Table 1

Whole system policy recommendations to address the obesity crisis

Highlighted issuesPolicy recommendations
The hostile political economy
  1. Equity, not austerity, must be at the heart of policymaking. Quality employment, rigorous welfare and bringing the minimum wage in line with the real living wage.1

  2. Increase levels of spending on early years and establish a rescue plan for these centres in the most deprived areas, often with the highest obesity levels. Early years centres improve equity and are vital in the ‘levelling up’ agenda.1

The
obesogenic environment
  1. Implementation of healthier urban development and city planning. Measures to ban fast-food outlets within 400 m of a school are welcome and ought to be extended across the UK. Working with fast-food businesses in deprived communities to shift towards healthier menus establishes a foundation for private–public cooperation. Healthy urban development and city planning should be set to a minimum standard to reduce the significant heterogenicity across the UK.4

The wider
neighbourhood factors
  1. Neighbourhood factors conducive to health-promoting physical activity need to be considered as part of the ‘whole system’ obesity strategy. This can be achieved through introduction of safe, aesthetic and welcoming open spaces and greenspaces with adequate security forming the nucleus for physical activity in the most deprived neighbourhoods. Locally delivered free physical activity initiatives should be developed and implemented at these hubs.5 Children have suggested that free Wi-Fi access in these areas would encourage use.

The emerging
food exclusivity
  1. A 10% food subsidy programme on fresh produce should be available nationwide. A simple 10% reduction in prices of healthier foods results in a 14% increase in the consumption of fruit and vegetables, benefiting stakeholders and policymakers.7 In the most deprived communities and most deprived individuals, a voucher scheme or a 100% subsidy on fresh produce should be sought as a measure to tackle obesity, a novel initiative of great success in the city of Washington, DC.7