Children's and adolescents' responses to public health obesity policies and weight monitoring in England: A qualitative study.

Abstract

There is a lack of understanding of the benefits and potential inadvertent harms associated with public health obesity policies. The aim of this study was to explore with children in England the impact of selected public health obesity policies and weight monitoring, within the context of their overall food environment. Qualitative study. Focus group discussions were conducted in primary and secondary schools in the southeast of England with children in Years 5-8 (aged 9-13 years). Discussions focused on two policies considered salient to children (multiple traffic light labels (MTL) and calories on menus), and the National Child Measurement Programme (NCMP). Interviews were analysed using framework analysis. 16 focus groups were conducted across 4 schools (n = 80 children). 4 themes and 10 sub-themes were developed: (1) MTL included 'only red and green make sense' and 'they're not for us'; (2) Calories on menus included 'calories might mean health', 'I just choose what I like' and 'it could make people feel bad'; (3) NCMP included 'most of us don't remember it' and 'what if people find out my weight'; (4) Wider food environment included 'TikTok shows ways to become perfect', 'fast food adverts pop up all the time' and 'my mum is against sugar'. Discussions with children indicate little, if any, perceived positive impacts of the selected obesity policies and weight monitoring, and potential negative impacts for some children. Findings also highlight the need for effective policies to protect children from food marketing and social media risks.