Implementing lifestyle interventions
Multicomponent interventions are the treatment of choice. Ensure weight management programmes include behaviour change strategies to increase people's physical activity levels or decrease inactivity, improve eating behaviour and the quality of the person's diet and reduce energy intake. (See
behaviour change in adults and
behaviour change in children in this pathway for more information.)
When choosing treatments, take into account:
- the person's individual preference and social circumstance and the experience and outcome of previous treatments (including whether there were any barriers)
- the person's level of risk, based on BMI and, where appropriate, waist circumference (see identifying people who are overweight or obese in this pathway).
- any comorbidities.
Document the results of any discussion. Keep a copy of the agreed goals and actions (ensure the person also does this), or put this in the person's notes.
Offer support depending on the person's needs, and be responsive to changes over time.
Ensure any healthcare professionals who deliver interventions for weight management have relevant competencies and have had specific training.
Provide information in formats and languages that are suited to the person. Use everyday, jargon-free language and explain any technical terms when talking to the person and their family or carers. Take into account the person's:
- age and stage of life
- gender
- cultural needs and sensitivities
- ethnicity
- social and economic circumstances
- specific communication needs (for example because of learning disabilities, physical disabilities or cognitive impairments due to neurological conditions).
Praise successes – however small – at every opportunity, to encourage the person through the difficult process of changing established behaviour.
Give people who are overweight or obese, and their families and/or carers, relevant information on:
- being overweight and obesity in general, including related health risks
- realistic targets for weight loss (for adults see the NICE pathway on lifestyle weight management services for overweight or obese adults)
- the distinction between losing weight and maintaining weight loss, and the importance of developing skills for both; advise them that the change from losing weight to maintenance typically happens after 6–9 months of treatment
- realistic targets for outcomes other than weight loss, such as increased physical activity and healthier eating
- diagnosis and treatment options
- healthy eating in general (more information on healthy eating can be found at NHS Choices)
- medication and side effects
- surgical treatments
- self-care
- voluntary organisations and support groups and how to contact them.
Ensure there is adequate time in the consultation to provide information and answer questions.
If a person (or their family or carers) do not feel this is the right time for them to take action, explain that advice and support will be available in the future whenever they need it. Provide contact details so that the person can get in touch when they are ready.
Be aware that the aim of weight management programmes for children and young people can vary. The focus may be on either weight maintenance or weight loss, depending on the person's age and stage of growth.
Encourage parents of children and young people who are overweight or obese to lose weight if they are also overweight or obese.
Sources
The NICE guidance that was used to create this part of the pathway.