Obesity

Obesity

This section website aims to put in one place the relevant sources of information about obesity from the website.
From this section of the website you can access information relating to policy and strategy, surveys, initiatives, key resources and useful links.
Information about maternal obesity is available from the pregnancy area of interest.
For information about the impacts of obesity, scale of the problem, what best the public can do to prevent becoming overweight and what is being done to manage the impact visit the Public Health Wales website.

National Obesity Forum Meeting

A very successful Welsh Region National Obesity Forum (NOF) Meeting was held on 24th May 2012 at the University Hospital of Wales, Cardiff. It was attended by over 100 medical and health professionals including Consultants, GP’s, Nurses, Dietitians, Physiotherapists, Public Health, Rehabilitation Medicine and Sports Medicine.

Another successful meeting of the Welsh Region National Obesity Forum (NOF) was held on 23 May 2013 at the Village Hotel Swansea. Presentations on the day included the financial costs of obesity, weight management programmes for children, exercise advice with an evidence base and an update of bariatric surgery in Wales.

The next meeting will be held in 2014 – date and venue to be confirmed.

If you would like to be notified, with a view to attending, please email Marilynletitiallewellyn@hotmail.com (Secretary to the Welsh Region NOF).

Policy and Strategy

The white paper takes an integrated EU approach to reducing ill health due to poor nutrition, overweight and obesity.
Ministers from across the World Health Organisation European Region (2006) have adopted a European Charter on Counteracting Obesity which calls for specific action, including regulatory measures that each country can take to tackle obesity.
Evidence based guidelines for the management of obesity were published by NICE (National Institute for Health and Clinical Excellence) in 2006.
The All Wales Obesity Pathway is a tool for Health Boards, working jointly with Local Authorities and other key stakeholders, to map local policies, services and activity for both children and adults against four tiers of intervention and to identify any gaps.

Data, Research, Surveys and Evaluation

The Child Measurement Programme is a national programme run by Public Health Wales and has collected information on the heights and weights of 29,400 reception age children in Wales during the 2011/12 academic year.
A report has been published by the Nuffield Council on Bioethics which considers some of the ethical issues that arise from efforts to improve health at the population level.
The Governments Foresight programme produced a report in October 2007 considering how society might deliver a sustainable response to obesity in the UK over the next 40 years. The report shows that nearly 60% of the UK population could be obese by 2050 with the socially and economically disadvantaged and some ethnic minorities being more vulnerable.
The Health Behaviour in School-Aged Children (HBSC) Survey aims to gain insight into children’s health, health behaviour and lifestyles. It examines children aged 11, 13 and 15 years. It is collaborative cross-national research supported by the World Health Organisation.
Data from the UK-wide Millennium Cohort Study examines the development of obesity and its consequences from a very young age. The Childhood Overweight and Obesity Briefing provides an analysis of the weight and height data obtained when cohort members were aged 3 and 5. It also reports on the prevalence of obesity and overweight at these ages, examines stability and change between these ages, and identifies risk factors.
The Welsh Health Survey is a source of information about the health of people in Wales, the way they use health services, and the things that can affect people’s health. The 2013 survey found that 58% of adults were classified as overweight or obese, including 22% classified as obese.
The Public Health Wales Observatory has published a new web-based resource on obesity in adults, using data from the Welsh Health Survey. The resource, available on the Public Health Wales Observatory website, presents information on the prevalence of overweight and obesity by age and sex, and at a range of geographical levels. An animated map also shows the change in levels of obesity across Wales over recent years.
The Welsh Government has asked Public Health Wales to undertake a national height and weight measuring programme for Wales. The programme will see the way primary school children are measured standardised across Wales. The data collected will help health staff understand patterns of how children are growing and help plan better health services. The programme will use information collected by school nursing services who already measure the heights and weights of all reception class children in Wales.
The National Obesity Observatory for England has developed a standard evaluation framework to support high quality, consistent evaluation of weight management interventions in order to increase the evidence base.

Measuring diet and physical activity in weight management interventions

This paper identifies a shortlist of practical and validated questionnaires for the assessment of physical activity and diet, to support public health practitioners to evaluate weight management interventions.
Research studies into obesity.
 ‘Measuring Up: The medical profession’s prescription for the nation’s obesity crisis’ report
The Academy of Medical Royal Colleges has published a report designed to tackle the UK’s obesity epidemic.
The report presents 10 key recommendations on new ways to address the growing public health problem of obesity, including:
• banning junk food advertising before the 9pm watershed
• reducing the proximity of fast food outlets to schools, colleges and other places were young people gather
• a one-year trial of a 20% tax on sugary drinks, to see what effect this could have
The report is said to represent the views of the vast majority of the UK’s 220,000 practicing doctors, who are ‘united in seeing the epidemic of obesity as the greatest public health crisis facing the UK’.
It is said to be ‘unprecedented’ for medical colleges and faculties to come together like this, but they have done so in recognition of the massive crisis that is happening and the fact that current strategies to reduce obesity are having an insufficient impact.

Initiatives

The Obesity Pathway has four tiers and describes minimum service requirements and best practice. The four tiers are:

Level 1: Community based prevention and early intervention (self care) 

Community based prevention activities include all initiatives to promote healthy eating, physical activity and the maintenance of a healthy body weight throughout the lifecycle such as in schools or for the workforce. Examples include:

  • Planning policy to support physical activity and healthy eating – including active travel planning, consideration of green spaces and availability of land for growing food and number and location of fast food outlets
  • Community based cookery clubs in disadvantaged communities
  • Schools adopting Appetite for Life recommendation and developing and implementing a food and fitness policy

Level 2: Community and primary care weight management services

Community and primary care weight management services include the availability of a range of services for children, young people and adults who wish to lose weight. Examples include:

Mind, Exercise, Nutrition, Do it! A weight management programme for children aged 7 -13 and their families which is available in all local authorities in Wales.

The National Exercise Referral Scheme which is a 16 week programme that enables sedentary people with a medical condition to become engaged in structured physical activity opportunities supervised by a qualified exercise professional.

Identification of overweight and obesity as part of health checks in primary care and delivering a brief intervention.

Level 3: Specialist multi disciplinary team weight management services

Specialist multi-disciplinary team weight management services are those that provide more specialist interventions including dietary, physical activity and behavioural components and are delivered both through primary and secondary care; they can be combined with drug therapy.

Level 4: Specialist medical and surgical services

Specialist medical and surgical services include access to bariatric surgery for those that have failed to achieve weight loss.

Campaigns

A British Heart Foundation, Cancer Research UK and Diabetes UK campaign to raise awareness of the dangers of carrying extra weight around their middle.
A social marketing programme from England designed to help people make changes to their lifestyles, so that they can eat well, move more and live longer. Welsh Government launched Change4Life in Wales to challenge people to lead more active lives and develop better eating habits. Change4Life is a sub-brand of Health Challenge Wales for addressing physical activity and healthy eating.

Key Resources

A free booklet aimed at adults who want advice about weight management.
A factsheet from the British Dietetic Association. To be used with all adults who want advice on eating for to manage their body weight.
National Obesity Observatory (April 2011) Brief Interventions for Weight Management
This briefing paper aims to provide a guide to current best available evidence around brief interventions for weight management with adults.
Standard Evaluation Framework for physical activity interventions 
The National Obesity Observatory (NOO) has published this resource for physical activity interventions, aimed at practitioners, commissioners and managers of physical activity interventions and projects.
The resource builds on the Standard Evaluation Framework (SEF) for weight management interventions, published by NOO in 2009. It takes the principles described in the original SEF and applies them to physical activity interventions.
Department of Health (2006) Raising the Issue of Weight in Adults
Department of Health (2006) Raising the Issue of Weight in Children

Useful Links