Change kids’ environment to tackle childhood obesity

A major report from Guy’s and St Thomas’ Charity argues that framing obesity as an issue of individual willpower overlooks the overwhelming evidence from behavioural science on how environments influence people’s decision-making.

Despite increasing rates of childhood obesity across the developed world, Bite Size: Breaking down the challenge of inner-city childhood obesity claims progress is possible if efforts are focused on breaking the link between deprivation and obesity, particularly in inner-cities.

The report has been developed in partnership with the Behavioural Insights Team and features contributions from the Alexandra Rose Charity, who are a member of Sustain. It reflects experiences from projects on the ground as well as families living in disadvantaged areas. The report finds that it is in these areas in particular where people are bombarded with opportunities to eat high energy food and have less defence against ‘obesogenic’ city environments that promote unhealthy choices.

Key insights of the report:

  1. We need to rethink and reframe childhood obesity as a normal response to an abnormal environment. The frequent framing of obesity as an issue of individual willpower ignores the overwhelming evidence from behavioural science that reinforces the need to consider the role our surroundings play in driving unconscious decision-making each day.
  2. Childhood obesity is a problem of inequality. These is a clear and persistent relationship between childhood obesity and deprivation. The burden is falling heaviest on disadvantaged neighbourhoods with children twice as likely to be obese as their wealthier neighbours. This ‘deprivation gap’ has increased by over 50% in the last ten years.
  3. Poor decisions are exacerbated by ‘scarcity’ (of money, time and headspace). In an ideal world, we’d all be completely rational, able to make considered, informed decisions. But the reality is none of us are, and families in disadvantaged areas in particular have less cognitive defence against unhealthy environments. Decision- making is affected by having less available time, money and a need to focus on immediate issues.
  4. Solutions don’t have to be complicated. The relationship between deprivation, diversity and the urban context is often unpredictable and nonlinear. But despite this, the complexity of what drives childhood obesity does not mean that interventions must be equally complex. A broad range of interventions - applied consistently at both the individual and community levels - has the most potential to tackle childhood obesity when aggregated at the population level.

Bite Size suggests many practical principles to tackle childhood obesity. Amongst these is that physical activity is secondary to calorie consumption. “An 80-20 split in focus on diet over exercise is a good rule of thumb.” Using the evidence from behavioural economics the report emphasises the importance of making healthy choices easier and to have realistic expectations of the amount of spare time and cognitive effort people have, particularly amongst people living in deprived areas.

Kieron Boyle, Chief Executive of Guy’s and St Thomas’ Charity said:

“To tackle childhood obesity we need to be clear that its effects are disproportionately centred on poorer families; that it is as much a problem of environments as it is of willpower; and that although the issue is complex, the solutions do not have to be. Our report demonstrates that everyone needs to play a role. The places our children grow up – our homes, schools and streets – are influenced by many different people. We will succeed by bringing them together and creating environments that make the healthy thing to do, the easy thing to do.”

Sustain's Deputy CEO, Ben Reynolds, contributed a quote to the report:

"We are all up against the contast drip, drip effect of promotions and marketing for sugary food and drink, coupled with handily situated chicken shops and various tricks of the trade designed to tempt us to choose less healthy items.

We welcome the confident vision and 'can do' attitude that this report takes, and hope that the programme that follows in Southwark and Lambeth is able to lead the way in showing local areas that change is possible."

Sustain’s Children’s Food Campaign champions children’s rights, parent power and government action to improve the food environment children grow up in.

Children's Food Campaign


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Children's Food Campaign: Better food and food teaching for children in schools, and protection of children from junk food marketing are the aims of Sustain's high-profile Children's Food Campaign. We also want clear food labelling that can be understood by everyone, including children.

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