich foods.

Public Health England (2017) Health Matters: Obesity and the Food Environment. London: GOV.UK. Available at: https://www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment--2 (Last accessed on: 3 April 2025).

Thomas, C., Breeze, P., Cummins, S., Cornelsen, L., Yau, A. and Brennan, A., 2022. The health, cost and equity impacts of restrictions on the advertisement of high fat, salt and sugar products across the transport for London network: a health economic modelling study. International Journal of Behavioral Nutrition and Physical Activity, 19(1), p.93.