Background Following considerable interest in the relationship between obesity and COVID-19, the UK Government have released a policy paper: ‘Tackling obesity: empowering adults and children to live healthier lives’.¹ This response may be focused on a limited and potentially historical view of overweight and obesity. We consider the complexity of the condition, its determinants, and co-existing conditions.²

Objectives We sought to gain consensus iteratively, using implementation framework thinking, to advocate for the appreciation of a wider, more complete understanding of the existing science behind obesity and the appropriate strategies needed to address it.

Results We identified four strategic points and provided recommendations for more comprehensive coverage and greater impact: 1. Improving focus and messaging 2. Understanding drivers of food choice and nutritional status 3. Promoting healthy eating from early years 4. Addressing the complexity of obesity

Discussion 1. Effective messaging should be inclusive, collaborative and non-judgemental, promoting co-participation in the development of messages used in public national campaigns.³ 2. Higher rates of obesity are observed in socioeconomically deprived groups who rely on food assistance programmes, in which nutritional quality could be improved through involvement of nutrition professionals.⁴ In order to influence behaviour, basic food literacy and financial management skills could be developed, while subsidies for healthier alternatives may complement taxes on less healthy foods.⁵ 3. Advocating for better education on food science and nutrition from early learning sectors will promote increased awareness early in life.⁶ This could be augmented by reinstatement of initiatives like the healthy start programme. 4. Human health is multi-dimensional, therefore focussing on a single-metric risks oversimplifying this complexity and undervaluing the importance of healthy behaviours, even those not directly associated with weight.⁷ Instead, we should consider positive lifestyle habits, rather than a narrow focus on weight or BMI alone for the individual, informed by existing and accepted scientific findings.

Conclusion An integrated systems approach ought to be developed with a multipronged intervention strategy, targeting food production, supply and environments as well as marketing to improve availability of as well as accessibility to more nutrient-rich but less energy-dense foods. These combined with appropriate food education for consumers would enable more consistently healthy food choices.

Acknowledgements NNEdPro Virtual Core and Global Innovation Panel; Nutrition and COVID19 Taskforce

References

1. UK Government - Tackling obesity: empowering adults and children to live healthier lives. July 2020.

2. Foresight, Obesity Systems Map. 2007.

3. Language Matters: Language and diabetes. 2018.

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