1. Lambeth Specialist Healthy Weight Project
Vanessa Impey- Paediatrician
Deborah Thompson- Specialist Dietitian

2. Prevalence of obesity by Local Authority
Year 6 children (age years) resident in London, NCMP 2009/10
Low prevalence
High prevalence
Child obesity: BMI ≥ 95th centile of the UK90 growth reference
© NOO 2011
This slide shows an example of obesity prevalence mapped at LA level – extracted directly from the e-Atlas.
In Lambeth this equates to:

3. Childrens Weight:Lambeth Context
NCMP data - Levels of obesity (2010/11)
Reception %
Year %
Consistently above average for London and England for both age groups.

4. Lambeth Specialist Healthy Weight Project
Aims for a change in how we deliver a healthy weight service
A whole system or integrated approach
Systemic Family Therapy principles and practice
Families as resourceful 5

5. Principles and practice - examples
working with the whole family in mind
non judgmental
wider contextual and social factors - communities and cultures
reaching out - bridging hospital and clinic
multi disciplinary and multi agency - joined up working between health, family, activity and diet
team learning - what are our beliefs and experiences relating to health and diet? 6

6. The process of our work
Working as part of the Lambeth Healthy Weight Care Pathway
Initial referral
Two initial home visits / appointments
Full assessment including health checks
Plan and set up goals
Weekly sessions until three month review
3 month review includes height/weight checks along with some re-evaluations
Appointment frequency to be assessed at this point
Until 6 month review

7. Physical Activities - aims
Encourage and support families to make changes to current activity levels.
Identify local community sessions activity sessions for families.
Promote the long term benefits of regular physical activity.
Assess children's cardiovascular responses to exercise over project time frame.

8. Dietetic Therapy Aim of dietetic therapy: To assess nutritional status
To identify the main dietary causes of weight- gain
To provide nutritional education
To support family with making dietary changes
Use Eatwell plate as a basis for dietary guidance/ comparisons
Work on increasing fruit and vegetables

9. Paediatric input Full health and medical check
Screening out underlying causes
Looking at the impact of obesity on the child
Blood tests taken

10. Family Therapy input The team works under a systemic umbrella.
Connecting medical, physical, dietetic and emotional/psychological/, mental health issues
Family patterns and underlying issues can be worked with
Experiences of health and health care professionals
Seeing weight issues as having a ‘logic’ within a family.

11. Case Examples include:
Working with the impact of:
parental mental health issues
parental experiences of violence
learning difficulties
bereavement
significant child mental health issues

12. Success and challenges
appointment attendance improved
engaging with families where other services don’t
higher referral of children with special needs
referrals to other services including adult community services
referrals of families which appear to fall between gaps
success in dietetics, physical health and parenting strategies all identified in quarterly reports
families referred for medical investigations as necessary which wouldn’t have been picked up elsewhere
identified children with vitamin deficiencies
Changes in personnel

13. Making connnections :
Social services were contacted and asked to cascade down
Links were made with consultants at St Thomas’s
Increased links with paediatricians at the Mary Sheridan Centre
Links were made with dieticians in Lambeth (Community) and at St Thomas
Links have been made with GP surgeries at Clapham Common , Mawby Clinic Gracefield Gardens and meetings arranged to discuss the project in more detail
Team members are taking in project posters to schools when they visit
The team gave out fliers at Gracefield Gardens Anniversary day and made some links with other health professionals

14. Referrals to the service: how you can work with us
Identify families where children are aged between 4-12 with a BMI of over 98.
Where there are psychosocial issues or other complexities
Where families may have tried a Tier 2 service. If not, would that be helpful now : Ready Steady Go instead?
Families must agree to a referral

15. Any Questions