Tackling Obesity in Devon National Guidance and Local Action

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Tackling Obesity in DevonNational Guidance
and Local Action

• Steven Brown
• Assistant Director of Public Health

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National Guidance and Local Action

• Obesity pathway
• What works (NICE Guidance)
• - Local Authorities and Partners
• - Workplaces
• - Health Promotion
• - The Public
• - NHS Local Action
• Conclusions

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Managing Overweight and Obesity
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Local Authorities and Partners NICE Guidance (43)

• Policy and Planning
• - Identify environmental barriers
• - Assess health impact of policies
• - Building designs
• Encourage Active Travel
• - Cycle lanes and secure cycle parking
• - Walking routes (area maps)
• - Traffic calming and street lighting

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Workplace NICE Guidance (43)

• Policies and working practices
• Encourage activity and health eating
• e.g. Provide showers, secure cycle parking,
  lunchtime activity (Active Travel Plan)
• Actively promote healthy choices
• e.g. Restaurants, hospitality, vending
  machines, staff shops
• Health Promotion
• Incentive schemes for staff
• - Travel expenses policy, gym membership. etc
• Health Checks for staff

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The Public

• Check you weight/waist measurement every now and
  then.
• Adopt a healthy balanced diet (5-a-day)
• Make activities part of your everyday life
• Avoid sitting too long in front of the
  TV/computer
• Discuss any concerns with your GP

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Lifestyle Interventions (Level One)

• Sign posted to lifestyle programmes which adhere
  to best practice guidance (NICE).
• - Aim for maximum weekly weight loss of 0.5-1kg.
• - Multi-component
• - Recommend regular physical activity
• - Using balanced, healthy eating approach
• - Focus on long term lifestyle change rather
  than short term fix.
• e.g. Self Help Groups, Commercial and community
  weight management programmes, Walking for Health,
  Cycling programmes, etc.

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Specialist Weight Management Programmes(Level
Two)

• Referral to multi component local interventions
  to encourage-
• - Increased physical activity
• - Improved eating behaviour
• - Healthy Eating
• - Drug Treatment (where appropriate)
• e.g. Primary care weight management Programmes,
  Exercise on Prescription, Slimming on referral,
  etc

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Specialist Obesity Service (Level Three)

• Based within hospital or community and staffed by
  multidisciplinary team.
• Specifically for patients with
• - Complex disease state
• - Conventional treatment failed
• - Specialist interventions required
• - If surgery is considered appropriate

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Bariatric Surgery (Level Four)

• Considered for people with sever obesity if
• - BMI of 40 or between 35-40 and
  significant disease
• - All non-surgical measures have failed
• - Received /will receive specialist
  management
• -BMI50 first-line option to be considered

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Bariatric Surgery
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Conclusions

• Various healthy weight programmes which have/are
  taking place across Devon.
• Lack of comprehensive NHS obesity management
  services or programmes
• Challenge
• - Evidence based?
• - Evaluated?
• - Available to all those in need?