Link[1] Action on obesity: Comprehensive care for all
En citant: Royal College of Physicians
Publication info: 2013 January
Cité par: David Price 6:48 PM 8 September 2014 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, 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, 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, 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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