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| Improve obesity training for healthcare professionals How1 #396117 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. | From the NICE Guidelines: [8] "Those responsible for setting competences and continuing professional development programmes for health professionals (including local education and training boards; local education and training councils and professional bodies) should: - Ensure professional development training on weight management is available for health and social care professionals.
- Train GPs and other health and social care professionals to identify when to raise weight management with someone and to do so confidently, but with empathy. They should understand why many adults have difficulty managing their weight and the experiences they may face in relation to it. This includes considering the effect of their attitudes to, and any concerns about, their own weight.
- Train GPs and other health and social care professionals to accurately measure and record height and weight, determine BMI and accurately measure waist circumference.
- Train GPs and other health and social care professionals to understand the practical skills and behaviours that can help someone lose or maintain their weight and how to provide ongoing support and encouragement. This includes encouraging people to self-manage and self-monitor their weight and any associated behaviours over the long term.
- Train GPs and other health and social care professionals to discuss the likely benefits of a lifestyle weight management programme with service users, taking into account someone's personal circumstances. For example, they should take into account any associated medical conditions or personal factors, such as someone's commitment to change.
- Train GPs and other health and social care professionals in how to help people make an informed decision about the best weight management option for them. They should also be able to refer people to the most appropriate weight management service. This includes identifying people with more complex needs and referring them to appropriate services (such as mental health, psychological or alcohol services).
- Train GPs and other health and social care professionals to identify when someone may benefit from re-referral to a lifestyle weight management programme."
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+Citations (8) - CitationsAdd new citationList by: CiterankMapLink[1] Action on obesity: Comprehensive care for all
Author: Royal College of Physicians
Publication info: 2013 January
Cited by: David Price 12:22 PM 21 June 2015 GMT
Citerank: (46) 348686Improve support for people with severe and complicated obesityGreater focus needs to be devoted to strategies supporting individuals who are already obese. Current government policy is focused largely on prevention, which is vital in ensuring the scale of the obesity problem and its associated costs do not increase. It does not, however, address the problems of those people already obese or morbidly obese and the costs associated with their health conditions. Moreover, obesity treatment is often cost effective.109FDEF6, 3523581 in 5 UK children aged 10-11 are obeseThe National Child Measurement Programme (NCMP) figures for 2013/14, show that 19.1% of children in Year 6 (aged 10-11) were obese and a further 14.4% were overweight. Obese children and adolescents are at an increased risk of developing various health problems—such as asthma, cardiovascular disease and type 2 diabetes (as well as low self-esteem and depression)—and are also more likely to become obese adults.648CC79C, 352454What is obesity?Obesity is a medical condition in which excess body fat has accumulated to the extent that it may result in increased health problems and reduced life expectancy. As central obesity (excess ectopic fat stored around major organs and abdomen) is the most dangerous form to health, waist measurement can be a key indicator of risk. Generally, men with a waist circumference of 94cm or more (and women of 80cm or more) are more likely to develop obesity-related health problems.82AECCD8, 352559Weight management services in the UK are poorly developedAlthough the prevalence of obesity in adults and in children in the UK is amongst the highest in the developed world, the multidisciplinary services necessary to manage patients with an established problem of excess weight and its clinical consequences are poorly developed within the UK. Some prevention and intervention strategies are provided in primary care, but secondary care and specialist services remain underdeveloped or unavailable to meet the need.555CD992, 352560Existing training is inadequate and ineffectiveTraditional methods of training for healthcare professionals are inadequate and ineffective with respect to obesity.1198CE71, 352562Multidisciplinary teams to cover severe and complex obesity across UKCommissioning of specialist obesity services should be for multidisciplinary care of ‘severe and complex obesity’ and not directly for rather than just bariatric surgical treatment. Need multidisciplinary teams (MDTs) available to cover severe and complex obesity throughout the UK.109FDEF6, 352563Increase investment in obesity research565CA4D9, 352564Every local authority should have an obesity champion565CA4D9, 352565Better weight management resources for obese healthcare workersBetter weight management resources for healthcare workers who have an obesity problem.565CA4D9, 352566Set up a specialist group of bariatric nursesThe Royal College of Physicians in conjunction with the Royal College of Nursing should up a specialist group of bariatric nurses who are trained in the specialist aspects of bariatric medicine and surgery, including post-surgery follow-up.565CA4D9, 352569Develop a patient charter for those with obesity problems109FDEF6, 352570Undertake a systematic review of specialist obesity servicesUndertake a systematic review of specialist obesity services between the Royal College of General Practitioners community leads and the Royal College of Physicians (RCP) and learned societies, including the Society for Endocrinology, Diabetes UK and the Association of British Clinical Diabetologists565CA4D9, 352589RCP oversee the development of multidisciplinary bariatric servicesThe Royal College of Physicians (RCP) should oversee the development of multidisciplinary bariatric services to cover the population in the UK.109FDEF6, 352590RCP should provide courses to train doctors in MDT formationThe RCP should promote the provision of these multidisciplinary groups by developing and providing courses that advise, encourage and train doctors (and other healthcare professionals) on their formation.109FDEF6, 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, 352714Pharmacological treatment can be cost-effectiveA systematic review of pharmacological treatment in primary care (orlistat, sibutramine and rimonabant– the latter two now withdrawn) has shown all were effective at reducing weight and BMI, and cost effective when using a threshold of £20,000 per QALY. 1198CE71, 352716Bariatric surgery can be cost effectiveAnalysis by the Office of Health Economics estimated that between around 10,000 and 140,000 of patients could receive bariatric surgery based on the assumption of between 1% and 25% of patients eligible for surgery choosing to take this option. Overall the economic benefit ranged between £382m and £1,295m savings after three years to the NHS after surgery if 25% of patients potentially eligible for surgery chose this option.1198CE71, 352718Invest in employee health and wellbeingEncourage organisations to invest employee health and wellbeing; including a health risk assessment and the provision of resources to help employees address the factors that pose the greatest risk to their health and wellness. [1], [2], [3], [4], [5]565CA4D9, 352913Royal College of PhysiciansIn addition to supporting physicians in their daily practice, our public health activities include campaigning for change, advising government and parliament, and taking part in national debates on medical, clinical and public health issues. The RCP has supported and represented physicians for nearly 500 years. Our roots stretch back to Henry VIII, but our 29,000 members today work in the fast-paced, ever-changing, highly technological world of medicine in the UK and across the globe.58D3ABAB, 362143Appoint an obesity champion or tsarAppoint a government obesity champion to drive a coordinated obesity strategy between and across central government departments which include Health, the Treasury, Sport, Education, Agriculture, the Department of Work and Pensions, and local government for the local environment. This person should have a strong but politically independent status (e.g. a member of the House of Lords) with the skills and authority to address issues which need multiple government departmental involvement.565CA4D9, 370326Many health professionals still have inadequate knowledgeMany recently trained health professionals still have an inadequate knowledge of the nutritional aspects of health promotion and disease treatment and the potential benefits of regular physical activity.1198CE71, 370327Understand the ten essential facts about obesityAll healthcare professionals should know and understand the ‘Ten essential facts about obesity’.109FDEF6, 371613Strong business case for investment in employee health and wellbeingInvesting in the health and wellbeing of employees makes business sense. It has been estimated that working age ill-health costs the UK £100 billion per annum, more than the annual budget for the NHS. In 2009–10, 23.4 million days were lost due to work-related ill-health.1198CE71, 399548Invest in employee health and wellbeingEncourage organisations to invest employee health and wellbeing; including a health risk assessment and the provision of resources to help employees address the factors that pose the greatest risk to their health and wellness. [1], [2], [3], [4], [5]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, 399564Better weight management resources for obese healthcare workersBetter weight management resources for healthcare workers who have an obesity problem.565CA4D9, 399569Strong business case for investment in employee health and wellbeingInvesting in the health and wellbeing of employees makes business sense. It has been estimated that working age ill-health costs the UK £100 billion per annum, more than the annual budget for the NHS. In 2009–10, 23.4 million days were lost due to work-related ill-health.1198CE71, 399585Undertake a systematic review of specialist obesity servicesUndertake a systematic review of specialist obesity services between the Royal College of General Practitioners community leads and the Royal College of Physicians (RCP) and learned societies, including the Society for Endocrinology, Diabetes UK and the Association of British Clinical Diabetologists565CA4D9, 399593Increase investment in obesity research565CA4D9, 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, 399619Appoint an obesity champion or tsarAppoint a government obesity champion to drive a coordinated obesity strategy between and across central government departments which include Health, the Treasury, Sport, Education, Agriculture, the Department of Work and Pensions, and local government for the local environment. This person should have a strong but politically independent status (e.g. a member of the House of Lords) with the skills and authority to address issues which need multiple government departmental involvement.565CA4D9, 399699Set up a a specialist group of bariatric nursesThe Royal College of Physicians in conjunction with the Royal College of Nursing should up a specialist group of bariatric nurses who are trained in the specialist aspects of bariatric medicine and surgery, including post-surgery follow-up.565CA4D9, 399713Improve support for people with severe and complicated obesityGreater focus needs to be devoted to strategies supporting individuals who are already obese. Current government policy is focused largely on prevention, which is vital in ensuring the scale of the obesity problem and its associated costs do not increase. It does not, however, address the problems of those people already obese or morbidly obese and the costs associated with their health conditions. Moreover, obesity treatment is often cost effective.109FDEF6, 399734Many health professionals still have inadequate knowledgeMany recently trained health professionals still have an inadequate knowledge of the nutritional aspects of health promotion and disease treatment and the potential benefits of regular physical activity.1198CE71, 399742Every local authority should have an obesity champion565CA4D9, 399792Multidisciplinary teams to cover severe and complex obesity across UKCommissioning of specialist obesity services should be for multidisciplinary care of ‘severe and complex obesity’ and not directly for rather than just bariatric surgical treatment. Need multidisciplinary teams (MDTs) available to cover severe and complex obesity throughout the UK.109FDEF6, 399793Develop a patient charter for those with obesity problems109FDEF6, 399794Pharmacological treatment can be cost-effectiveA systematic review of pharmacological treatment in primary care (orlistat, sibutramine and rimonabant– the latter two now withdrawn) has shown all were effective at reducing weight and BMI, and cost effective when using a threshold of £20,000 per QALY. 1198CE71, 399795Bariatric surgery can be cost effectiveAnalysis by the Office of Health Economics estimated that between around 10,000 and 140,000 of patients could receive bariatric surgery based on the assumption of between 1% and 25% of patients eligible for surgery choosing to take this option. Overall the economic benefit ranged between £382m and £1,295m savings after three years to the NHS after surgery if 25% of patients potentially eligible for surgery chose this option.1198CE71, 399833Understand the ten essential facts about obesityAll healthcare professionals should know and understand the ‘Ten essential facts about obesity’.109FDEF6, 399859RCP oversee the development of multidisciplinary bariatric servicesThe Royal College of Physicians (RCP) should oversee the development of multidisciplinary bariatric services to cover the population in the UK.109FDEF6, 399860RCP should provide courses to train doctors in MDT formationThe RCP should promote the provision of these multidisciplinary groups by developing and providing courses that advise, encourage and train doctors (and other healthcare professionals) on their formation.109FDEF6, 399892What is obesity?Obesity is a medical condition in which excess body fat has accumulated to the extent that it may result in increased health problems and reduced life expectancy. As central obesity (excess ectopic fat stored around major organs and abdomen) is the most dangerous form to health, waist measurement can be a key indicator of risk. Generally, men with a waist circumference of 94cm or more (and women of 80cm or more) are more likely to develop obesity-related health problems.82AECCD8, 399931Weight management services in the UK are poorly developedAlthough the prevalence of obesity in adults and in children in the UK is amongst the highest in the developed world, the multidisciplinary services necessary to manage patients with an established problem of excess weight and its clinical consequences are poorly developed within the UK. Some prevention and intervention strategies are provided in primary care, but secondary care and specialist services remain underdeveloped or unavailable to meet the need.555CD992, 3999751 in 5 UK children aged 10-11 are obeseThe National Child Measurement Programme (NCMP) figures for 2013/14, show that 19.1% of children in Year 6 (aged 10-11) were obese and a further 14.4% were overweight. Obese children and adolescents are at an increased risk of developing various health problems—such as asthma, cardiovascular disease and type 2 diabetes (as well as low self-esteem and depression)—and are also more likely to become obese adults.648CC79C URL:
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Link[2] State of the Nation's Wasitline - Obesity in the UK: Analysis and Expectations
Author: National Obesity Forum
Publication info: 2013 December
Cited by: David Price 12:22 PM 21 June 2015 GMT
Citerank: (37) 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, 348677Implement hard hitting campaigns, similar to those for anti-smokingHarder hitting campaigns, similar to those for anti-smoking, are required.1198CE71, 348678Incentivise GPs to improve patient outcomesThe Quality and Outcomes Framework should be amended to provide incentives for GPs to proactively offer advice to overweight and obese patients and refer them to weight management services where appropriate, rather than simply keeping a register of these patients. [1]565CA4D9, 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, 348680Need to make every contact with patients countGPs and other health professionals should be encouraged and required to make every contact with patients count. Very few patients will cite obesity or weight management as the reason for seeing their GP, and will instead present with conditions that are clearly a result of weight issues. GPs should talk with their patients about weight in these instances. [1]109FDEF6, 348684Improved GP training on obesityGPs should be provided with appropriate support and training to help them have the necessary conversations with patients. Better quality training should be provided both during GP training and for current GPs to help them provide better advice to patients. [1]109FDEF6, 348685Better hydrationGovernment initiatives should include a greater focus on the importance of good hydration in weight management and health outcomes.565CA4D9, 348687More physical activity for kids within and beyond educational settingsThe introduction of compulsory physical education in schools is positive. However, greater promotion of physical activity outside of educational settings is also key to ensure any participation amongst pupils is not limited to school. Similarly, caution is needed to ensure that the promotion of competitive sport does not put off children less disposed to that sport. This could result in children either returning to or increasing their sedentary lifestyle.565CA4D9, 348688Impacts of obesityObesity presents a significant threat to the health of the UK population and a significant drain on the nation's financial resources. 24.9% of adults in England are obese—with a body mass index of over 30—62% of adults are either overweight or obese (with a BMI of over 25), and 32% of 10–11-year-olds are overweight or obese. The annual cost of obesity to the UK is estimated to be £27bn–£46bn [1], [2]; although international comparisons suggest that the true cost could be significantly higher.57DE7179, 348689Encourage physical activity in daily lifeThe Chief Medical Officer’s report (2011) recommends that adults aged 19-64 years undertake 150 minutes of moderate intensity physical activity per week in bouts of 10 minutes or more. [1]565CA4D9, 348695The Quality and Outcomes FrameworkThe QOF was introduced in 2004 as a voluntary incentive scheme for GP practices in the UK. It contains groups of indicators against which practices score points according to their level of achievement, with a higher score leading to higher financial rewards. The aim of the QOF is to highlight priorities for improving patient care and provide incentives for GPs to drive up quality in these areas.82AECCD8, 348704GPs should measure waist circumferenceGPs should measure waist circumference rather than just BMI to help them identify patients who are most at risk and identify the indicators of poor health outcomes. [1]109FDEF6, 348706National Obesity ForumThe National Obesity Forum (NOF) was established in May 2000 to raise awareness of the emerging epidemic of obesity and the effect that it was going to have on both individuals and the NHS.58D3ABAB, 348770Tackling obesityMany policy interventions have been suggested to address the obesity crisis across multiple studies—and indeed many such measures have been implemented, and are being implemented, now. There's recognition too that these interventions need to be part of a coherent and comprehensive whole systems strategy [4]; with some grounds for optimism that such an approach has the potential to accomplish a significant reduction in the prevalence of obesity in the UK across the next decade. [2]565CA4D9, 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, 366828Shape the physical environment to encourage physical activity565CA4D9, 370326Many health professionals still have inadequate knowledgeMany recently trained health professionals still have an inadequate knowledge of the nutritional aspects of health promotion and disease treatment and the potential benefits of regular physical activity.1198CE71, 371560British Heart Foundation recommends at least 60 minutes every dayThe British Heart Foundation recommends that to maintain their health, children take part in a minimum of 60 minutes of at least moderate intensity physical activity every day. This could include PE lessons, but also swimming, dancing, cycling, most other sports and brisk walking, as well as active play. 1198CE71, 371561Quality and prevalence of physical activity in schools is variableThe Ofsted Physical Education report published in February 2013 found that the physical aspect of physical education was not doing enough to tackle sedentary lifestyles amongst children and young people, with teachers often spending too much time talking and not enough time getting children moving.1198CE71, 399546Tackling obesityMany policy interventions have been suggested to address the obesity crisis across multiple studies—and indeed many such measures have been implemented, and are being implemented, now. There's recognition too that these interventions need to be part of a coherent and comprehensive whole systems strategy [4]; with some grounds for optimism that such an approach has the potential to accomplish a significant reduction in the prevalence of obesity in the UK across the next decade. [2]565CA4D9, 399553Shape the physical environment to encourage physical activity565CA4D9, 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, 399584Incentivise GPs to improve patient outcomesThe Quality and Outcomes Framework should be amended to provide incentives for GPs to proactively offer advice to overweight and obese patients and refer them to weight management services where appropriate, rather than simply keeping a register of these patients. [1]565CA4D9, 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, 399642Implement hard hitting campaigns, similar to those for anti-smokingHarder hitting campaigns, similar to those for anti-smoking, are required.1198CE71, 399667Better hydrationGovernment initiatives should include a greater focus on the importance of good hydration in weight management and health outcomes.565CA4D9, 399668Encourage physical activity in daily lifeBuild exercise into daily life to promote energy balance. Adults are recommended to take part in 150 minutes of moderate intensity activity every week.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, 399734Many health professionals still have inadequate knowledgeMany recently trained health professionals still have an inadequate knowledge of the nutritional aspects of health promotion and disease treatment and the potential benefits of regular physical activity.1198CE71, 399737Improved GP training on obesityGPs should be provided with appropriate support and training to help them have the necessary conversations with patients. Better quality training should be provided both during GP training and for current GPs to help them provide better advice to patients. [1]109FDEF6, 399768More physical activity for kids within and beyond educational settingsThe introduction of compulsory physical education in schools is positive. However, greater promotion of physical activity outside of educational settings is also key to ensure any participation amongst pupils is not limited to school. Similarly, caution is needed to ensure that the promotion of competitive sport does not put off children less disposed to that sport. This could result in children either returning to or increasing their sedentary lifestyle.565CA4D9, 399787The Quality and Outcomes FrameworkThe QOF was introduced in 2004 as a voluntary incentive scheme for GP practices in the UK. It contains groups of indicators against which practices score points according to their level of achievement, with a higher score leading to higher financial rewards. The aim of the QOF is to highlight priorities for improving patient care and provide incentives for GPs to drive up quality in these areas.82AECCD8, 399831Need to make every contact with patients countGPs and other health professionals should be encouraged and required to make every contact with patients count. Very few patients will cite obesity or weight management as the reason for seeing their GP, and will instead present with conditions that are clearly a result of weight issues. GPs should talk with their patients about weight in these instances. [1]109FDEF6, 399832GPs should measure waist circumferenceGPs should measure waist circumference rather than just BMI to help them identify patients who are most at risk and identify the indicators of poor health outcomes. [1]109FDEF6, 399840British Heart Foundation recommends at least 60 minutes every dayThe British Heart Foundation recommends that to maintain their health, children take part in a minimum of 60 minutes of at least moderate intensity physical activity every day. This could include PE lessons, but also swimming, dancing, cycling, most other sports and brisk walking, as well as active play. 1198CE71, 399841Quality and prevalence of physical activity in schools is variableThe Ofsted Physical Education report published in February 2013 found that the physical aspect of physical education was not doing enough to tackle sedentary lifestyles amongst children and young people,with teachers often spending too much time talking and not enough time getting children moving.1198CE71, 399972Impacts of obesityObesity presents a significant threat to the health of the UK population and a significant drain on the nation's financial resources. 23% of adults are obese—with a body mass index of over 30—61% of adults are either overweight or obese (with a BMI of over 25), and 33% of 10–11-year-olds are overweight or obese. The annual cost of obesity to the UK economy has been estimated to be £27bn–£46bn [1], [2]; although international comparisons suggest that the true cost could be significantly higher.57DE7179 URL:
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Link[4] 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 12:22 PM 21 June 2015 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, 348703Actions – Industry2794CAE1, 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, 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: |
Link[8] Overweight and obese adults: lifestyle weight management services
Author: NICE - Public health guideline 53
Publication info: 2014
Cited by: David Price 1:13 PM 21 June 2015 GMT
Citerank: (8) 369907NICE Guidance on Diet, Nutrition and ObesityNote: extended excerpts from National Institute for Health and Care Excellence are included and cross-linked here to help explore and understand their intersection with the policy space and their implications. Those seeking specific guidance should refer to the full Guidelines and Pathways directly.565CA4D9, 369909NICE – Lifestyle weight management for overweight or obese adultsLocal authorities, working with other local service providers, clinical commissioning groups and health and wellbeing boards, should ensure there is an integrated approach to preventing and managing obesity and its associated conditions.565CA4D9, 369912NICE – ObesityGuidelines on preventing and managing obesity.565CA4D9, 369926NICE – Advice for adults who wish to lose weightSee also the NICE guidance on diet and activity to maintain a healthy weight.565CA4D9, 370073Training for GPs and healthcare professionals – NICE Guidance565CA4D9, 370075Raise awareness of programmes among the local populationLocal authorities and Public Health England should ensure sources of information and advice about local lifestyle weight management services are included in any communications about being overweight or obese.565CA4D9, 370076Raise awareness of services among health and social care professionalsLocal authorities, working with other local service providers, clinical commissioning groups and health and wellbeing boards, should ensure staff in local health services are aware of, and make referrals to, the lifestyle weight management service.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 URL: |
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