Whole Systems Approach to Diet and Healthy Weight – Community Pilots Project, Scotland

Evaluation Completed March 2023

What does the research mean for Local Authorities?

Findings from this research will help local authorities to identify the most effective way of addressing diet and healthy weight in their community, as well as promote engagement of key stakeholders who play a role in the delivery of a healthier environment. Moreover, findings from this research will also help local authorities to identify how to effectively make use of their community and local assets. The involvement of local communities in the research will take account of the views, knowledge and priorities of the communities who are ultimately the beneficiaries of whole system efforts to address diet and healthy weight. 

What does the evaluation research mean for the Public?

In addition to benefiting people’s health and delivering a more health-promoting environment, findings from this evaluation will improve local stakeholdersknowledge and understanding of how best to address diet and healthy weight issues. It will also identify to what extent the whole systems approach met the needs of local stakeholders and the community. 

How are the public involved in the evaluation?

Local stakeholders (including young people and families) and the Public Involvement in Research group (PIRg) based at the University of Hertfordshire will be involved in the design and implementation of this project, adding their insight to help answer the research questions identified. They will also help with understanding the results of this evaluation and in sharing the findings. 

Lay summary of research

Tackling the causes of obesity and promoting healthy weight and diet throughout life requires joint effort from the government, service deliverers and people in the community. Using a method called a ‘Whole Systems Approach’ (WSA) allows different people and communities to work together to:

  • find a shared understanding of tackling diet and healthy weight issues
  • consider how well the local system is working to support diet and healthy weight
  • find out what can be changed quickly and over time to encourage a healthy diet and healthy weight
  • find out how well the WSA is working

Once the various elements of the ‘system’ are better understood, partners can agree on actions and decide how to work together to create changes that last.

Public Health Scotland is providing funding to try-out the WSA to tackle diet and healthy weight. The East Region of Scotland has asked the PHIRST Connect to evaluate their WSAs, to determine whether a WSA works; what can be done to make it more effective; how funding was used, and what the findings mean for what should be done in the future.

Scotland, like other parts of the UK, is experiencing an obesity problem which particularly affects certain groups of people, such as those living in poverty and more ‘‘deprived’’ communities. With an increase in childhood obesity among those living in “deprived” areas, it continues to be a major public health issue despite the introductions of policies and programmes to reverse the trend. Obesity is linked with health and wellbeing issues for children and adults throughout their life.

We want to investigate whether a WSA to addressing diet and healthy weight is useful for the longer-term management and prevention of obesity among children and young people. We will find out whether local councils, community planning partners and other organisations can work together to identify ways to address diet and healthy weight. We have selected Midlothian and West Lothian for this evaluation because they are relatively similar in terms of location and resident type but are setting-up a WSA in different ways. We will study and compare how well the approach works in each area.

The overall aim of the study is to evaluate how the Whole Systems Approach to diet and healthy weight is put into practice over time. This will include exploring the drivers and barriers to achieving a Whole Systems Approach within Midlothian and West Lothian.

The research design will include:

1. A review of published articles will take place to see how Whole Systems Approaches have been used to tackle diet and healthy weight in the UK or internationally, and how well the process went.

2. Focus groups and interviews will be carried out with key stakeholders from Midlothian and West Lothian at different points over 18 months. We will ask people to take part who contributed to the Whole Systems Approach design, development, and implementation in Midlothian and West Lothian.

3. Participants will be asked to complete short surveys as part of a ‘momentary analysis’ throughout the duration of the study - this record of activities means we can identify any changes over time.

4. Systems Dynamics Modelling is an approach used to understand the different components that influence a complex issue. Our data will be used, alongside discussions with stakeholders, to understand the components that are important in putting in place an effective WSA.

Local Authority/Partner(s)

Public Health Scotland
Obesity Action Scotland
Food Standards Scotland


PHIRST Connect Research Team

Dr Gavin Breslin
Charis Bontoft
Dr Olujoke Fakoya
Nigel Lloyd
Dr Adam P Wagner
Amanda Wellings
Professor Wendy Wills

*All PHIRST Connect members input into every project