1. Preventing Overweight and Obesity in Scotland: a route map towards healthy weight UPDATE

3. The Problem... 11 million more UK Adults will be Obese by 2030 from a baseline of 15 million (Lancet Series on Obesity 26 th August 2011) Link between BMI & Hospital Stay- Obese spend 50% more time in hospital (Edinburgh University- Scottish Medical Journal 28 th August 2011) o Associated with major health problems- diabetes, heart disease, arthritis, high blood pressure, cancers, mental health problems ALSO economic burden to NHS and Council services- treatment & care; reduced productivity, employee sickness & absence. o Moray is the fourth worst Community Health Partnership for obesity levels in adults aged > 16 years of age.

4. UPDATE Launch of ‘Preventing Overweight and Obesity In Scotland: a Route Map Towards Healthy Weight ‘ – (Scot Gov/COSLA 2010 ) Scot Gov Joint Obesity Group (chair Nicola Sturgeon Deputy First Minister) – Oct 2010 Healthier Theme Group (11 th Nov 2010) agreed to support the planned approach to address population overweight and obesity in Moray Publication of ‘Route Map Action Plan’ – (Scottish Government) Feb 2011 Publication of ‘Indicators to Monitor Progress of the Obesity Route Map’ – (Scottish Government) March 2011 Publication of ‘Elected Member Briefing Note No. 9: The Obesity Time Bomb Why It’s Everyone’s Business’- (NHS Health Scotland/improvement service) May 2011 Start Active, Stay Active: Report on Physical Activity for Health - July 2011 COSLA- Local Authority Survey to determine support needed (toolkit) for local planning, delivering and monitoring actions - Aug’s 2011 Healthier Theme Group (1 st September)- recommendation to adopt prevention of overweight & obesity as a Healthier theme priority for inclusion in SOA 2012-15 2013- Report of the progress and actions taken towards the policy direction set out in the Route Map.

5. Route Map The Route Map recommends actions across four areas: Energy Consumption (energy in) Energy Expenditure (energy out) Early Years Working Lives Obesity is fundamentally caused by an energy imbalance between the calories consumed and calories expended... HOWEVER- Obesity is a complex issue & requires a significant change in emphasis...............

6. A Change in Emphasis... Foresight Recommends- A strategy to tackle obesity must include both treatment and prevention. Preventing obesity is a lifelong challenge. Focusing solely on children will miss the opportunities to improve the health of adults (life-course). The determinants of obesity go beyond the obvious elements of diet and inactivity. The complexity is such that isolated initiatives are unlikely to be effective unless embedded within an overarching strategy. An obesity strategy must go beyond exhorting individuals to eat less and do more. It must seek to change the ‘environments’ in which we live today (e.g. social, cultural, physical and economic environments) and which foster weight gain. The evidence base of effective interventions to prevent and treat obesity is inadequate, but the need to act promptly means that greater emphasis must be placed on practice-based evidence, with an emphasis on the monitoring and evaluation of interventions. (FORESIGHT REPORT- Tackling Obesities: Future Choices 2007) “People in the UK today don’t have less willpower and are not more gluttonous than previous generations. Nor is their biology significantly different to that of their forefathers. Society, however, has radically altered over the past five decades, with major changes in work patterns, transport, food production and food sales.” (Foresight 2007)

7. Culture, Leisure & Recreation o Affordability & Access Schemes i.e. passport to recreation, high life access scheme Education & Community Learning o Cycle & walking to school schemes, cooking & budgeting skills courses, school meals, nutritional guidelines, health promotion events Roads & Transportation o Workplace health promotion schemes i.e. active travel to work plans & staff schemes (HWL), Planning & the Environment o Supermarkets, Healthy Urban Planning Principles, Health Impact Assessments, Healthy Cities (WHO) Housing & Regeneration o Greenspaces, play & recreation, walking & cycling paths Social Work & Community Care o Vulnerable groups & nutritional guidance, health promoting environments Moray Healthy Weight Strategy/Action Plan Build upon Hungary for Success (2003); Healthy Eating, Active Living Action Plan (2008-11); HEAT: Child Healthy Weight (2011-14) etc. Dahlgren & Whitehead 1991 Determinants of Obesity: A social perspective on health & wellbeing…

8. Some Questions?... o Does Overweight & Obesity require a high level strategic partnership response via community planning i.e. SOA 2012-15? o Do the 4 areas that the Route Map recommends actions across provide the proper focus for a local strategy/action plan? - energy consumption - energy expenditure - early years - working lives o Would it be useful for the ‘Elected Members Briefing (obesity time- bomb) to be promoted more widely amongst elected members, others- How?