CO-CREATE and childhood obesity
CO-CREATE aims to prevent overweight and obesity in adolescents by providing knowledge and infrastructure on policies to support making the healthiest choices the preferred ones. Adolescents are included in all aspects of the project, rooting the perspective of the key stakeholders themselves into project activities.
Childhood obesity – a growing epidemic
Childhood obesity is one of the most serious global public health challenges of the 21st century. As highlighted in the World Obesity Federation’s Global Atlas of Childhood Obesity, no country has a better than fifty percent chance of meeting their target for halting the rise in childhood obesity, and no country is on track to meet the WHO targets for childhood obesity by 2025: if current trends continue, the global prevalence of childhood obesity is expected to reach 254 million by 2030, an increase of 100 million over the next decade. In Europe, it is estimated that by 2025, overweight and obesity will affect one in every five children, representing more than 16 million children across Europe.
Living with overweight or obesity in youth and during adolescence (13-18 years) is a strong predictor of adulthood overweight and obesity. Furthermore, obesity is also a risk factor for a number of non-communicable diseases including type-2 diabetes, hypertension, heart disease, psychosocial morbidity, and certain types of cancers. Children living with obesity are also more likely to experience negative consequences including lower levels of self-esteem, higher likelihood of being bullied, poorer health attendance levels, poorer school achievements, poorer health in adulthood as well as poorer employment prospects. Childhood obesity therefore leads to several health, social and economic consequences throughout the life-course.
Traditionally, childhood obesity interventions have largely focused on individual-level behaviours. Considering the current trends, it is clear that a new approach is needed. Multi-component interventions that include diet, physical activity and family components are often identified as the first line of treatment options. Prevention should also be a central prioritised strategy with a strong focus on the adolescent age group.
From individual to contextual changes
What we eat and how much we move are direct results of the many individual choices we make each day. Obesity prevention efforts have often focused on trying to influence such individual choices as if they were conscious and rational. However, these choices are strongly influenced by the social, physical and economic environments in which we live. This is especially relevant for children and adolescents, who have lower levels of behavioural autonomy than adults do.
In our present-day environment of ever-presence and easy access to cheap, palatable high-calorie foods appealing to our natural preferences for fat, sugar and salt, our sedentary work and leisure environments, as well as a lack of opportunities for daily physical activity, unhealthy choices are often the easiest, default choices. A large and growing body of research shows that people’s nutrition and physical activity behaviours are influenced by complex sets of contextual elements, including unhealthy and unsupportive physical, social, cultural, economic, and political environments.
To be successful in reducing the prevalence of overweight and obesity, we need to move towards comprehensive policies addressing the food and physical activity systems and environments surrounding us, reshaping the context to make healthy choices the easiest and most widely preferred.
Policies for a healthier future
In line with this, CO-CREATE focuses on policy actions with a potential to sustainably reduce the prevalence of obesity among adolescents in Europe. To achieve their objective, the project works with adolescents as active partners to identify the drivers of obesity and the obesity-related policies that hold promise in building a healthier future. Learn more about youth involvement in CO-CREATE here.
CO-CREATE’s systems mapping work with adolescents has demonstrated causal chains driving dietary and physical activity habits and reiterated the lack of public policy that focuses on increasing physical activity and mental health. The influence of social media use among adolescents on their body image and motivation to exercise are not reflected in policy and research. Society is not promoting these topics now. Our environments do not support them. And therefore, people are not able to access physical activity opportunities and mental health services easily.
By using a complex systems approach, the project provides valuable contributions to enhance our understanding of how the broad range of factors at different policy and contextual levels impacts adolescents’ diet, physical activity, and weight, and identify relevant policy responses.