Evaluation of Public Health approaches of obesity prevention and management in England: lessons learned for Brunei

Abstract

Tackling obesity is a major public health challenge. Obesity strategy and policy in England has been heavily criticised for being ineffective in tackling the problem of obesity. Although many studies have evaluated interventions for obesity, there is no clear evidence about which interventions are effective in the prevention and management of obesity in primary care and community settings. The main purpose of the study was to evaluate the effectiveness of current public health approaches for obesity prevention and management, in particular focusing on behaviour change models as intervention and also policy actions implemented at local level (primary care trusts) in England. It also intended to identify obesity strategies relevant to Brunei as lessons learned from England. The methods used were systematic review, policy analysis and validation. The main finding of this study had shown that the ‘Transtheoretical model stages of change’ used in combination with diet and physical activity has limited impact on weight loss (about 2 kg or less) and there was no conclusive evidence for sustainable weight loss beyond 12 months. In addition, there were significant variations found in obesity strategies implemented by primary care trusts in north-west London based on analysis using the Imperial College Obesity Strategy Assessment Framework. The key lesson learned for Brunei from England’s experiences was the development and application of Brunei-IC-OSAF that contributed to the formulation of ‘comprehensive obesity policy’ for Brunei. The tool had identified strengths and weaknesses of the existing obesity strategies implemented in the country. The outcomes of the study contributed to the existing evidence about what works in tackling obesity in public health settings, informing better pathway development and commissioning decisions.