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+Citations (5) - CitationsAdd new citationList by: CiterankMapLink[3] An update on the government’s approach to tackling obesity
Author: National Audit Office
Publication info: 2012 July, 17
Cited by: David Price 5:03 PM 7 September 2014 GMT
Citerank: (4) 348675Adopt a whole systems approach to obesityTackling obesity effectively—accomplishing a population wide-shift—requires a comprehensive and integrated whole systems approach, involving a range of measures focusing on individuals, social and other systems, including at the local and community level, and on the interrelated physical, physiological, social and cognitive factors that determine health outcomes.565CA4D9, 352457Public Health Responsibility DealThe Public Health Responsibility Deal aims to tap into the potential for businesses and other influential organisations to make a significant contribution to improving public health by helping us to create this environment. The Responsibility Deal embodies the Government’s ambition for a more collaborative approach to tackling the challenges caused by our lifestyle choices.62C78C9A, 399547Adopt a whole systems approach to obesityTackling obesity effectively—accomplishing a population wide-shift—requires a comprehensive and integrated whole systems approach, involving a range of measures focusing on individuals, social and other systems, including at the local and community level, and on the interrelated physical, physiological, social and cognitive factors that determine health outcomes.565CA4D9, 399705Public Health Responsibility DealThe Public Health Responsibility Deal aims to tap into the potential for businesses and other influential organisations to make a significant contribution to improving public health by helping us to create this environment. The Responsibility Deal embodies the Government’s ambition for a more collaborative approach to tackling the challenges caused by our lifestyle choices.62C78C9A
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| | Excerpt / Summary This briefing explains how responsibility for measures to tackle obesity is changing and it reviews what the Department of Health has done, and is now doing, to address the main areas of concern highlighted by the Committee of Public Accounts. |
Link[4] Overcoming policy cacophony on obesity: an ecological public health framework for policymakers
Author: Tim Lang, Geoff Rayner
Publication info: 2007, Obesity Reviews 8 (Suppl. 1): 165.
Cited by: David Price 10:54 PM 9 September 2014 GMT
Citerank: (21) 348675Adopt a whole systems approach to obesityTackling obesity effectively—accomplishing a population wide-shift—requires a comprehensive and integrated whole systems approach, involving a range of measures focusing on individuals, social and other systems, including at the local and community level, and on the interrelated physical, physiological, social and cognitive factors that determine health outcomes.565CA4D9, 348693Stakeholders – Groups & ActionsExplore the map via the different stakeholder groups and the measures each group can take to help tackle the obesity crisis.58D3ABAB, 348702Individuals and FamiliesThe actions and choices of individuals and families are fundamental to the challenge of tackling obesity. 84E4A378, 348780Causes of obesityUnderstanding the causes of obesity is critical to the success of prevention and treatment strategies. However, while (simply put) obesity occurs when energy intake from food and drink consumption is greater than energy expenditure through the body’s metabolism and physical activity over a prolonged period (resulting in the accumulation of excess body fat), in reality many complex behavioural and societal factors contribute systemically to the current crisis and no single influence dominates.555CD992, 352281Changes required across many different policy areasObesity has to be seen as not just a technical, food, physical activity or healthcare problem but a challenge for what sort of society is being built. Small, incremental, publicity-driven (i.e. social market-based) changes might suit the existing balance of policy interests, but a more extensive, co-ordinated, cross-sectoral action would be more effective.1198CE71, 352314Actions – Central Government2794CAE1, 352387Previous physical activities replaced by industrially generated energyIndustrial development allows many different aspects of life that previously involved daily physical activity to be accomplished through industrially generated energy instead; for example, the substitution of motorised transport for walking and cycling, a shift from manual and agricultural work towards office work, and a multitude of labour saving devices at work and in the home.555CD992, 352388Advertising and marketing reinforce new eating patterns Marketing and advertising instil and reinforce new cultural norms about what (e.g. fast food) and how to eat (e.g. snacking), and how much (e.g. larger portions) to eat.555CD992, 352389Reluctance to talk about and address implications of own weightThe weight of the population continues to rise despite media imagery of thin models encouraging a slim ideal that is far out of reach for most of the public. In this context, “Fat” remains an emotive and stigmatic subject – and often perceived as an insult – which makes it harder for people to acknowledge, confront and address their own obesity (and harder for others including health professionals to encourage them to do so too).555CD992, 352391Industrial development changes what and how people eatEconomic and industrial development has tended to be accompanied by a historic shift in patterns of food consumption from diets high in cereal and fibre to diets high in sugars, fat, animal-source food and highly-processed foods – creating a socio-cultural environment in which obesity is more likely to emerge in the population.555CD992, 352399Successive governments have made counterproductive policy choicesThe growing prevalence of obesity in the UK is partly the result of well-intentioned but counterproductive policy choices made by successive governments over several decades.555CD992, 352400Many individuals are consuming more energy than they are expendingPublic Health England estimates that the average man in England is consuming around 300 calories a day more than they would need were they a healthy body weight.555CD992, 399547Adopt a whole systems approach to obesityTackling obesity effectively—accomplishing a population wide-shift—requires a comprehensive and integrated whole systems approach, involving a range of measures focusing on individuals, social and other systems, including at the local and community level, and on the interrelated physical, physiological, social and cognitive factors that determine health outcomes.565CA4D9, 399558Changes required across many different policy areasObesity has to be seen as not just a technical, food, physical activity or healthcare problem but a challenge for what sort of society is being built. Small, incremental, publicity-driven (i.e. social market-based) changes might suit the existing balance of policy interests, but a more extensive, co-ordinated, cross-sectoral action would be more effective.1198CE71, 399887Causes of obesityUnderstanding the causes of obesity is critical to the success of prevention and treatment strategies. However, while (simply put) obesity occurs when energy intake from food and drink consumption is greater than energy expenditure through the body’s metabolism and physical activity over a prolonged period (resulting in the accumulation of excess body fat), in reality many complex behavioural and societal factors contribute systemically to the current crisis and no single influence dominates.555CD992, 399890Successive governments have made counterproductive policy choicesThe growing prevalence of obesity in the UK is partly the result of well-intentioned but counterproductive policy choices made by successive governments over several decades.555CD992, 399891Many individuals are consuming more energy than they are expendingPublic Health England estimates that the average man in England is consuming around 300 calories a day more than they would need were they a healthy body weight.555CD992, 399896Industrial development changes what and how people eatEconomic and industrial development has tended to be accompanied by a historic shift in patterns of food consumption from diets high in cereal and fibre to diets high in sugars, fat, animal-source food and highly-processed foods – creating a socio-cultural environment in which obesity is more likely to emerge in the population.555CD992, 399907Reluctance to talk about and address implications of own weightThe weight of the population continues to rise despite media imagery of thin models encouraging a slim ideal that is far out of reach for most of the public. In this context, “Fat” remains an emotive and stigmatic subject – and often perceived as an insult – which makes it harder for people to acknowledge, confront and address their own obesity (and harder for others including health professionals to encourage them to do so too).555CD992, 399917Advertising and marketing reinforce new eating patterns Marketing and advertising instil and reinforce new cultural norms about what (e.g. fast food) and how to eat (e.g. snacking), and how much (e.g. larger portions) to eat.555CD992, 399923Previous physical activities replaced by industrially generated energyIndustrial development allows many different aspects of life that previously involved daily physical activity to be accomplished through industrially generated energy instead; for example, the substitution of motorised transport for walking and cycling, a shift from manual and agricultural work towards office work, and a multitude of labour saving devices at work and in the home.555CD992 URL:
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Link[5] Measuring Up: The Medical Profession's Prescription for the Nation's Obesity Crisis
Author: Academy of Medical Royal Colleges
Publication info: 2013 February
Cited by: David Price 4:36 PM 26 December 2014 GMT
Citerank: (67) 340964Tackling obesity in the UKWith concern growing that the Foresight analysis—that 50% of the UK population could be obese by 2050, at an annual cost to the nation of around £50 billion per year [2]—substantially underestimates the scale of the unfolding obesity crisis, the College of Contemporary Health is working with the wider policy community to develop a whole systems map of the obesity crisis and the potential responses.7F1CEB7, 348679Focus outcomes indicators on action by primary health professionalsThe Quality Outcomes Framework indicators on obesity should include, and focus on, indicators on the action taken by primary healthcare professionals on behalf of overweight or obese patients. [1]565CA4D9, 348700Health Professionals84E4A378, 349151AMRCThe Academy of Medical Royal Colleges comprises the 20 medical Royal Colleges and Faculties across the UK and Ireland whose presidents meet regularly to agree direction in common healthcare matters. It provides a collective, clear and sure voice for the bene?t of patients and healthcare professionals across the four nations of the UK.58D3ABAB, 352368AMRC – RecommendationsThe AMRC presents 10 key recommendations – an ‘action plan’ – of steps that it believes must be taken to make real inroads into tackling the obesity crisis in the UK. The recommendations fall into three areas: actions to be taken by the healthcare professions; changing the ‘obesogenic’ environment; and making the healthy choice the easy choice.565CA4D9, 352369Actions to be taken by the healthcare professionsActions to be taken by the healthcare professions suggested by the AMRC.565CA4D9, 352370Changing the ‘obesogenic’ environment565CA4D9, 352371Making the healthy choice the easy choice565CA4D9, 352373Invest in weight management servicesThe departments of health in the four nations should extend and increase the provision of weight management services across the country, to mirror the provision of smoking cessation services.565CA4D9, 352374Improve nutritional standards for food in hospitalsIntroduce food-based standards—in line with those put in place for schools in England in 2006—in all UK hospitals in the next 18 months; with commissioners working with a delivery agent similar to the Children’s Food Trust to put these measures into place.565CA4D9, 352375Increase support for new parentsThe current expansion of the health visitor workforce in England should be accompanied by 'skilling up' the wider early years workforce to deliver basic food preparation skills to new mothers and fathers, and to guide appropriate food choices which will ensure nutritionally balanced meals, encourage breastfeeding and use existing guidance in the Personal Child Health Record as a tool to support this.565CA4D9, 352376Improve nutritional standards in schoolsThe existing mandatory food- and nutrient-based standards in England should be applied to all schools including free schools and academies. This should be accompanied by a new statutory requirement on all schools to provide food skills, including cooking, and growing – alongside a sound theoretical understanding of the long-term effects of food on health and the environment.565CA4D9, 352377Reduce fast food outlets near schoolsPublic Health England should, in its first 18 months of operation, undertake an audit of local authority licensing and catering arrangements with the intention of developing formal recommendations on reducing the proximity of fast food outlets to schools, colleges, leisure centres and other places where children gather.565CA4D9, 352378Restrict junk food advertisingBan television advertisements of foods high in saturated fats, sugar and salt before 9pm, and seek agreement with commercial broadcasters not to advertise these foods on internet ‘on-demand’ services. [2]565CA4D9, 352379Pilot a 20%+ tax on all sugary, soft drinks for 1 yearFor an initial one year, a duty should be piloted on all sugary soft drinks, increasing the price by at least 20%. This would be an experimental measure, looking at price elasticity, substitution effects, and to what extent it impacts upon consumption patterns and producer/retailer responses.109FDEF6, 352380Improve food labellingMajor food manufacturers and supermarkets should agree in the next year a unified system of traffic light food labelling (to be based on percentage of calories for men, women, children and adolescents) and visible calorie indicators for restaurants, especially fast food outlets.565CA4D9, 352381Mandatory health impact assessments for local planning decisionsLocal authority planning decisions should be subject to a mandatory health impact assessment, which would evaluate their potential impact upon the populations’ health.565CA4D9, 352560Existing training is inadequate and ineffectiveTraditional methods of training for healthcare professionals are inadequate and ineffective with respect to obesity.1198CE71, 352713Who should improve obesity training for healthcare professionals?Who should improve systems of obesity education and training across all health professional groups to ensure that all professional primary and secondary healthcare groups are appropriately competent to respond to the demands of the obesity crisis.58D3ABAB, 370328Some clinicians are insensitive in dealing with obese patientsSome clinicians continue to be insensitive, ineffective, and lack confidence when dealing with patients who have problems with their weight.1198CE71, 370330Weight management services are in short supplyThe Academy of Medical Royal Colleges notes that doctors don't have sufficient services available to refer people – that there are a limited number of well-designed fully evidence-based, effective and transferable weight management programmes, available for use in routine NHS primary care.1198CE71, 370331Most obese UK children lack access to weight management programmesThe majority of obese children in the UK don't have access to an evidence-based, proven, multicomponent child weight management programme as recommended by NICE (2006).1198CE71, 370332Early intervention programmesThe investment in weight management services should include greater provision for early intervention programmes.109FDEF6, 370334Weight management service provision is poor in comparison to smokingFrom a clinical perspective, weight management provision needs to mirror the coverage that smoking cessation services have achieved; yet, the investment in smoking cessation programmes remains significantly higher than the investment in weight management programmes. As a comparator, the NHS spent £88.2 million on smoking cessation services in 2011/12.1198CE71, 370335Many healthcare professionals are overweight and obeseDoctors continue to be a trusted and respected source of advice and guidance for patients over their lifestyle choices; however, many healthcare professional struggle with their own weight which can make them less effective both as messengers and exemplars. 1198CE71, 370336Require and examine obesity knowledge as part of curriculaKnowledge, understanding and training in nutrition, physical activity, exercise and the public health aspects of obesity should be an essential part of undergraduate and postgraduate curricula in every discipline because complications of obesity cross all specialty and professional boundaries. This knowledge should be examined. 959C6EF, 370338Weight management services can save more money than they costSome well-designed fully evidence-based, effective and transferable weight management programmes are even economically ‘dominant’ (i.e. they save the NHS more money than it costs to provide the service).1198CE71, 370339Many smaller providers lack formal evidence to support interventionsWhile some of the larger commercial providers have had their efficacy assessed by means of randomised control trials and other evaluative methods, many smaller providers have no such formal evidence to support their interventions.1198CE71, 370342Training should reflect the different needs of different team membersDifferent members of the team will need different training. For example, the role of the GP in an initial consultation differs greatly from that of the bariatric surgeon and his or her team assessing a patient’s suitability for surgery. Different teams need different skills for different patients in different scenarios but healthcare professionals’ education.959C6EF, 370346Training should include sensitive recognition and appropriate referralAll health professionals should have some basic training in sensitive recognition and appropriate referral for overweight and obese patients.959C6EF, 370347NICE guidance has been ignored on bariatric servicesAn investigation by GP newspaper published in December 2014 found that over half of the UK's primary care organisations (PCOs) do not follow NICE or SIGN guidance on bariatric surgery [2].1198CE71, 371449Early years’ intervention is vital to reducing health inequalities1198CE71, 371774Protect and increase green spacesPublic Health England should provide guidance to Directors of Public Health in working with Local Authorities to encourage them to protect or increase green spaces.565CA4D9, 371802Improved engagement and concentrationImproving the food and dining environment for children increases the likelihood that children will be engaged and concentrate in afternoon lessons.1198CE71, 371803Apply mandatory food- and nutrient-based standards to all schoolsThe existing mandatory food- and nutrient-based standards in England should be applied to all schools including free schools and academies.565CA4D9, 371804Require all schools to provide food skills and understandingIntroduce a statutory requirement on all schools to provide food skills, including cooking, and growing, alongside a sound theoretical understanding of the long-term effects of food on health and the environment.565CA4D9, 396117Improve obesity training for healthcare professionalsImprove systems of obesity education and training across all health professional groups to ensure that all professional primary and secondary healthcare groups are appropriately competent to respond to the demands of the obesity crisis.565CA4D9, 399556Improve obesity training for healthcare professionalsImprove systems of obesity education and training across all health professional groups to ensure that all professional primary and secondary healthcare groups are appropriately competent to respond to the demands of the obesity crisis.565CA4D9, 399572Improve food labellingMajor food manufacturers and supermarkets should agree in the next year a unified system of traffic light food labelling (to be based on percentage of calories for men, women, children and adolescents) and visible calorie indicators for restaurants, especially fast food outlets.565CA4D9, 399577Improve nutritional standards for food in hospitalsIntroduce food-based standards—in line with those put in place for schools in England in 2006—in all UK hospitals in the next 18 months; with commissioners working with a delivery agent similar to the Children’s Food Trust to put these measures into place.565CA4D9, 399578Improve nutritional standards in schoolsThe existing mandatory food- and nutrient-based standards in England should be applied to all schools including free schools and academies. This should be accompanied by a new statutory requirement on all schools to provide food skills, including cooking, and growing – alongside a sound theoretical understanding of the long-term effects of food on health and the environment.565CA4D9, 399592Invest in weight management servicesThe departments of health in the four nations should extend and increase the provision of weight management services across the country, to mirror the provision of smoking cessation services.565CA4D9, 399598Mandatory health impact assessments for local planning decisionsLocal authority planning decisions should be subject to a mandatory health impact assessment, which would evaluate their potential impact upon the populations’ health.565CA4D9, 399602Protect and increase green spacesPublic Health England should provide guidance to Directors of Public Health in working with Local Authorities to encourage them to protect or increase green spaces.565CA4D9, 399605Existing training is inadequate and ineffectiveTraditional methods of training for healthcare professionals are inadequate and ineffective with respect to obesity.1198CE71, 399606Who should improve obesity training for healthcare professionals?Improve systems of obesity education and training across all health professional groups to ensure that all professional primary and secondary healthcare groups are appropriately competent to respond to the demands of the obesity crisis.58D3ABAB, 399607Many healthcare professionals are overweight and obeseDoctors continue to be a trusted and respected source of advice and guidance for patients over their lifestyle choices; however, many healthcare professional struggle with their own weight which can make them less effective both as messengers and exemplars. 1198CE71, 399653Increase support for new parentsThe current expansion of the health visitor workforce in England should be accompanied by 'skilling up' the wider early years workforce to deliver basic food preparation skills to new mothers and fathers, and to guide appropriate food choices which will ensure nutritionally balanced meals, encourage breastfeeding and use existing guidance in the Personal Child Health Record as a tool to support this.565CA4D9, 399674Improved engagement and concentrationImproving the food and dining environment for children increases the likelihood that children will be engaged and concentrate in afternoon lessons.1198CE71, 399675Apply mandatory food- and nutrient-based standards to all schoolsThe existing mandatory food- and nutrient-based standards in England should be applied to all schools including free schools and academies.565CA4D9, 399676Require all schools to provide food skills and understandingIntroduce a statutory requirement on all schools to provide food skills, including cooking, and growing, alongside a sound theoretical understanding of the long-term effects of food on health and the environment.565CA4D9, 399677Restrict junk food advertisingBan television advertisements of foods high in saturated fats, sugar and salt before 9pm, and seek agreement with commercial broadcasters not to advertise these foods on internet ‘on-demand’ services. [2]565CA4D9, 399695Focus outcomes indicators on action by primary health professionalsThe Quality Outcomes Framework indicators on obesity should include, and focus on, indicators on the action taken by primary healthcare professionals on behalf of overweight or obese patients. [1]565CA4D9, 399716Weight management services are in short supplyThe Academy of Medical Royal Colleges notes that doctors don't have sufficient services available to refer people – that there are a limited number of well-designed fully evidence-based, effective and transferable weight management programmes, available for use in routine NHS primary care.1198CE71, 399717Most obese UK children lack access to weight management programmesThe majority of obese children in the UK don't have access to an evidence-based, proven, multicomponent child weight management programme as recommended by NICE (2006).1198CE71, 399718Early intervention programmesThe investment in weight management services should include greater provision for early intervention programmes.109FDEF6, 399719Weight management service provision is poor in comparison to smokingFrom a clinical perspective, weight management provision needs to mirror the coverage that smoking cessation services have achieved; yet, the investment in smoking cessation programmes remains significantly higher than the investment in weight management programmes. As a comparator, the NHS spent £88.2 million on smoking cessation services in 2011/12.1198CE71, 399720Weight management services can save more money than they costSome well-designed fully evidence-based, effective and transferable weight management programmes are even economically ‘dominant’ (i.e. they save the NHS more money than it costs to provide the service).1198CE71, 399721Many smaller providers lack formal evidence to support interventionsWhile some of the larger commercial providers have had their efficacy assessed by means of randomised control trials and other evaluative methods, many smaller providers have no such formal evidence to support their interventions.1198CE71, 399735Some clinicians are insensitive in dealing with obese patientsSome clinicians continue to be insensitive, ineffective, and lack confidence when dealing with patients who have problems with their weight.1198CE71, 399738Require and examine obesity knowledge as part of curriculaKnowledge, understanding and training in nutrition, physical activity, exercise and the public health aspects of obesity should be an essential part of undergraduate and postgraduate curricula in every discipline because complications of obesity cross all specialty and professional boundaries. This knowledge should be examined. 959C6EF, 399739Training should reflect the different needs of different team membersDifferent members of the team will need different training. For example, the role of the GP in an initial consultation differs greatly from that of the bariatric surgeon and his or her team assessing a patient’s suitability for surgery. Different teams need different skills for different patients in different scenarios but healthcare professionals’ education.959C6EF, 399740Training should include sensitive recognition and appropriate referralAll health professionals should have some basic training in sensitive recognition and appropriate referral for overweight and obese patients.959C6EF, 399767Early years’ intervention is vital to reducing health inequalities1198CE71, 399777Reduce fast food outlets near schoolsPublic Health England should, in its first 18 months of operation, undertake an audit of local authority licensing and catering arrangements with the intention of developing formal recommendations on reducing the proximity of fast food outlets to schools, colleges, leisure centres and other places where children gather.565CA4D9, 399796NICE guidance has been ignored on bariatric servicesAn investigation by GP newspaper published in December 2014 found that over half of the UK's primary care organisations (PCOs) do not follow NICE or SIGN guidance on bariatric surgery [2].1198CE71, 399872Pilot a 20%+ tax on all sugary, soft drinks for 1 yearFor an initial one year, a duty should be piloted on all sugary soft drinks, increasing the price by at least 20%. This would be an experimental measure, looking at price elasticity, substitution effects, and to what extent it impacts upon consumption patterns and producer/retailer responses.109FDEF6 URL: |
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