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Feature Public Health

Whole city working against childhood obesity

BMJ 2018; 361 doi: (Published 14 June 2018) Cite this as: BMJ 2018;361:k2534
  1. Tony Sheldon, freelance journalist, Utrecht, Netherlands
  1. tonysheldon5{at}

Amsterdam has been lauded for its approach and results. But is it really making a difference, and could British cities do the same? Tony Sheldon reports

Amsterdam’s claims that data show a “12% drop” over three years in the proportion of overweight and obese children in the city have sparked international interest, glowing headlines, and calls for cities such as London to consider the Dutch approach.

Two fifths of children aged 10 and 11 in London are overweight or obese,1 and London’s adults have higher rates of obesity than those in New York, Sydney, Paris, and Madrid.2 A UK government strategy on childhood obesity is expected imminently.3 London's mayor, Sadiq Khan, is also consulting on a London Food Strategy that includes a ban on “advertising of food and drink that is not healthy” on public transport.4

The UK’s Centre for Social Justice think tank, the International Panel of Experts on Sustainable Food Systems, and, most recently, the UK junior public health minister Steve Brine have highlighted Amsterdam’s citywide Healthy Weight Programme as a beacon of good practice.56

The approach puts child and adolescent health at the heart of all municipal policies and involves collaboration among many sectors. Many Dutch cities work similarly, encouraged by the national Young People at Healthy Weight (JOGG) programme.

However, Amsterdam’s data have also roused scepticism because they have not been published in any peer reviewed journal and their observational nature means that causality cannot be inferred. The programme arrives at a 12% drop using approximate rates for overweight children of 21% in 2012 and 18.5% in 2015, which is an absolute decrease of only 2.5% (box 1).7 Its gross figures for the number of children who were overweight or obese are 27 000 in 2012 (total population 130 363) …

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