Obesity is one of the biggest public health crises in the UK. Almost two-thirds of adults in England are overweight or obese. 1 in 3 children leave primary school overweight or obese.[1]

Evidence suggests weight management services can help people adopt healthier behaviours and lose weight. These behavioural changes help improve a person’s general wellbeing. In 2021 the government pledged to invest £100 million to support children, adults and families to achieve and maintain a healthier weight. Over £70 million will be invested into weight management services which are made available through the NHS and local councils. The remaining £30 million will fund initiatives to help people maintain a healthy weight. This is all part of a place-based, systemic approach to tackling obesity and promoting healthier lifestyles.[2]

There are wide-ranging environmental causes of obesity as laid out in the Foresight Report(2007) and there is no single solution to tackling obesity.

Some drivers of obesity:

  • Behaviour – Eating and physical activity are two key behaviours that influence the energy balance of the body and what needs to be consumed or burned off to maintain a healthy weight
  • Environment – We live an increasingly urbanised environment. Urban lifestyles are typically low-level activity and rely on the conveniences of fast food.
  • Genetics – Increased genetic tendencies to becoming overweight or obese due to naturally slower metabolisms.

Knowing the drivers of obesity means actions can be taken to help people achieve healthier lifestyles.[3]

This is why we need to invest in services and take a multi-agency approach to help people achieve a healthier lifestyle.

Multi-agency Approach

When agencies work together they can create a whole system approach to tackling obesity and its causes.[4] The ‘Whole Systems Approach to Obesity’ published in 2019, provided local authorities with the tools and resources to transform their weight management systems over a 5 year period.[5] A whole Systems approach helps local authorities deliver and fix their approaches to weight management over short, medium and long term plans. The process helps them assess their strategies and assess whether they are addressing the inequalities in access to weight management programmes.

Better Health Campaign

The Public Health England Better Health Campaign(2020) aims to support the nation to take steps to better their physical and mental wellbeing.[6]

  • It encourages positive changes and directs users to evidence-based apps. These apps support people in making and sustaining changes to improve their health.
  • The 12 Week Weight-Loss plan is an app launched as part of this campaign, it creates an easy to use and interactive weight loss plan
  • Other apps used in the campaign include ‘Couch to 5K’ and the free NHS quit smoking app
  • The apps work to complement the systems and services in place to help people with their health, taking pressure off local government and the NHS.

The work of the app-based campaign contributes to helping people change behaviours. Knowledge from this campaign will help establish evidence to improve weight management services.

Investment to Help Tackle Inequalities

Recent government investment into local authority weight management services aims to help those who have been marginalised achieve a healthier lifestyle. The Office for Health Improvements and Disparities was set up to tackle preventable poor health. The office is working across the health system to drive forward actions on health disparities and improve access to health services across the country.

Obesity is at the forefront of this work due to the current rates across the country. People who come from Black and Ethnic Minority backgrounds are more likely to be overweight, and discrimination based on weight stigma or race sometimes prevents them from receiving the support they need. Increased funding helps local authorities to identify the local needs of these communities so that services can be adapted to meet those needs.

Healthy Weight Coaches

The funding also includes a commitment to offer all primary care networks the opportunity for staff to train as Healthy Weight Coaches. The training is an e-learning programme, making it accessible remotely. Coaches are trained to support people who want to prioritise their health, weight and wellbeing. The e-learning programme is made up of 8 sessions that help individuals learn how to challenge weight stigma and bias whilst encouraging behaviour changes in food and exercise. Supporting people to have healthier lifestyles can benefit their health and wellbeing. It also supports primary care networks, GP practices and wider NHS by reducing ill-health related to obesity.

Collaboration

Collaboration between services is key when helping people achieve healthier lifestyles. Users need to be at the centre of weight management services. Government investment into services supports this as it is directed at identifying community needs. Collaboration between weight management service providers helps identify gaps in understanding on how to meet the needs of service users.

Emerging data on the impact of Covid-19 on obese people shows how it has impacted behaviours that may be associated with excess weight gain, including diet and physical activity. In the UK around 30% of Covid-19 hospitalisations were directly attributed to being overweight or obese. Deprived areas in England have a higher obesity rate, putting increased pressure on hospitals in these areas.

To deepen the understanding of how weight management systems function the Office for Health Improvements and Disparities have issued Baseline Weight Management surveys. The surveys collect baseline data on BMIs and short term behavioural changes concerning food choices and exercise. Data collected helps services evaluate their projects and understand where more help or resources are needed.

Working collaboratively allows for learning across all levels of the system, from Public Health England to the NHS and local government. Weight management programmes need to be aligned across these levels to transform services and give people the best possible support.

Conclusion

  • Learning has to be constant to allow for continual improvement in weight management systems
  • Evidence for behavioural changes needs to be consulted and consolidated to help identify what weight management approaches best suit different communities.
  • Be empathetic as weight stigma and discrimination causes harm, this discrimination needs to be eradicated to provide the best support.
  • The environment we live in is not always conducive to supporting healthier options. Promoting healthy choices needs to become the default.

[1] Department for Health and Social Care, New Specialised Support to Help Those Living with Obesity to Lose Weight, (2021)
[2] UK Health Security Agency, Investing in Weight Management Services, (2021)
[3] Government Office for Science, Foresight report, (2007)
[4]Jamie Blackshaw, National Lead Physical Activity and Healthy Weight, Public Health England, (2021)
[5] Public Health England, Whole Systems Approach to Obesity, (2019)
[6] Public Health England, Better Health Campaign, (2020)

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Obesity is one of the biggest public health crises in the UK today. Almost two-thirds of adults in England are overweight or obese. To tackle this ongoing issue the Government is investing in weight management services and gathering data to help improve these services. This article looks at where this Government funding is being used.

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