Public views and acceptability of policies designed to achieve a healthy weight across the United Kingdom: qualitative analysis of the role of government mistrust and legitimacy of policy actors

Abstract Background Rates of overweight and obesity for children, young people and adults remain high in the UK and globally. Research demonstrates that policies continue to drift downstream and focus largely on individual behaviours. In response, the Obesity Health Alliance (OHA) in the UK published– Turning the Tide: A 10 Year Healthy Weight Strategy – a long-term agenda of evidence-informed policies with 30 recommendations. A key aspect to the successful implementation of policies is public acceptability. The study aimed to explore public views of obesity policy recommendations in the OHA’s Healthy Weight Strategy, and broader views on the policy process surrounding the implementation of these recommendations. Methods Participants engaged in a qualitative two-stage interview approach was designed for the study, with 26 participants recruited across England, Scotland and Wales. Participants were recruited to the study using a commissioned, established, GDPR compliant market research agency based in England. Interviews were conducted between October 2021 and January 2022. Data were analysed thematically using NVivo. Results Findings demonstrate a broad acceptance of the policy recommendations, with a desire for those that support individual autonomy. Children were viewed as a key population, as well as a powerful framing device through which to improve policy support. Despite policy support, participants expressed a lack of trust in the government’s will or ability to implement the policies, something that a range of studies relating to other policy areas have found in the UK context. There was also a tension surrounding who is or is not a legitimate policy actor, with strong support for government and public involvement, and a rejection of industry participation in policy making. Conclusions These findings add to the growing literature on public acceptability of policies relevant to overweight and obesity. In this study, the acceptability of such policies appeared to be underpinned by whether or not participants trusted those holding power to implement the policies effectively and act in the best interests of the public. There is a need to continue to engage the public in wider policy debates regarding population health and policy options available to improve it.