A holistic or ‘whole systems approach’ to obesity prevention could offer a more effective means of tackling high, unequal and increasing levels of obesity in Northern Ireland.
That’s according to a new report examining best international evidence and case studies of this approach, developed by researchers at the Institute of Public Health, Ulster University, Queen’s University Belfast, and University of Hertfordshire for the Department of Health.
The report comes as the Department of Health prepares to draft a new obesity prevention strategy this year to replace its predecessor, ‘A Fitter Future for All 2012-22’.
The latest data shows that one in four adults (27%) and around one in 16 children (6%) are living with obesity in Northern Ireland.
Official data further shows that the development of obesity is strongly linked to deprivation status. Between 2011/12 and 2018/19, one in three (36%) Primary Year 1 children living in the most deprived areas were more likely to have overweight or obesity compared to those living in the least deprived areas, representing a 12% increase since 2011/12 (24%).
Obesity increases the risk of developing chronic disease, such as colon cancer, high blood pressure, or type 2 diabetes, and is linked to substantial direct and indirect costs – estimated to be of the order of £370 million in Northern Ireland in 2009.
This new report explores how a whole systems approach (WSA) can be used in obesity prevention by focusing on the systems within which people are born, grow, live, work and age.
International examples show that a WSA can offer an alternative and potentially effective means of addressing obesity, where a multi-agency and partnership approach was adopted.
In real terms this could mean introducing policy change, new ways of government departments working together, interventions at community level or improving local amenities and facilities to support healthier food and dietary choices or enhanced opportunities for physical activity.
Lead researcher on the report Dr Gavin Breslin, Senior Lecturer in the School of Psychology at Ulster University, said: “The rate of obesity in Northern Ireland is high and rising – more than a quarter (27%) of adults are living with obesity, putting this group at a higher risk of developing chronic disease. Inequalities in health are continuing to widen, with socially disadvantaged communities experiencing an excess of obesity-related harms. Given these challenges, we need to consider a more holistic approach to tackling obesity. By tackling physical health concerns, mental health concerns that are linked can also be reduced.”
“We have reviewed international good practice examples of applying a whole systems approach to preventing obesity. This report shows there is significant potential to use this approach to prevent obesity in Northern Ireland by working collaboratively across departments and agencies, targeting policies and implementing interventions at a community level. In my view there is a need for a psychological shift in how we approach obesity through adopting a whole systems approach.”
Dr Jenny Mack, Public Health Consultant at the Institute of Public Health, added: “Addressing the environmental and commercial determinants of health is at the heart of the ‘whole systems approach’ to obesity prevention. The City of Amsterdam has led the way in this regard with the ‘Amsterdam Healthy Weight Approach’ (AHWA); a whole systems approach to tackling obesogenic environments. The approach has focused on the importance of early intervention, ‘Health in All Policies’ and reducing inequalities in obesity and, so far, the results are promising. We now have an opportunity to learn from cities like Amsterdam, to take a more holistic, collaborative approach to preventing obesity in our local communities.”
Dr Laura McGowan, Lecturer in Nutrition and Behaviour Change at Queen’s University Belfast, and Lead for the Association for the Study of Obesity Northern Ireland Network said: “Addressing obesity to improve population health is really important – both in terms of prevention, and having the appropriate services for managing obesity in those who already live with the condition. Whole systems approaches to obesity prevention allow us to see the wider drivers of obesity, which reach far beyond individual responsibility, and help us to see the changes that are needed at many different levels in our society to support individuals with healthy behaviours.”
Professor Wendy Wills, Professor of Food and Public Health, University of Hertfordshire and Director of the Centre for Research in Public Health and Community Care, added: “Exploring the whole systems that shapes obesity ensures that we do not drift into focusing on individual behaviour only and that we take a wider societal and holistic view of other contributing factors and challenges.”
Northern Ireland’s previous obesity prevention strategy, ‘A Fitter Future For All’, was launched in 2012 and ended last year.
The Department of Health intends to launch a public consultation on a new obesity prevention strategy for Northern Ireland this year.
Read the report below and download it here.