Obesity is a complex global health concern affecting approximately 800 million people worldwide. World Obesity Day – 4th March – is a unified day of action to increase awareness, encourage advocacy, and improve existing policies and interventions. This World Obesity Day, we urge you to consider childhood obesity: currently surpassing rates of adulthood, it has now been recognised as one of the most serious public health challenges of this century (Forouzanfar et al., 2016; WHO, 2016). 

It’s plausible that this leading health concern has been exacerbated by disruption to health behaviours – including eating, physical activity, and screen time – as a result of the COVID-19 pandemic (Moore et al., 2020; Pietrobelli et al. 2020). The pandemic has aggravated inequalities in childhood obesity, stemming from socioeconomic status and poverty, with children in the North of England experiencing less investment for intervention, higher poverty, and coincidingly, much higher rates of obesity. Whilst rates continue to rise, there is little evidence regarding effective and successful interventions for childhood obesity, particularly considering the disruption caused by COVID-19.

Prior research conducted at the University of Liverpool has found that people with obesity have disproportionately been affected by the environmental and social disruption caused by the pandemic; being less capable to maintain healthy weight-related behaviours (Robinson et al., 2020). This study found that 56% of participants found they were snacking more, whilst 73% reported spending an increased amount of time sat down. As childhood obesity often pertains into adulthood, it is important to successfully implement care or treatment options to prevent the rising rates of childhood obesity. More specifically, the age range of 7-12-years-old is a key period in which children become more autonomous in their daily weight-related behaviours, having greater involvement in decisions such as food choices and participation in physical activity (Guay et al. 2008; Reeve, 2006; Saelens et al. 2013). It is thus important to examine the barriers and facilitators to healthy weight behaviours in children of this age category.

The University of Liverpool currently has a team of researchers investigating this issue: with their current project involving two phases. The first phase aims to recruit ~800 parents and children throughout the North West of England. They will complete a survey investigating the specific barriers that children encounter when attempting to maintain health-related weight behaviours, particularly in times of disruption such as COVID-19. This study will aim to recruit participants from a nationally derived survey panel, to ensure a sample that is ethnically diverse, gender-balanced and incorporates a range of individuals of various socio-economic status and Body Mass Indexes (BMI). Drawing upon the findings of this survey, the second phase will consist of meetings and discussions involving children with obesity, caregivers, and health professionals to develop a novel and person-centred intervention to support children in maintaining healthy behaviours. 

One intervention of particular interest is Motivational Interviewing (MI), having previously shown promising results. Motivational interviewing embodies a non-judgemental and collaborative conversation, aiming to improve adherence to health behaviours by expressing empathy, support, facilitating self-efficacy, and valuing independence (Miller & Rollnick, 2012). This form of intervention has demonstrated its efficacy across a range of health-related domains including alcohol and drug use (Britt, 2004; Ludhal, 2010, 2013), improving vegetable consumption and physical activity (Campbell, 2009; van Wormer, 2004), and managing health conditions such as diabetes (Knight, 2006). Specifically, Motivational Interviewing may be valuable in childhood obesity, with evidence showing that MI may improve parental involvement and decision making in health behaviours – decreasing unhealthy food choices whilst promoting fruit and vegetable consumption and physical activity. (Kameron et al.,2020)  

The current research project holds great implications concerning how we approach obesity among children, particularly as we begin to rebuild from the disturbance caused by the pandemic. Examining the specific barriers and facilitators faced by children, with regard to weight and socioeconomic status, will allow for both greater understanding of the disruption by caused COVID-19 but also allow for improved weight management interventions. In consequence, adopting an age-appropriate, family-oriented, and person-centred intervention that focuses on the prominent barriers and facilitators to healthy weight management may provide a promising intervention to improve childhood overweight and obesity.

Written by Connor O’Reilly and Kira Spooner, Research Assistants at the University of Liverpool’s Department of Psychology