Intended for healthcare professionals

Analysis

Holistic modelling as a catalyst for effective obesity policy

BMJ 2024; 386 doi: https://doi.org/10.1136/bmj-2023-077139 (Published 10 September 2024) Cite this as: BMJ 2024;386:e077139
  1. Joanna McLaughlin, public health academic clinician1,
  2. Carlos Sillero Rejon, senior research associate in health economics12,
  3. Mike Bell, public contributor3,
  4. Bjoern Schwander, health economics consultant4,
  5. Karen Coulman, clinical lecturer15,
  6. Hugh McLeod, senior lecturer in health economics12
  1. 1Bristol Medical School, University of Bristol, Bristol, UK
  2. 2National Institute for Health and Care Research, Applied Research Collaboration West, Bristol, UK
  3. 3Public representative, UK
  4. 4Agency for Health Economic Assessment and Dissemination, Bietigheim-Bissingen, Germany
  5. 5North Bristol NHS Trust, Bristol, UK
  1. Correspondence to: J McLaughlin Joanna.mclaughlin{at}bristol.ac.uk

Reducing the prevalence of obesity requires multifaceted intervention, and system-wide modelling would support a move away from current piecemeal policy making towards an equitable and cost effective strategy, argue Joanna McLaughlin and colleagues

Despite longstanding government rhetoric of a commitment to tackling obesity, UK policies have not provided an adequate and coherent response. A 2021 analysis of 14 key obesity policy documents since 1992 identified repeated inadequacies in policy design, implementation, and evaluation.1 The 2023 Institute for Government report on tackling obesity concluded that the government had no serious plan to meet the aim of tackling obesity and called for learning from past mistakes.2

Obesity is one of the biggest health challenges of our age; prevalence in England continues to rise and reached 26% in 2021 (32% of those aged 55-74), one of the highest rates worldwide, and shows stark inequalities by deprivation.3 It is well established that population obesity is not going to be solved through treatment or simplistic encouragement for individuals to eat less and move more.2 As a report from the UK Government Office for Science concluded in 2007, obesity is a system level problem that requires simultaneous action on multiple fronts.4

The World Health Organization’s 2022 plan for obesity further highlights the range of settings and approaches where action must be taken, including fiscal, regulatory, and lived environment interventions.5 Nevertheless, UK obesity policy includes minimal population level interventions and continues to rely on short term, individual level, treatment focused approaches12 that only a small percentage of the eligible population can access.6 The problems in policy making on obesity are symptomatic of inadequacies across many public health policy areas,78 but obesity provides a good example of the problematic influence of “nanny statism” political concerns.1

Current …

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