Obesity Public Health Government regulation to promote healthy food environments – a view from inside state governments J. Shill 1 , H. Mavoa 1 , S. Allender 1 , M. Lawrence 1 , G. Sacks 1 , A. Peeters 2 , B. Crammond 2 and B. Swinburn 1 1 WHO Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Victoria, Australia; 2 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Received 14 June 2011; revised 16 August 2011; accepted 29 August 2011 Address for correspondence: Miss J Shill, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia. E-mail: jane.shill@deakin.edu.au Summary Food policy interventions are an important component of obesity-prevention strategies and can potentially drive positive changes in obesogenic environments. This study sought to identify regulatory interventions targeting the food environ- ment, and barriers/facilitators to their implementation at the Australian state government level. In-depth interviews were conducted with senior representatives from state/territory governments, statutory authorities and non-government orga- nizations (n = 45) to examine participants’ (i) suggestions for regulatory interven- tions for healthier food environments and (ii) support for pre-selected regulatory interventions derived from a literature review. Data were analysed using thematic and constant comparative analyses. Interventions commonly suggested by partici- pants were regulating unhealthy food marketing; limiting the density of fast food outlets; pricing reforms to decrease fruit/vegetable prices and increase unhealthy food prices; and improved food labelling. The most commonly supported pre- selected interventions were related to food marketing and service. Primary pro- duction and retail sector interventions were least supported. The dominant themes were the need for whole-of-government and collaborative approaches; the influ- ence of the food industry; conflicting policies/agenda; regulatory challenges; the need for evidence of effectiveness; and economic disincentives. While interven- tions such as public sector healthy food service policies were supported by par- ticipants, marketing restrictions and fiscal interventions face substantial barriers including a push for deregulation and private sector opposition. Keywords: Australia, obesity, policy, whole of government. obesity reviews (2012) 13, 162–173 Introduction Governments worldwide have recognized the need for improved policy to address the growing prevalence of obesity. In Australia, it has been predicted that 34% of the adult population will be obese by 2025, compared with 21% in 2000 (1). There is limited evidence showing sig- nificant and sustained effects of current obesity-prevention education and treatment programmes (2,3). Furthermore, current strategies may preferentially disadvantage those from lower socioeconomic backgrounds (4,5). Successful public health campaigns, such as tobacco control and road safety, have demonstrated that the most effective approach is one which includes informed policy approaches, par- ticularly those of a regulatory nature (6). Regulatory approaches can potentially drive positive, sustainable and equitable changes in obesogenic environments (7), particu- larly because they influence the environments for the whole population rather than only those of individuals or small groups. Modelling studies demonstrate that many of the most effective and cost-effective interventions are regula- tory in nature (8,9), and many have strong public support obesity reviews doi: 10.1111/j.1467-789X.2011.00937.x 162 © 2011 The Authors obesity reviews © 2011 International Association for the Study of Obesity 13, 162–173