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Weight Management Brief Interventions Training Friday 12 th July 2013

Aims of Training  Background to obesity  Local and National Facts  Obesity and Health  Raising the issue of obesity  Brief Intervention Training: Obesity  Next steps

Foresight Report 2007

The key findings include: Most adults in the UK are already overweight. Modern living ensures every generation is heavier than the last – `Passive Obesity’. By % of men and 50% of women could be clinically obese. Without action, obesity-related diseases will cost an extra £45.5 billion per year. Preventing obesity is a societal challenge, similar to climate change. It requires partnership between government, science, business and civil society.

Stages of Obesity

Body Mass Index

Adult BMI Ranges If your BMI is between 25 and 29, you would be considered overweight If your BMI is between 30 and 40, you would be considered obese If your BMI is over 40, you would be considered very obese (known as ‘morbidly obese’)

Adult waist circumference risk by ethnicity EthnicityMaleFemale European, Sub-Saharan African, Eastern Mediterranean and Middle East (Arab) populations (increased risk) 94 cm/37 inches (severe risk) 102 cm/40 inches (increased risk) 80 cm/31.5 inches (severe risk) 88 cm/34.5 inches South Asians, Chinese, Japanese, Ethnic South and Central Americans (severe risk) 90 cm and over (severe risk) 80 cm and over

Prevalence of overweight and obesity in adults Obese Adult Men Obese Adult Women Obese and overweight Adults 45–65 years old %16%Over 30% %26%Over 70% Health Survey for England

Percentage of the adult population assessed as obese in a selection of countries

Children’s BMI Children’s Growth Charts Separate ones for Girls and Boys Use height and weight to plot 91 st Centile for overweight 98 th Centile for obese

Children’s BMI Centile Range Underweight (children may be healthy at this BMI centile) Below 2 nd BMI centile Healthy WeightBetween 2 nd and 90 th BMI centiles OverweightBetween 91 st and 97 th BMI centiles Very overweight (doctors call this clinically obese) At or above 98 th BMI centile

Prevalence of overweight and obesity in children YR Children Y6 Children YR Children Y6 Children Overweight 13%14.1%13.1%14.7% Obese 9.9%17.5%9.5%19.2% Government’s National Child Measurement Programme (NCMP) for England, 2006/07 and 2011/12 school year

Sheffield Data YR Children Y6 Children YR Children Y6 Children Overweight 9.7%12.5%13.0%14.0% Obese 6.9%14.8%10.0%20.0%

Consequences of Obesity Conditions highlighted in blue are noticeable in children; Reproductive Problems and earlier onset of Puberty Raised Cholesterol Depression and low self esteem Cancers Women - Uterus, Gallbladder, Cervix, Ovary, Breast, Colon. Men – Prostate, Colon, Rectum. High Blood Pressure Fatty Liver Back and Joint Pain Osteoarthritis Gout Respiratory Problems Gallbladder Disease Type II Diabetes Heart Disease Gastric Reflux Stroke

Stages of Change

Brief Intervention What do you think it is?

Brief Intervention 1. Offered by “professionals/appropriately trained staff” in a variety of settings; 2. Opportunistic in nature; 3. Targeting individuals, families or groups; 4. Limited duration and frequency (e.g. vary from 1 session to 4); 5. Identify health issue and assess individual’s motivation and stage of behaviour change; 6. Negotiate goals via: provision of advice, counselling, information, or referral as appropriate and; follow-up and reinforcement, as appropriate.

What can YOU do? 1 st step in helping people to lose weight is having the ‘conversation’. Studies show that a short 3 to 5 minute conversation can contribute to behaviour change. Talk Non-offensive language Advice they can use

Behaviour Change Self Monitoring of behaviour change- log book/apps Goal Setting- SMART Social Support – do it with others/groups Relapse Prevention Strategies to deal with weight gain

Tips 1.Discuss primary issue for coming to you 2. Open the discussion Link reason for attending to weight management discussion.

Tips 3. Ready Willing and Able? a.Importantb. Confident ‘Is this the right time to be focusing on weight loss?’’ ‘What are your goals regarding your weight? ‘Are there any changes you think you could make to your eating habits?’

Tips 4. Set a goal 1-2 pounds for adults, per week is a safe rate of weight loss. 5-10% reduction in body weight over 6 months Goal around weight maintenance Offer people printed info. 5. Follow Up: Praise, discuss setbacks and how to overcome these

NHS Sheffield Commissioned Services

Zest for Health NHS Sheffield Commissioned Referral Criteria: Children aged: 7-15 Overweight or Obese (91 st Centile and above) Parents must attend 60% of sessions Commitment to 12 week programme

Zest for Health One to One support Group Sessions Family Session Activity Session Health Line form parents and professionals Mon, Tue, Wed 10am-12pm ( ) Community Work Business Work Health Checks Workshops Exhibitions Training Strand

Weigh Ahead – Referral Criteria Age 15+ registered with a Sheffield GP BMI > 35 (BMI 32+ South Asian) with co-morbidities BMI 40+ with no co-morbidities All patients for consideration of Bariatric surgery must complete Weigh Ahead Referral from GP or health care professional

Treatment Options Come to a 60 minute assessment at the Wicker – agree treatment pathway 10 treatment appointments booked with interim (3 months) and final assessment (6 months) All ten weeks with team member – either a combination of therapies or one therapist throughout –Psychologist –Physiotherapist –Dietetics – could include psychological and behavioural techniques –Personal guide One to one, telephone, or text Patient group – diet or physiotherapy group Groups for pregnant women

Thank you