Background Food environments are important determinants of healthy diets among young people. Yet, policy efforts to tackle childhood obesity in England have been criticised for their focus on individual behavior change, rather than structural and environmental factors. In addition, engagement of young people in the development of obesity prevention policies is scarce and under-researched from a youth perspective. Involving youth in policy-making processes can lead to greater policy integrity and inclusiveness. In this study we aimed to understand young people’s perspectives on 1) local action to create healthier food environments, 2) youth engagement, and 3) their recommendations to policy-makers.

Methods Four qualitative focus group discussions were conducted with 39 young people (13-21 years) living in a town in North West England and a metropolitan area in the Midlands. Both areas received government funds to invest in innovative solutions to tackle childhood obesity. Participants were recruited from local youth organisations. Three focus groups took place in-person and one through videoconference. Written informed consent was obtained from participants. Data were transcribed and analysed on NVivo 12 using Braun and Clarke’s thematic analysis. Young people were involved in independent data analysis and the selection of illustrative quotes.

Results Young people’s main reported concerns about their food environment were the density of fast food outlets, the unaffordability of healthier food options and fast food advertisement. Health was believed to not be prioritised enough at local and national level. Participants’ knowledge on specific local policies and interventions targeting the food environment was limited. Young people did not feel engaged in local decisions about the food environment, despite having been involved in consultations. They expressed a need for more meaningful and long-lasting engagement and co-production. Policy recommendations were mainly for more structural food environment policies, including restrictions on fast food outlet density and advertisement, and rules and incentives for healthier food offer. Young people also suggested better education on healthy diets in schools, and a need for action across the food system.

Conclusion While small-scale, this study adds to previous research highlighting young people’s deep understanding of social and environmental determinants of diet and health. Young people called for stricter structural policies to create healthier food environments. It is essential that policy-makers aiming to improve young people’s diets take their unique views and concerns into account to create effective policies that address young people’s needs.