Obesity Prevention in Scotland: A Policy Analysis Using the ANGELO Framework

Background: The Scottish Government's ‘Route-Map Action Plan' for obesity prevention sets out 62 potential intervention policies across all stages of the life course. We used the ANGELO Framework (Analysis Grid for Environments Linked to Obesity) to assess the appropriateness and likely impact of the balance of measures being proposed. Methods: Two assessors (JM & RJ) independently allocated a category for each intervention according to its domain (physical, economic, legislative or socio-cultural), scale (macro or micro) and predominant ‘focus' (physical activity versus diet). A third assessor (RG) examined discordant allocations. Results: Across the four ANGELO domains, the distribution of interventions was skewed towards socio-cultural measures (37.1%) and the physical environment (33.1%) with less emphasis on legislative or economic interventions (21.8% and 6.4% respectively). Distribution by both intervention scale and focus was more even with just over half of all policies (51.8%) at the macro-level scale and just under half (46.7%) having a dietary focus. Conclusion: The predominance of socio-culturally orientated interventions over their legislative and economic counterparts is at odds with the balance of international evidence on what would be most effective for obesity prevention. The ANGELO framework provides a useful tool for policy makers to monitor progress towards an appropriately balanced policy mix.