Best use of social care or health research

Britain Thinks and Healthy London Partnership – The Great Weight Debate


London’s childhood obesity epidemic is a public health crisis.

Tackling this crisis will require engaging both policy experts and the public. To kick-start this conversation, Healthy London Partnership commissioned BritainThinks to deliver the Great Weight Debate. This multi-stage, co-creative engagement work culminated in a day-long event which brought together 120 Londoners and 30 healthy policy experts to develop, refine and prioritise ideas for change.

This complex work was characterised by:

  • Ongoing engagement with multiple stakeholders in this space (e.g. NHS England)
  • Sensitive engagement with the public, to ensure language and tone was correct
  • Widespread consultation with experts in the childhood obesity space
  • An imaginative approach to including children’s voices in the event, ultimately delivered through filmed ‘vox pop’ interviews
  • A robust analytical framework

The project is a powerful example of the effectiveness of co-creative approaches in allowing the public to work on equal footing with “experts”.

It is also evidence of the importance of framing. By positioning childhood obesity as an environmental issue, we were able to move beyond concerns about personal responsibility and to inspire real desire for change.

Since the event, engagement has been continued, notably through local Great Weight Debate events hosted in London’s boroughs.

Wow factor

Contrary to expectations, the public and health experts agree about what is needed to tackle childhood obesity. Combining the experiences of Londoners with the policy knowledge of professionals resulted in public attitudes shifting away from a focus on education and individual responsibility towards support for more interventionist policies.


London has higher rates of childhood obesity than any peer global city. One in five children in reception in London schools is overweight or obese. By Year 6, this has risen to one in three.

Healthy London Partnership (HLP) is committed to tackling this crisis. They recognise that, to achieve this, they will need to engage not only those working in the health sector, but also galvanise Londoners to take action.

HLP therefore commissioned BritainThinks to deliver a research and engagement programme to explore Londoners’ understanding of the issue of childhood obesity and, together with those working in the health sector, develop ideas for change.

This was a complex project, posing many challenges and requiring an innovative approach.

There are many stakeholders with an interest in childhood obesity. It was essential that they were engaged

  • We consulted a broad range of stakeholders throughout the process, inviting them to feed into the design and comment on outputs. These stakeholders included Public Health England; NHS England; the London Obesity Leadership Group; CCGs

On an issue this sensitive, it was essential we used language rooted in Londoners’ own experience, and which would not inadvertently offend anyone

  • We therefore commenced the research with focus groups to understand what language to use, and played this back throughout the programme

We knew that there are already many ideas about how to tackle childhood obesity – and that to have credibility with stakeholders we would need to consider and incorporate these

  • We therefore conducted a series of roundtables with a broad range of experts working in the health space to identify these ideas

To really galvinise Londoners, they needed to be involved in designing the solutions

  • The programme therefore culminated in a day-long co-creative event (the Great Weight Debate), bringing together 120 Londoners and 30 health policy experts to work together to design and develop ideas for change

It was essential that the ideas generated at the event were robust, and not simply rooted in personal experience

  • We therefore developed an analysis framework that was used to assess ideas in the workshop, looking at cost effectiveness, feasibility and sustainability

Finally, it was important that the event itself was rooted in the voice of London’s children

  • We therefore conducted a series of filmed interviews with London school children that we showed at the start of the event

The priority ideas for change have since been used by HLP as the basis of policy discussions with the wider health world.

In addition, the project has had a number of additional impacts:

  • It generated publicity around the issue of childhood obesity in London, through BBC London coverage of the event
  • The project has been used as a platform to engage more Londoners in this vital issue. Most notably, the Great Weight Debate format has been replicated across London boroughs
  • Young people at the event were invited to act as health champions
  • Engagement with Londoners who took part has continued through HLP’s online platform

Lessons learned

It is easy to assume that the public are not able to engage in complex policy debates on an equal footing with ‘experts’. This project showed that this assumption is incorrect.

With the correct structure, and the right information and support, the public are comfortable debating with and challenging experts. Moreover, this process is mutually beneficial for both sides; feedback from the Great Weight Debate showed how valuable our expert participants found it.

In addition, the work demonstrates the vital importance of how discussions are framed. Often, childhood obesity is discussed in terms of personal responsibility, which can make it difficult to have a rounded conversation. However, sharing information about the impact of the environment had a transformational impact on how Londoners conceptualised this issue, and moved them from disassociation and blame, to a sense of solidarity, and a strong desire to take action.

Find out more by downloading the report