Developing a local Obesity and Weight Management Strategy

1. Developing a local Obesity and Weight Management Strategy Jane Richards Associate Director of Public Health Southend on Sea PCT

2. Local context • No clear baseline in respect of prevalence of obesity in South East Essex but using national trends would suggest that generally the population is becoming heavier and less active • Reducing obesity recognised as a priority by Southend Health Improvement Partnership Network in 2003 and highlighted as an area for action in the Annual Public Health Report 2004 • No defined obesity service – community dietetic service working to capacity, separately managed acute based service, range of primary prevention initiatives focussed on healthy eating and physical activity

3. Estimated local prevalence Essex

4. Estimated local prevalence - Southend

5. Local practice examples - prevalence

6. Local practice examples – co morbidity comparison

7. Aim • To reduce the incidence of overweight and obesity among the population of south east Essex, particularly amongst the most socially disadvantaged, in order to improve health and reduce health inequalities

8. Objectives • To develop a comprehensive care pathway for weight and obesity management, providing a model for prevention and treatment and thresholds for intervention • To promote the development and implementation of effective initiatives to prevent an increase in the prevalence of obesity in children and adults • To develop evidence based guidelines for best practice in the management of overweight and obesity in adults and children, thereby promoting a reduction in levels of overweight and obesity

9. Objectives • To promote strategies to enable weight maintenance and prevent increases of weight in individuals who have successfully reduced their body weight • To develop training programmes for primary care staff and other relevant professionals working in multi disciplinary team to support the care pathway • To identify opportunities for multi agency and partnership working to promote consistent messages and ensure effective use of resources across south east Essex

10. Key priorities • Baseline measurement of prevalence of overweight and obesity (as defined by BMIs of over 25 an over 30 respectively) amongst population aged between 15 and 75 • Implementation of DH Guidance for measuring obesity among children (January 2006) • Baseline assessment of all primary and secondary prevention activities relating to the prevention and management of treatment e.g. healthy eating projects, exercise referral schemes

11. Key priorities • Establishment of integrated care pathway, including access to primary and secondary prevention programmes, management and treatment of overweight and obesity, including the use of pharmacotherapy and surgical intervention where of primary care weight management pilots and subsequent clinically indicated • Establishment roll out • Provision of awareness raising and training for heath and other professionals e.g. leisure services staff

12. Target areas – children and young people • Increase rates of breastfeeding to provide the best start for healthy nutrition • Increase awareness of healthy weaning and food preparation • To use a whole school approach through the expansion of the Healthy Schools Scheme to encourage healthy lifestyles • Improve nutritional policy in all education settings • Encourage and increase opportunities to participate in formal and informal physical activity

13. Target areas - community • Link to national awareness campaign on obesity to promote health by influencing attitudes • Expand physical activity referral schemes to include more activities and link to care pathway • Increase access to and acceptability of healthy food choices • Increase access to physical activity opportunities • Encourage employers to provide health improvements in the workplace

14. Target areas - healthcare • Establishment of a single year Locally Enhanced Service (LES) to provide baseline data on the prevalence of overweight and obesity among practice populations of patients aged 15 – 75 • Training for healthcare and other relevant professionals on preventing obesity and weight management • Care pathway established

15. Initial resource requirements identified • Measurement of prevalence in adult population through LES • Measurement of prevalence in children aged under 11 – DH Guidance • Development of public health dietetic service – to support professionals in practice • Training resource • Partnerships with commercial sector

16. Challenges • Maintaining multi agency focus – local authority boundaries • Meeting the needs of diverse populations • Ensuring the engagement of clinicians • Involving the non statutory sector • Resources!

17. Opportunities • National media interest – especially in respect of children and young peoples agenda • Local media interest – sustained awareness raising campaign • LAA targets/Community Plan– creating ownership • Inclusion of BMI measurement in QOF/HCC targets • Enhanced Services – developing primary care based services • Positive involvement of the pharmaceutical industry • Networking/ creating effective partnerships and alliances

18. What next? • Formal adoption of Strategy by PCT Boards • Implementing DH Guidance on measuring childhood obesity • Delivery of Essex LAA targets and preparing for Southend LAA (March 2007) • Developing care pathway and service provision – creative use of resources!