Intended for healthcare professionals

Rapid response to:


The failure of anti-obesity programmes in schools

BMJ 2018; 360 doi: (Published 07 February 2018) Cite this as: BMJ 2018;360:k507

Rapid Response:

Re: The failure of anti-obesity programmes in schools

The research and your editorial clearly identified that the particular approach to obesity did not work.

This is not surprising as childhood obesity is primarily an environmental issue rather than a disease or condition which requires therapy or medical interventions.

For countless generations children have played outdoors close to their homes at no cost to themselves or Government. This is so natural that we have taken it for granted and failed to recognise its importance.

Not only is the play beneficial exercise it is also when children learn how to take turns, reach agreements, settle disputes, reach compromises. All this without adult supervision.

Schools are only open half the days in the year and the school journey is only twice a day so it is obvious that initiatives based on schools are severely hampered.

The simple fact is that road traffic has so dominated residential roads that children can no longer pay out and get healthy exercise every day of the year. This fact has been ignored by the NHS, Public Health England, Chief Medical Officer for England, NICE, etc. The approach by PHE of blaming parents is misguided. Parents quite sensibly keep their children indoors because the roads outside have become too dangerous. Many do try to compensate by taking the children to clubs and classes but these can never be as beneficial as every-day play.

An approach which suggests that all children should go to organised activities every day would cost more than the total schools budget.

The obesity epidemic was predictable. We know from zoos that mammals need to run around just outside their houses if their health is to be maintained.

My research and experience (1) has found that children still play out as they always have done where traffic speeds are slow, particularly in cul-de-sacs, Radburn designed estates and similar where traffic is significantly calmed.

The vast majority of roads are residential side roads. We need to make them the equivalent of a zebra crossing along their whole length. Giving pedestrians priority will enable children to get out and play. A healthy environment will give us healthy children.


(1) Child's Play: Facilitating Play in Housing Estates, (with Dr Alison Millward) (1997) (reprint 98); pub. Chartered Inst. of Housing & Joseph Rowntree Foundation. Download free from

In addition 12 unpublished reports based on the same methodology have been made to local authorities and housing associations. Also 25 years of assessing hundreds of children's playground each year.

Competing interests: No competing interests

15 February 2018
Rob Wheway
Children's Play Consultant
Children's Play Advisory Service Ltd
Coventry CV3 6HA