Obesity has been a consistent public health concern in the United Kingdom with rising prevalence rates between 2007 and 2017. While its health and economic impacts have been recognised across the political and scientific spectrum, policy responses have been patchy and narrow in scope. This thesis seeks to explore how ideological narratives, political economies and power asymmetries informed obesity policy in the UK, using the development and implementation of the Soft Drinks Industry Levy (SDIL) as the primary case study. Based on Kingdon’s Multiple Streams Approach (MSA) and Lukes’ Three Dimensions of Power, the analysis seeks to understand how framing processes, stakeholder alliances, and institutional dynamics constrained or enabled structural interventions. For the study, a qualitative research design was used comprising two methodological strands. First, semi-structured interviews were carried out with three senior policy actors, who were purposely sampled due to their direct involvement within UK obesity policymaking processes. Using NVivo software, interview data were thematically analysed to identify narrative patterns across six/main and twelve/sub themes. Second, a documentary content study was performed. This involved content and discourse analysis to assess the framing of obesity, regulatory omissions and industry influence within the three streams of problem, policy and politics.
The analysis identified six main themes and twelve subthemes in UK obesity policy from 2007 to 2017. Parliamentary records showed that 71% of the discourse painted obesity as an individual issue while only 29% accounted for structural causes. Industry sway was strong, resulting in only a 3% sugar reduction when the policies were voluntary, compared to a 44% reduction when policies were implemented by law through the SDIL. These include political-economic determinants, tensions between industrialisation and advocacy, implementation opacity, ideological framings, bureaucratic inertia, and unintended political consequences. Interview data illustrated how “nanny state” rhetoric and neoliberal assumptions limited ambition. Collectively, the findings illustrate how the institutional complexity, competing narratives, and power asymmetries undermined substantive reform and prioritised tokenistic policy gestures.
The study concludes that UK policymaking on obesity, during a window of opportunity, was shaped by political hesitance, industry influence, and entrenched neoliberal ideologies. Although the SDIL represented some measure of success, it was a balancing act between strategic interests rather than an exercise in transformative change. Fragmented governance, ideological framing, and power asymmetries restricted structural reforms. It may take reframing obesity as a systemic issue, reinforcing regulatory frameworks and addressing the entrenched institutional and ideological barriers identified in this research for policy to remain effective in the future.
