Identifying the views of adolescents in five European countries on the drivers of obesity using group model building
Open accessAbstract
Background: To make effective progress towards a global reduction in obesity prevalence, there needs to be a focus on broader structural factors, beyond individual-level drivers of diet and physical activity. This article describes the use of a systems framework to develop obesity prevention policies with adolescents. The aim of this research was to use the group model building (GMB) method to identify young people’s perceptions of the drivers of adolescent obesity in five European countries, as part of the EU-funded Co-Create project. Methods: We used GMB with four groups of 16–18-year-olds in schools in each of the five European countries (The Netherlands, Norway, Poland, Portugal and the UK) to create causal loop diagrams (CLDs) representing their perceptions of the drivers of adolescent obesity. The maps were then merged into one, using a new protocol. Results: Two hundred and fifty-seven participants, aged 16–18 years, engaged in 20 separate system mapping groups, each of which generated 1 CLD. The findings were largely congruent between the countries. Three feedback loops in the merged diagram particularly stand out: commercial drivers of unhealthy diets; mental health and unhealthy diets; social media use, body image and motivation to exercise. Conclusions: GMB provides a novel way of eliciting from young people the system-based drivers of obesity that are relevant to them. Mental health issues, social media use and commercial practices were considered by the young people to be key drivers of adolescent obesity, subjects that have thus far had little or no coverage in research and policy.
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In CO-CREATE systems mapping workshops with 16-18-year-olds in six countries, social media, and in particular influencers and celebrities, was consistently reported as negatively impacting mental health, which in turn encouraged excessive and compulsive dietary intakes and reduced motivation to exercise and eat healthily.
“Social media, and in particular influencers and celebrities, was consistently reported as negatively impacting mental health -specifically body image, self-esteem, stress, personal relationships and loneliness, anxiety, and depressive symptoms, which in turn encouraged excessive and compulsive dietary intakes and reduced motivation to exercise and eat healthily.”
From Associations between social media, adolescent mental health, and diet: A systematic review (2023) · cites this paper as [20]
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- Authors
- Savona, N., Macauley, T., Aguiar, A., Banik, A., Boberska, M., Brock, J., Brown, A., Hayward, J., Holbæk, H., Rito, A. I., Mendes, S., Vaaheim, F., van Houten, M., Veltkamp, G., Allender, S., Rutter, H., & Knai, C.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- University of Bergen (NO)
- Uniwersytet SWPS (PL)
- City, University of London (GB)
- Deakin University (AU)
- University of Oslo (NO)
- Centre for Studies and Research on Social Dynamics and Health—CEIDSS, Lisbon, Lisbon, Portugal
- Press, Oslo, Norway
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
- University of Amsterdam (NL)
- University of Bath (GB)
- Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Corresponding author
- Savona, Natalie
- ORCID
- Venue
- European Journal of Public Health
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-02-20
- Volume
- 31
- Issue
- 2
- Pages
- 391-396
- ISSN
- 1101-1262 (ISSN-L)
- 1464-360X
- PMC
- PMC8071593
- OpenAlex
- W3129623921
- Cited by
- 80
- References
- 20
- Citations by year
- 2026: 9 · 2025: 19 · 2024: 20 · 2023: 20 · 2022: 10 · 2021: 2
- FWCI
- 6.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, cc-by)
- City Research Online (City University London) (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Own your potential (DEAKIN) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by-nc)
- Funders
- European Union’s Horizon 2020 research and innovation programme for Sustainable Food Security (774210)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Social Sciences › Decision Sciences › Management Science and Operations Research › Complex Systems and Decision Making
- Keywords
- adolescent obesity, group model building, causal loop diagrams, youth perspectives, obesity prevention policy, mental health, social media use, body image, feedback loops, systems thinking
- MeSH terms
- Adolescent, Europe, Humans, Netherlands, Norway, Obesity, Poland, Portugal
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