5. Tackling such a complex issue
5 Obesity: Tipping back the scales of the nation
6. Global Burden of Disease: Changes
in health in England
6 Obesity: Tipping back the scales of the nation
Newton JN et al., (2015) Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for
the Global Burden of Disease Study 2013. Lancet. S0140-6736(15)00195-6.
7. Trend in severe obesity among adults
Health Survey for England 1993 to 2014 (three-year average)
Policy Forum for London
Adult (aged 16+) severe obesity: BMI ≥ 40kg/m2
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
3.0%
3.5%
4.0%
Prevalenceofsevereobesity
Women
Men
7 Obesity: Tipping back the scales of the nation
8. Prevalence of obese children in year 6 for the
least and most deprived areas (2007/08 –
2015/16)
8 Obesity: Tipping back the scales of the nation
Source: NCMP 2015/16 Deprivation based on postcode of the school
10. The costs of obesity: health and
economic
10Obesity: Tipping back the scales of the nation
11. Attitudes to obesity
10 Obesity:
Tipping back the scales of
the nation
People tend to overestimate what obesity means in terms of body size
54% correctly identify when a woman is obese
39% correctly do this for a man
Widespread understanding of some of the health risks
over 80% understand that people who are obese are more likely to have heart
disease, high blood pressure, and diabetes
34% understand the increased risk of liver disease
People who are obese are often the object of stigmatising attitudes
53% agree that “most overweight people could lose weight if they tried”
75% believe that a person who is not very overweight would be more likely
than one who is very overweight to be offered an office manager’s job
12. Attitudes to obesity
12 Obesity:
Tipping back the scales of
the nation
Attitudes towards possible actions to encourage healthier lifestyles
Majority in consensus of better paths 81% and more weight management
approaches 81%;
Less supportive of more NHS funded operations 20% and broader measures
including higher fuel tax 15%
Attitudes towards possible actions to discourage the consumption of
unhealthy foods and drinks
Ban sugar drink ads 58%; ban fat food ads 53% ; cut snack size 49%; tax fatty
foods 45%; tax sugary drinks 58%
Attitudes found to vary between social groups – for instance women are
slightly more likely than men to support most of these measures
14. Obesity work plan: five pillars for
action
Where future generations live in an environment, which promotes healthy weight and wellbeing
as the norm and makes it easier for people to choose healthier diets and active lifestyles
1.Systems
Leadership
•Influence local &
national leaders
•raise the national
debate
•influence political
ambition
•maximise
communication
2.Community
Engagement
•enable behaviour
change through
social marketing
•drive social
investment through
local action
•support
communities with
tools on healthy
eating & getting
active to help
reduce health
inequalities
3.Monitoring
& Evidence
Base
• enhance
surveillance, analysis
& signposting of data
• tailor evidence to
meet local needs –
support effective
commissioning &
evaluation
• develop &
communicate
research to inform
strategy
• promote evidence of
good practice
4.Supporting
Delivery
•support the obesity
care pathway
•work with Directors
of Public Health &
Clinical
Commissioning
Groups
•support
commissioning
•practical tools to
help deliver
healthier places;
enable active travel
5.Obesogenic
Environment
•develop long term,
evidence based
strategy to deliver a
whole system
approach to tackle
the root causes of
obesity and
address health
inequalities
Tackle obesity, address the inequalities associated with obesity and improve wellbeing
14 Obesity: Tipping back the scales of the nation
16. Supporting local weight management
services
Food Matters Live
Weight
Management
commissioning
specifications
National
Mapping of
Services
NICE
Guidance
Evidence
Review:
‘What works’
for adults in
tier 2 services
Evidence Review:
‘What works’ for;
early years and
primary school
aged children in
tier 2 services?
Evidence
Review:
Scoping tier 3
obesity
approaches for
children and
adults
Insight
research with
practitioners
and users of
services
Insights into weight
management across
England to inform
commissioning
specifications
16 Obesity: Tipping back the scales of the nation
18. •Whole systems obesity programme
• Realising what the Foresight Tackling Obesities
report set-out, across the local system . With local
authorities at the heart of the programme
• Co-production of approaches with four pilot local
authorities: County Durham, Lewisham,
Gloucestershire and North Kesteven.
• Community of Learning set up to share experience
and good practice
• Aim to develop a transferable roadmap of
approaches to support local authorities across the
country.
• Website for more information:
http://www.leedsbeckett.ac.uk/wholesystemsobesi
ty
•
Food Matters Live
System Wide PreventionApproaches
18 Obesity: Tipping back the scales of the nation
19. Thank you for listening
jamie.blackshaw@phe.gov.uk
Follow us on twitter@PHE_UK
Editor's Notes
Explanation that Emma has already spoken about the challenge of tackling childhood obesity/scale of the challenge
Food consumption, energy and nutrient intakes and nutritional status of infants and young children
Infant feeding data source
For those aged 4 – 10 weeks: NHS England
For those aged 4 – 10 months: Public Health England (data submitted by local authorities)
High percentage of mothers initiate breastfeeding after birth, however this drops by around 30% by 6 – 8 weeks
75% of mothers introduced solids before their baby was 5 months old
Infants and young children (4-18 months)
The majority of children had adequate haemoglobin and serum ferritin concentrations with only about 3% below the thresholds at which anaemia is indicated.
% energy from carbohydrate (50.6) and fat (34.0) in line with dietary guidelines
Intakes of salt (3.3g) higher than SACN recommendation for children aged 1-3 years (2g)
% energy from non-milk extrinsic sugar (11.9) above 2015 SACN recommendation (as free sugars)
Children aged 4 – 10 years are consuming more than double the recommended amount of sugar, although consumption of sugary drinks has fallen compared to 6 years ago.
What are we currently doing in terms of obesity
To take account of this fact, PHE’s developed an ambitious work plan that covers 5 broad themes (and examples of what are we doing).
Systems leadership
PHE has led the way in utilising the evidence base to drive the debate on physical activity and sugar.
Everybody Active Every Day, the national physical activity framework to embed physical activity into daily life. It synthesises international evidence on ‘what works’ to increase population physical activity through sustained cross-section action at all levels to increase physical activity.
July 2015 SACN published its final Carbohydrates and Health report. Embed scientific evidence on sugar and obesity, dental care; engage and partner with stakeholders on sugar reduction. Next few slides will talk about obesity and sugar
Community engagement
Change4Life continues to enable families to engage with health promoting behaviours.
Local support through action learning and prioritisation for tackling childhood obesity. Supporting community projects involved with getting different population groups engaged with healthy eating & getting active e.g. social housing project, South Asian temples project, projects with young people delivered through Premiership rugby. Work with communities such as HOOP (helping people overcome obesity problems) to develop community networks of overweight and obese people who will come together to form peer support, advocate local programmes and inform the national debate.
Monitoring and evidence base
Monitoring & evidence base- e.g. NDNS, SACN, HSE and evaluation of project interventions e.g. work with Men’s Health Forum to increase the uptake of men into weight management programmes in 3 local areas and rapid review to inform the intervention for the Diabetes Prevention Programme.
Increased engagement and support for parents through National Child Measurement Programme.
Knowledge and Intelligence and how PHE support interpretation and application at local level - PHOF
Supporting delivery
Develop a blueprint for the provision of workplace weight management services and the National diabetes prevention programme.
There are tools to promote the adoption of a healthy eating patterns. The eatwell plate provides a visual representation of the types and proportions of foods that should be eaten. Set of standards and tools to encourage healthier & more sustainable food procurement and provision. mapping access and provision of tier 2 and 3 weight management services across England in order to review the obesity care pathway and evidence reviews on effective interventions
Obesogenic environment
Investment in programme to co-produce tools with local authorities to support taking a whole systems approach to tackle obesity.
Obesogenic environment e.g. Work with Town and Country Planning Association who are working with town planners to create more green spaces, recreational spaces, reduce the number of takeaways.
