Slimming World

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Slimming Worlds Approach to Weight Management

• Paul Sharpe
• Sue Gibson

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Agenda

• Overweight Obesity scale and cost
• Raising the issue of weight with patients
• The Slimming World approach
• Slimming World on Referral
• Accessing the referral scheme in Bracknell Forest
• Evidence of Success
• The link between alcohol and obesity new
  research

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Scale and Cost

• People who are overweight or obese have an
  increased risk of developing Type 2 diabetes,
  heart disease and certain cancers.
• There is no silver bullet to reducing obesity. It
  is an issue that requires action at national,
  local, family and individual level.
• Local authorities are ideally placed to develop
  co-ordinated action across their departments,
  services and partner organisations to tackle
  overweight and obesity in the local population.
• Diana Grice, Thames Valley Public Health England
  Centre Director

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Public Health England (Feb 2014)

Berkshire Districts levels of overweight and
obesity
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Making Every Contact Count

• preventing poor health and promoting healthy
  living is essential to reduce health inequalities
  and sustain the NHS for future generations

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Potential Concerns
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Suggested questions
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Own weight

• 50 of nurses believe they are overweight
  (Nursing Times)
• Fears no credibility, hypocritical
• But research shows patients sometimes feel more
  comfortable with somebody who understands
• Health behaviours can be difficult - acknowledge
  it
• Empathy - If it was easy wed all be a size 12
• Self-disclosure I eat healthily 80 of the time
  but!

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Accessing Slimming World on Referral

• Issue patient with referral letter
• Contains info on Slimming World
• Dedicated phone number 01773 546242
• We manage enrolment
• Establish where referral is from
• Conversational style
• Test readiness to change
• Select group and issue joining pack
• Follow up contact after 2-3 weeks
• Evaluation questionnaire
• Follow up weight at 6 months

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Support System

• Facilitate behaviour change
• Trained consultants who have all lost weight with
  Slimming World
• Warm, non-judgemental group environment
• Empowerment
• Self-determined behaviour change
• Set own goals weight and action targets
• Share practical skills strategies, including
  coping with lapses and high risk situations
• Problem solving
• Praise, recognition, award system

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Dietary approach

• Reduces energy intake
• Balanced approach
• Normal everyday foods
• How foods affect appetite
• Energy density of foods
• User friendly practical system
• Feel free and relaxed about food
• Eliminate distress of guilt, deprivation or loss
  of control

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Promotion of Activity

• Facilitate behaviour change
• No matter what starting point
• Why its important to me?
• How can I get started?
• Foot out of the door strategies
• Making it a habit
• Build commitment
• Support turning of new skills into a routine
• Recognise commitment with awards

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Maintaining Weight Loss

• Free week once 10 weight loss achieved and
  maintained for 10 weeks
• Free attendance once personal target achieved
  (and /-3lbs)
• May self-fund after referral, no membership fee ,
  max 4.95pw
• Website access continues for further 4 weeks

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Bracknell Forest - results to date

• 60 patients currently in service

Finished Lost 5 Lost 10 completers Completers lost 5 Completers lost 10 Average weeks attended
Latest published results 34,271 36 5.8 58 55 9.7 8.9
Current average (Super Service) 11,210 44.5 9.1 65.7 62.1 13.7 9.4
Bracknell Forest 40 42.5 17.5 65.0 53.8 19.2 9.4
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Service satisfaction (all schemes)
Data for all schemes (Bracknell Forest only 11
questionnaires completed so far)
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Improved self-esteem
Data for all schemes
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Dean Worrall

• Referred for 7 x 12 weeks by GP in Dudley
• Then self-funded
• Lost 16st 13.5lbs

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Kim Freshwater

• Referred for 12 weeks by
• GP in Hampshire
• Lost 3st 2lbs
• Then self-funded
• Total loss 17st 5lbs

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Alcohol and Obesity

• The UK has the highest prevalence of obesity in
  Europe1
• It has among the highest proportion of binge
  drinkers in Europe2
• UKs consumption of alcohol is rising, other
  countries are reducing3
• These combined issues are placing a huge strain
  on the NHS
• The cost of treating conditions associated with
  obesity estimated at 5.1 billion4
• Treatment costs associated with alcohol estimated
  at 3.5 billion5.
• 1. The Press Association (2010). UK tops European
  obesity league, Health Service Journal.
• 2. TNS Opinion and Social (2010). EU citizens
  attitudes towards alcohol.
• 3. OECD (2011). Health at a Glance 2011. OECD
  indicators, OECD publishing.
• 4. The economic burden of ill health due to,
  diet, physical inactivity, smoking, alcohol and
  obesity in the UK.
• Journal of Public Health 33 (4) 527-535
• 5. Secretary of State for the Home Department
  (2012). The Governments Alcohol Strategy.

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Alcohol and obesity

• Currently two separate public health campaigns
• Reducing obesity
• Raising awareness of the dangers of excessive
  drinking and in particular binge drinking
• Slimming Worlds Tipping Point campaign raising
  awareness of the link between the two.

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Research has shown that

• Alcohol provides 7 calories per gram,
• therefore.
• alcohol consumption within government guidelines
  provides up to 2,880 / 3,840 calories a week
  (women/men)

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Alcohol Units/Calorie Values
Typical Units Typical Calories
Wine (175ml, 13 ABV) 2.1 160
Wine (250ml, 13 ABV) 3 228
Beer/Lager (pint, 3.6 ABV) 2 180
Beer/Lager (pint, 5.2 ABV) 3 244
Cider (pint, 4.5 ABV) 2.6 256
Cider (pint, 7.5 ABV) 4.3 386
Alcopop (275ml, 5 ABV) 1.4 192
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Research has shown that

• Alcohol consumption can lead to an increase in
  food intake (stimulates appetite, lowers
  inhibitions)
• Heavy but less frequent drinkers at greater risk
  of obesity than low-to-moderate, frequent
  drinkers
• Higher alcohol intake associated with greater
  central obesity (carrying excess fat around the
  stomach), particularly in men
• Alcohol reduces the quality and quantity of sleep
  which may increase the risk of obesity.

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Tipping Point
The point at which people go on to make
unhealthy choices with food and alcohol
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Tipping Point Survey

• The average tipping point is 9.3 units of
  alcohol, equivalent to 3.7 pints of beer or 3.1
  large glasses wine
• 51 of alcohol consumers acknowledge a tipping
  point with alcohol
• The average additional energy intake an
  estimated 4,305 additional calories
• 58 who acknowledge a tipping point report
  they pass this point at least once on an
  average weekend
• YouGov Survey, 2042 members of UK population

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Tipping Point Survey

• 63 reported being more likely to eat a larger
  amount
• 57 more likely to snack on a family-sized packet
  of crisps or nuts
• 58 more likely to order a takeaway
• 65 more likely to rely on convenience food
• 34 more likely to go out for an unplanned meal.
• YouGov Survey, 2042 members of UK population

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Tipping Point

• People continue to make unhealthy food choices
  the day after passing their tipping point
  average estimated additional intake 2,051
  calories
• Estimated total additional calorie intake
  therefore around 6,000
• The day after passing their tipping point, 50
  cancel planned activity

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Tipping Point

• With a 1lb weight gain said to be the equivalent
  of 3,500 calories
• the reported additional energy intake..
• and decreased energy expenditure
• potential weight gain of 2lbs

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Key Recommendations

• Slimming World calls on Government and health
  authorities to improve the links between public
  health campaigns on obesity and alcohol by
  raising awareness of how drinking too much
  alcohol can impact on weight-affecting lifestyle
  behaviours.
• Slimming World calls on the Government to raise
  awareness of the calories contained in alcohol by
  supporting clear labelling on alcoholic drinks.

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• Thank you for listening