Research project Laying the Foundation for Overcoming Overweight and Obesity: A Path to Precision Health for Expectant Parents and Children Through Realist Evaluation
The world is grappling with rising rates of overweight and obesity (OWOB) among adults and children, males and females. Prevention efforts have largely failed globally, also in the Nordic countries and Sweden. Obesity is acknowledged as a disease requiring specialized treatment, but current healthcare structures are not adequately equipped to manage this effectively. Against this backdrop of concern, Västerbotten County in northern Sweden has experienced a decline in childhood OWOB over the past two decades, with levels stabilizing among expectant parents.
The world is grappling with rising rates of overweight and obesity across all demographics: among adults and children, males and females. Prevention efforts have largely failed globally (ref), including the Nordic countries and Sweden. Obesity is increasingly acknowledged as a disease requiring specialized treatment, but current healthcare structures are not adequately equipped to manage this effectively. As obesity patterns are heterogeneous and the responses to treatment vary, there is an urgent need for increased precision and personalization of health prevention and care alongside universal preventions and interventions.
Despite these baffling challenges at a time when intensive therapy for children as young as six and weight loss drugs and surgery for those in their early teens are recommended, the Västerbotten region in northern Sweden is experiencing a different scenario than the disappointing and challenging situation described above. Here, as our research has shown, overweight and obesity rates have decreased over the last two decades among children, with the exception of a temporary surge during the Covid-19 period. The rates however seem to be stabilizing among the young adult population of childbearing age. This unexpected decline of overweight and obesity among children and almost flattening trends among expectant parents raises critical questions: why is Västerbotten different? What can be learnt from it?
The Västerbotten case presents a unique opportunity to uncover the mechanisms behind the decline in overweight and obesity rates, particularly among children, offering valuable insights to curb future obesity trends in adult populations. Through a realist evaluation framework combined with a multi-method and intersectoral approach, our overall aim is to deepen understanding of key drivers of change, evaluate their economic impact, and inform more effective obesity prevention strategies. The following sub-aims and research questions (RQs), will guide our approach.
Sub-Aim I – INVESTIGATE: To conduct a comprehensive quantitative analysis of overweight and obesity trends in Västerbotten County over time.
Sub-Aim II – UNDERSTAND: To qualitatively explore the positive shift in overweight and obesity trends in Västerbotten County.
Sub-Aim III – MOTIVATE: To provide health economic evidence supporting investments in preschool children’s healthy lifestyles.
Sub-aim IV – COMMUNICATE: To develop an interactive dashboard for visualizing overweight and obesity data, accessible to both the public and professionals, and to project future risks and benefits under different hypothetical scenarios.
In the short term, this project aims to offer an updated, co-created, and comprehensive understanding of the extent of overweight and obesity in the county potentially capable of turning the tide of this public health challenge. In the long term, our results will be used as a stepping-stone for prioritizing various tailored intervention strategies, ranging from population-based to personalised approaches, which can be thoroughly debated and discussed in an interdisciplinary and intersectoral network of public health academics and professionals, capable of operating beyond the scope of this specific project.
