Exploring UK adult and policy stakeholder perspectives on obesity prevention policy and inequalities

Abstract In England, 14 obesity strategies have been published, including 689 proposed policies, while rates of obesity persist, and inequalities worsen. This study explores adults’ attitudes in relation to food-related obesity policy and how socioeconomic inequalities in obesity are considered throughout the policy process through the perspective of policy stakeholders (PSH). 31 semi-structured interviews with UK-based adults (GPP) (18+) and 14 interviews with PSH categorised as government officials, academics, and advocacy group representatives were conducted and analysed using Braun and Clarke’s thematic analysis. Both PSH and GPP attributed obesity causation primarily to the food environment rather than to individual behaviour. The PSH identified the food industry’s role in shaping the environment. Level of deprivation was believed to exacerbate the barriers to healthy weight in both samples. All participants agreed that, in the UK, there was an unequal opportunity to attain a healthy diet. A disconnect was found between the GPP perspectives towards the barriers to healthy weight and their attitudes towards policy action. The GPP described mistrust in the government’s motives and willingness, fuelling the perspective that policy lacked impact and was disconnected from their lived experiences, particularly among participants of lower socioeconomic status and higher weight classifications. The PSH raised concerns regarding barriers to policy implementation, including inconsistent government commitment, competing priorities, and resistance to state intervention. PSH suggested that it was unfeasible to prioritise inequalities while population rates remain high, and the failure of implement proposed policies continue. This study shows the necessity of incorporating a health equity lens, breaking down policy silos, and amplifying community voices in the policy process to challenge assumptions regarding lived experiences and ensure healthier equitable policy outcomes. Key messages • The study shows the importance of integrating a health equity lens, breaking policy silos, and amplifying community voices to challenge assumptions and achieve more equitable policy outcomes. • Obesity policy requires greater consideration to inequalities to strengthen policy impact as demonstrated by all participants recalling the unequal opportunity to sustain a healthy weight in the UK.