A Literature Review: Impact of UK Policies on Childhood Obesity

This literature review assesses the impact of UK government strategies on childhood obesity, a significant public health concern. It examines various policies, including social marketing campaigns, population-based strategies, food marketing regulations, food tax policies, nutritional initiatives, and school-related programs. The review identifies gaps and strengths in past government approaches, noting that many strategies have been ineffective in reducing obesity prevalence due to environmental factors and implementation challenges. Recommendations include expanding advertising restrictions and focusing social marketing campaigns to improve future impact. The aim is to inform future policy development and enhance the effectiveness of interventions to combat childhood obesity in the UK. This assignment is available on Desklib, a platform offering study tools and resources for students.

Impact of UK government strategies to deal with childhood obesity
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Acknowledgement
Performing this particular research has been most knowledge gaining experiences of my
academic life. This research is sure to increase my knowledge base and analytical skill. It also
provided me the opportunity to experience the new challenges in research work. All this, would
be impossible without the dedicated support that I have received from my professors, seniors and
friends. I would like to take this opportunity to thank my supervisor ----------------------- for his
constant guidance and support and encouragement. Moreover, I liked to extend my gratitude to
library staffs for their kind help and support.
Lastly, I would like to thank the health and social care staffs who gave idea regarding various
obesity prevention campaigns launched in UK. The constant support received from all these
persons has been extremely inspiring. It has enlightened me with the thought process of the
research.
Warmest wishes,
Yours Sincerely,

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Abstract:
Introduction and background:
Obesity is a major public health burden and health care of UK has been facing great
burden due to obesity epidemic. Obesity prevalence rate has tripled in last 30 years and it is
estimated to reach 11 million by 2030. With the increase in prevalence rate, despite
implementation of several policies by the UK government, evaluating the strength and weakness
of past government strategy is essential.
Aim:
The main aim of the study is to evaluate the impact of government policies implemented
in UK to reduce the rate of childhood obesity, identify gaps and strength in past government
strategies and recommend innovative solutions to improve efficacy of government strategies to
prevent obesity.
Method:
Narrative review method has been used to explore past strategies and campaigns in an
effective manner. Thematic review method has been used to present research findings.
Results:
The narrative review of research articles gives idea about the strength gaps in government
strategies like social marketing campaigns, population based strategy, food marketing and food
tax policies, nutritional strategies and school related obesity prevention programs. The narrative
review describes results of each campaign.
Conclusion:
On the whole, majority of past strategies were found to be ineffective in reducing the
prevalence of obesity. Apart from various environmental factors, gaps in implementation process
were also found. Increasing the scope of advertising restrictions and narrowing focus of social
marketing campaigns were some recommended actions to have wider impact in the future.

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Table of Contents
Chapter 1: Introduction....................................................................................................................2
Chapter 2: Background and Rational...............................................................................................3
Chapter 3: Methodology..................................................................................................................5
Chapter 4: Presentation of main findings from the literature review:.............................................8
Chapter 5: Discussion and conclusion:..........................................................................................21
References:....................................................................................................................................28

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Chapter 1: Introduction
Obesity is defined as the abnormal accumulation of fat resulting in health issues for
people (Williams et al. 2015). Childhood obesity is one of the major concern for public health
department currently as the issue is prevalent globally both in developed countries and many low
and middle income countries (Patrick et al. 2013). Based on World Health Organization report,
the global prevalence is understood from the fact that in 2016, more than 41 million children
under the age of five were overweight (World Health Organization 2016). Apart from developed
countries, the prevalence rate is also increasing in developing countries. Majority of obese
children continue to be overweight during adulthood and they are most likely to suffer from
chronic diseases like diabetes and cardiovascular disease in the future (Patrick et al. 2013).
Hence, identifying the cause of childhood obesity and evaluating government strategies to tackle
the epidemic would have long consequences.
The problem of weight gain and obesity mostly arise because of the imbalance between
energy intake and expenditure. Although genetic background of an individual significantly
increases the risk of childhood obesity, however child specific risk factors for obesity include
sedentary behaviour, dietary intake and physical activity. These factors differ based on age and
gender. Family characteristics such as parenting style and environmental factors such as free
space and lifestyle also influence eating behaviour of children (Sahoo et al. 2015). Patrick et al.
(2013) argues that parents facilitate positive eating patterns and their parenting style significantly
influence risk factor of obesity. Reviewing parenting practices such as limiting screen time and
focus on physical activity may help to evaluate the cause of obesity in children. Several

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government policies and strategies in different countries target the risk factors and implement
interventions accordingly to deal with the problem of childhood obesity.
In UK, childhood obesity prevalence is going to epidemic levels. Prevalence of obesity
in UK has tripled in the last 30 years and the considering current rate, it is estimated that the
prevalence rate may reach up to 11 million by 2030. Hence, obesity is one of the leading
preventable diseases in UK and in Europe, it is the leading contributor of obesity epidemic with a
contribution of about 24.9% (Renewbariatrics. 2017). As this may have long term consequences
on the health of UK population and increase the burden of the health care system too, evaluating
government’s action taken so far in UK may help to identify the future action that can resolve the
issue of childhood obesity. The main aim of the dissertation is to conduct a narrative literature
review to understand the impact of UK government policies related to childhood obesity and
understand the strength and weakness of government’s action to deal with obesity. This may help
to identify gaps in current policies and future amendment needs to efficiently deal with
challenges of obesity.
Chapter 2: Background and Rational
Childhood obesity is turning out to be an epidemic in developed countries. UK is also one
of the countries that are currently experiencing childhood obesity. This is evident from the fact
that about one in every five children in primary schools is obese (Royal Society for Public Health
(RSPH) 2017). The health survey data for childhood obesity prevalence in England revealed that
one in every five children were obese in 2015/2016. The prevalence is also linked with level of
deprivation as children living in the most deprived areas were most likely to be obese than in the
least deprived areas. Difference in prevalence rate also differs based on ethnic diversity as the

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health survey data for England revealed high prevalence rate for Black/Black British children
(15%) compared to Chinese children (7%) (National Statistics 2017). In the long term, such
prevalence rate can have significant impact on the long-term future of the NHS (National Health
Services) and physical and mental health consequences for affected children. The burden for
NHS will increase due to prevalence of a number of physical health issues associated with
obesity such as cancer, asthma, respiratory problem and diabetes. It may also increase risk of
psychological problems such as anxiety, poor self-esteem and poor body image among children
(Sahoo et al. 2015).
Obesity is one of the preventable diseases has that increased the burden of the health care
system in UK too. Due to the increased diagnosis of childhood obesity and its long term impact
on physical health, UK government has spend about 48 billion pounds a year to take preventive
action against obesity. With the increase in rate each year, the NHS cost may double to 10 billion
pound a year by 2050 (Royal Society for Public Health (RSPH) 2017). To save the extra expense
spend of health issues related to obesity, implementation of effective intervention to lower the
rate of childhood obesity would be needed. Diagnosis of obesity increases many risk for affected
individual compared to a healthy individual. For example, obese people are five times more
susceptible to type 2 diabetes and two time more likely to develop blood pressure compared to
healthy individuals (Toplak et al. 2016). This in future can increase the likelihood of
cardiovascular disease and reduce life expectancy of the population. Hence, to increase the life
expectancy rate of the UK population, decreasing BMI can reduce life expectancy, promote
health and reduce health care associated cost too.
The main rational for reviewing and critically evaluating UK policies related to childhood
obesity by means of a narrative review is the increase in childhood obesity prevalence each year

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and little evidence of cost reduction due to implementation of policies or campaigns to prevent
obesity. Jebb, Aveyard and Hawkes (2013) states that obesity as health threat to the nation was
identified long back by the Conservative government in England. Since, then formal government
strategies were implemented in 2008 and 2011 to prevent childhood obesity. These targeted
active sports participating in schools, fruits and vegetable intake in children, eating habits, diet
status, park use and walking levels in children. Many new government policies for marketing
restriction in foods high in fats, sugar and salt, nutritional standards in schools, weight
management and sport programs were also developed. Annual surveys shows reduction in
obesity rates in recent years, however the problem has not been reversed. Hence, review of
research papers investigating about the impact of different government policies in UK may help
to determine gap in current child obesity prevention initiative and find out more about ways to
reduce issues found in past government strategies related to childhood obesity. It may help to
improve the implementation process and other challenges found in implementing government
strategies.
Aim and objectives:
The main aim of the study is to evaluate the impact of government policies implemented
in UK to reduce the rate of childhood obesity and other challenges associated with childhood
obesity.
The main objectives of the narrative review are
 To identify and evaluate different policies implemented in UK to prevent and control
childhood obesity

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 To identify gaps and strength in past government strategies related to childhood obesity
prevention
 To recommend future action to improve the efficacy of government strategies and
campaigns to reduce childhood obesity and other health concerns for the affected
population
Chapter 3: Methodology
Research design:
As the main aim of the research is to critically evaluate UK government policies related
to childhood obesity prevention, narrative literature review method has been chosen as the
research design for the study. Narrative reviews critically evaluates different primary studies
specific to the research topics and focus on holistic interpretation based on current theories
practice. Narrative reviews are suitable research design when the purpose of the research is get
comprehensive information related to a research (Hart 2018). This research design may help to
individually evaluate different policies in the area of food marketing, food and nutrition, physical
activity and school programs in UK to prevent childhood obesity. In contrast to systematic
review, a narrative review presents findings of a research in a condensed format that summarizes
and critiques each study (Green, Johnson and Adams 2006). Therefore, narrative review method
can help to present broad perspective related to the obesity prevention policies in UK and
identify improvements needed in current policy initiative.
Search strategy:
Search strategy is the process used to organize the search process and find relevant
articles related to the research topic and research objective. A comprehensive search for relevant

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literature is guided by specific search terms, selection criteria, critical assessment or evaluation
and data analysis process. Keywords and eligibility criteria forms the basis of searching articles
from relevant databases. Apart from key words, several phrases, Boolean operators and subject
headings also helps to retrieved relevant articles for reviewing the literature. For this research
wide variety of key words were used to find articles as the aim was to evaluate diverse range of
UK government policies related to obesity prevention. The search for articles were done from
PubMed, Medline and CINAHL databases and the key search terms included in the search
includes ‘childhood obesity’, ‘child obesity in UK’ and UK policy related to childhood obesity.
This was the primary search terms. Based on the identification of different UK policies, other
secondary search terms were also used to find relevant literature related to the topic. Boolean
operators like ‘AND’ and ‘OR’ was also used for searching articles from CINAHL databases.
The Boolean operators helped to separate different phrases and arrange key terms similar in
meaning. Hence, use of ‘AND’ narrowed down the search process to get more information on
policies and the use of ‘OR’ broadened the search hits by including all studies that is relevant to
childhood obesity.
Inclusion and exclusion criteria:
Setting eligibility criteria in a literature review supports a researcher in the search process
and selection of articles for research. To find research articles relevant to the impact of UK
government policies on dealing with childhood obesity, the following inclusion criteria where
developed:
 All research articles must critically evaluate UK policies related to obesity
 The article should give detail on research findings from UK

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 All research articles must be published within 2008 to 2018
 Articles published in English language should be included in the literature review
To get relevant research articles and segregate those which are not specific to the research
question, the following exclusion criteria were taken:
 Articles published before 2008 will be excluded from the review
 Articles published in other language other than English will not be taken in the review
 Articles which gives details on strategies implemented in other countries other than UK
will be excluded
 Articles discussion about adult obesity will be excluded
Data analysis:
Different qualitative research has different techniques for conducting and documenting
data analysis process. Thematic analysis is one of the data analysis methods that enable
developing sensitive and rich research findings. The advantage of thematic analysis method is
that it can be utilized to answer different types of research questions and epistemiology.
Thematic analysis has a flexible research approach and the findings presented in the form of
themes helps in easy grasp of research findings. A clear and organized report can be easily
produced through thematic analysis research methods (Nowell et al. 2017). However, the
common challenge in writing a thematic analysis is that it often contributes to many
inconsistency and lack of coherence while developing themes for research findings. However,
consistency can be improved by making explicit epistemiological position.
After selection of research articles based on inclusion and exclusion criteria and by
setting search limits, articles were analysed in two stages. In the first stage, the title and abstract

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were analysed to find its suitability to answer research question. In the second stage, the full text
articles were read to critically appraise research findings and identify strength and weakness of
UK policies related to childhood obesity. The findings were presented in the form of themes
according to thematic analysis of research literature. Thematic analysis is a method of data
synthesis, where the focus is to identify patterned meaning across wide range of data and analyse
research findings based on the identified themes (Braun, Clarke and Terry 2014). Thematic
analysis supports a researcher to find meaning in unrelated research materials and systematically
gain knowledge phenomenon or topic of interest. Thematic analysis is also a useful research
method when the purpose is to review large number of qualitative data (Braun and Clarke 2014).
Therefore, thematic analysis can yield useful research for this narrative review too.
Chapter 4: Presentation of main findings from the literature review:
Social marketing campaigns implemented in UK had large focus and very few positive outcomes:
Numerous initiatives were implemented by the UK government at school level to prevent
risk of childhood obesity. The Change4Life (C4L) was one of the campaigns that focused on
fulfilling the needs of physically inactive children. The research by Croker, Lucas and Wardle
(2012) investigated about the impact of C4L campaign on preventing obesity in England. C4L
targeted was a primary prevention approach launched in January 2009 in UK to prevent
childhood obesity. The social marketing campaign emphasized on targeted message to raise
awareness regarding long term consequences of overweight and obesity, developing healthier
habits and reducing consumption of foods high in fat and sugars. Families with children between
1-11 years and pregnant women were targeted and research participants were selected based on
research on people exhibiting behaviour and attitude that can increase risk of children becoming