Many of the benefits of engaging people in living healthier lives occur in the long term but there are also immediate and short-term benefits when demand for health services can be reduced, especially in those areas such as acute services where capacity is seriously constrained.

[This] review has been focused particularly on prevention and the wider determinants of health in England and on the cost-effectiveness of action that can be taken to improve the health of the whole population and to reduce health inequalities. It was asked to consider consistency of current policy with the public health aspects of the 'fully engaged' scenario outlined in the 2002 report. The definition of public health for this review has been drawn very widely; essentially it considers public health to be 'the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals.'

Citerank: (21) 348675Adopt a whole systems approach to obesityTackling obesity effectively—accomplishing a population wide-shift—requires a comprehensive and integrated whole systems approach, involving a range of measures focusing on individuals, social and other systems, including at the local and community level, and on the interrelated physical, physiological, social and cognitive factors that determine health outcomes.565CA4D9, 348693Stakeholders – Groups & ActionsExplore the map via the different stakeholder groups and the measures each group can take to help tackle the obesity crisis.58D3ABAB, 348703Actions – Industry2794CAE1, 348780Causes of obesityUnderstanding the causes of obesity is critical to the success of prevention and treatment strategies. However, while (simply put) obesity occurs when energy intake from food and drink consumption is greater than energy expenditure through the body’s metabolism and physical activity over a prolonged period (resulting in the accumulation of excess body fat), in reality many complex behavioural and societal factors contribute systemically to the current crisis and no single influence dominates.555CD992, 352281Changes required across many different policy areasObesity has to be seen as not just a technical, food, physical activity or healthcare problem but a challenge for what sort of society is being built. Small, incremental, publicity-driven (i.e. social market-based) changes might suit the existing balance of policy interests, but a more extensive, co-ordinated, cross-sectoral action would be more effective.1198CE71, 352314Actions – Central Government2794CAE1, 352387Previous physical activities replaced by industrially generated energyIndustrial development allows many different aspects of life that previously involved daily physical activity to be accomplished through industrially generated energy instead; for example, the substitution of motorised transport for walking and cycling, a shift from manual and agricultural work towards office work, and a multitude of labour saving devices at work and in the home.555CD992, 352388Advertising and marketing reinforce new eating patterns Marketing and advertising instil and reinforce new cultural norms about what (e.g. fast food) and how to eat (e.g. snacking), and how much (e.g. larger portions) to eat.555CD992, 352389Reluctance to talk about and address implications of own weightThe weight of the population continues to rise despite media imagery of thin models encouraging a slim ideal that is far out of reach for most of the public. In this context, “Fat” remains an emotive and stigmatic subject – and often perceived as an insult – which makes it harder for people to acknowledge, confront and address their own obesity (and harder for others including health professionals to encourage them to do so too).555CD992, 352391Industrial development changes what and how people eatEconomic and industrial development has tended to be accompanied by a historic shift in patterns of food consumption from diets high in cereal and fibre to diets high in sugars, fat, animal-source food and highly-processed foods – creating a socio-cultural environment in which obesity is more likely to emerge in the population.555CD992, 352399Successive governments have made counterproductive policy choicesThe growing prevalence of obesity in the UK is partly the result of well-intentioned but counterproductive policy choices made by successive governments over several decades.555CD992, 352400Many individuals are consuming more energy than they are expendingPublic Health England estimates that the average man in England is consuming around 300 calories a day more than they would need were they a healthy body weight.555CD992, 399547Adopt a whole systems approach to obesityTackling obesity effectively—accomplishing a population wide-shift—requires a comprehensive and integrated whole systems approach, involving a range of measures focusing on individuals, social and other systems, including at the local and community level, and on the interrelated physical, physiological, social and cognitive factors that determine health outcomes.565CA4D9, 399558Changes required across many different policy areasObesity has to be seen as not just a technical, food, physical activity or healthcare problem but a challenge for what sort of society is being built. Small, incremental, publicity-driven (i.e. social market-based) changes might suit the existing balance of policy interests, but a more extensive, co-ordinated, cross-sectoral action would be more effective.1198CE71, 399887Causes of obesityUnderstanding the causes of obesity is critical to the success of prevention and treatment strategies. However, while (simply put) obesity occurs when energy intake from food and drink consumption is greater than energy expenditure through the body’s metabolism and physical activity over a prolonged period (resulting in the accumulation of excess body fat), in reality many complex behavioural and societal factors contribute systemically to the current crisis and no single influence dominates.555CD992, 399890Successive governments have made counterproductive policy choicesThe growing prevalence of obesity in the UK is partly the result of well-intentioned but counterproductive policy choices made by successive governments over several decades.555CD992, 399891Many individuals are consuming more energy than they are expendingPublic Health England estimates that the average man in England is consuming around 300 calories a day more than they would need were they a healthy body weight.555CD992, 399896Industrial development changes what and how people eatEconomic and industrial development has tended to be accompanied by a historic shift in patterns of food consumption from diets high in cereal and fibre to diets high in sugars, fat, animal-source food and highly-processed foods – creating a socio-cultural environment in which obesity is more likely to emerge in the population.555CD992, 399907Reluctance to talk about and address implications of own weightThe weight of the population continues to rise despite media imagery of thin models encouraging a slim ideal that is far out of reach for most of the public. In this context, “Fat” remains an emotive and stigmatic subject – and often perceived as an insult – which makes it harder for people to acknowledge, confront and address their own obesity (and harder for others including health professionals to encourage them to do so too).555CD992, 399917Advertising and marketing reinforce new eating patterns Marketing and advertising instil and reinforce new cultural norms about what (e.g. fast food) and how to eat (e.g. snacking), and how much (e.g. larger portions) to eat.555CD992, 399923Previous physical activities replaced by industrially generated energyIndustrial development allows many different aspects of life that previously involved daily physical activity to be accomplished through industrially generated energy instead; for example, the substitution of motorised transport for walking and cycling, a shift from manual and agricultural work towards office work, and a multitude of labour saving devices at work and in the home.555CD992