Part 4: Case Studies
Strand 4: Evidence for a Whole Systems Approach to Obesity
Video
Learning Objectives
After watching this section, you should be able to:
- Describe the key components of the Shape Up Somerville intervention and explain how it illustrates a whole systems approach
- Identify other national and international examples of whole systems approaches to obesity
- Explain how early adopter sites in the UK and Ireland have begun to implement whole systems approaches
Key Points
- Shape Up Somerville (Massachusetts, USA, 2002–2005) was a 3-year community-level childhood obesity prevention programme using a community-based participatory research approach across multiple settings — school, home, and community
- Changes in the school environment (food service, curriculum, nurse training) were designed to be reinforced by changes at home and in the wider community — a defining feature of the whole systems approach
- Restaurants and businesses could earn ‘Shape Up approved’ status by meeting healthy food criteria, showing how commercial settings were integrated into the system
- Other notable international case studies include Romp and Chomp (Victoria, Australia), Be Active Eat Well (Australia), and the Amsterdam Healthy Weight Approach (Netherlands), which has received wide international attention
- In Scotland, the National Evaluation for Systems Approaches report documented WSA adoption across multiple council areas, with some areas receiving dedicated funding
- Wales implemented WSA through teams across all seven health boards, focusing on children and families in early obesity prevention pilots; England also has a number of designated early adopter areas
Further Reading
- A whole systems approach to obesity prevention: a rapid synthesis of evidence — the full IPH report containing detailed summaries of all the national and international case studies discussed in this video, including Shape Up Somerville, Romp and Chomp, Be Active Eat Well, and Amsterdam (Breslin et al., 2023)
- NIHR PHIRST: Getting RREAL about implementation of a WSA to obesity prevention in Northern Ireland — information on the Northern Ireland process evaluation project referenced at the end of this video, led by the NIHR Public Health Interventions Responsive Studies Team
- Reframing how we talk about children’s health and food (Impact on Urban Health) — guidance on communicating about childhood obesity in ways that focus on environment and systems rather than individual blame; relevant to how case study findings are presented to communities
- Food Active — a public health organisation working to reduce diet-related ill health in the north of England; includes case studies on local food environment work and a compassionate, non-stigmatising approach to healthy weight
Knowledge Check
Complete the questions below before moving on.
Which of the following was a component of the Shape Up Somerville whole systems intervention for childhood obesity prevention?
The correct answer is Restaurants could earn ‘Shape Up approved’ status. Shape Up Somerville, delivered in Massachusetts between 2002 and 2005, used a community-based participatory approach involving multiple settings. Restaurants and businesses were encouraged to enhance healthy food options and, if they met criteria such as offering low-fat dairy, smaller portions, fruits and vegetables, and visible signs highlighting healthier choices, they were designated as ‘Shape Up approved’. This illustrates how the whole systems approach worked across the community rather than focusing on a single setting.
- False — the intervention predates mobile health technology as a delivery mechanism and used newsletters, nurse training, and walking committees instead.
- False — financial incentives for children are not described as part of the Shape Up Somerville model; the approach focused on environmental and community-level changes.
- True
- False — teachers were trained to implement a new health curriculum (Healthy Eating and Active Time Club), but schools did not replace all existing curricula with a single national programme.