1. Supporting Healthy Weight Services Emma Parker Public Health Project Manager Public Health Directorate

2. Objectives To speed date the issue of weight in Medway, To raise awareness of current services available to families, Review how practitioners can raise the issue of weight

3. What’s the Issue with Weight?

4. One in five children in Reception is overweight or obese (boys 23.2%, girls 21.2%) One in three children in Year 6 is overweight or obese (boys 34.8%, girls 31.8%) National Child Measurement Programme 2012/13 Prevalence of excess weight among children Child overweight (including obesity): BMI ≥ 85 th centile of the UK90 growth reference

5. Obesity prevalence and deprivation National Child Measurement Programme 2012/13 – Year 6 children (aged 10-11 years) Local Authorities in England

6. Inequalities Gap in Child Obesity is widening Children in Reception (aged 4-5 years)

7. NCMP Local Authority Area Profile http://fingertips.phe.org.uk/profile/national-child-measurement-programme

9. Services to Support Medway Families

10. Supporting Healthy Weight Team Adult Services Tipping the Balance Exercise Referral Service Let’s Talk about Weight Active Travel Infant and Children Services Medway Breastfeeding Network Mend 2-4 Mend 5-7 Mend 7-13 Fit Fix Community Food Programme

11. National Child Measurement Programme Legal requirement to carry out measurements in year R and year 6 Year R is carried out by School Health Year 6 is carried out by the Supporting Healthy Weight Team Proactive Follow-up Raises parental awareness of child’s health status through our follow-up telephone calls Every child above 91 st BMI centile receives a telephone call from our Change4life helpline

12. Change4life 1-2-1 Programme 3 months personalised 1-2-1 support for families Available for children above a healthy weight for their age Pre and post healthy growth checks Family sets their own goals Weekly texts and emails Upon completing 3 months, free 3 month family swim pass Referral through Health Professional or self referral through change4life helpline

13. What is MEND? MEND is comprehensive, family–based education programme that has been specifically designed to help families live a healthier lifestyle. MEND was designed by leading experts from the Institute of Child Health, Great Ormond Street Hospital for Children and the University College, London. Age specific programmes: 2-4, 5-7, 7-13. In Medway, Mend 2-4, 5-7 and 7-13 are being run.

14. MEND 2-4 M(ind)E(xercise)N(utrition)D(o it!) A healthy lifestyle programme Families with 2-4 years olds NO weight criteria NOT a diet

15. Mend 2-4 Structure 10 Weeks (Break for Holidays) 1 ½ Hour Sessions Run in partnership with Children’s Centres

16. MEND 5-7 M(ind)E(xercise)N(utrition)D(o it!) 5-7 Community based, family intervention for children above a healthy weight (above 91 st BMI centile) 10 week programme (1hr45 once a week) 15 mins snack time (food exposure technique & peer learning) 30 mins family play (being active together) 45mins parental workshop / children’s activities Programmes are run in school settings

17. Mend 7-13 Specifically designed to prevent and treat children aged between 7-13 years old who weigh more than they should at their age. MEND is not a diet and does not encourage rapid weight loss. The principles of MEND aim to help families to adopt a healthy lifestyle and to lose weight naturally. Meets NICE recommendations for weight services for children

18. Structure of Mend 7-13 10 week programme 2 x 2hour sessions per week. 2 Measurement sessions 2 Theory sessions per week (total 18 sessions) 2 Activity sessions per week (total 18 sessions) FREE! Family packs for every child

19. What does the Mend Programme aim for families to achieve from the programme? Learn how to lead a healthy balanced lifestyle. Making families aware of the healthier options available to them when shopping, eating out and at parties. No food is forbidden. How to encourage your children and your family to become more active.

20. MEND Graduates Scheme Monthly Activities Game based Activities Linked to local sports clubs Summer Schemes Healthy Grow Checks every 3 months Attendance gives accesses free 6-week courses (e.g. badminton, street dance) Family Discount Card (discounts at clubs, shops, leisure activities)

21. Community Food Programme Medway Cooks! Free 6-week cookery groups (2 hour sessions) Healthy eating workshops (2 hour introductory sessions) Med Cooks! recipe collections (resident based recipe sharing) Medway Grows Master Gardener Project (20 expert gardener volunteers supporting local households) Medway Dines Eat Out Eat Well Award with Environmental Health

22. Fit Fix Scheme A community based healthy lifestyle course aimed at improving the health and well-being of young people 6-week health and well-being sessions based on units from National Open College Network Level 1 Personal Well-being qualification. Completion of portfolio achieves accredited units. 6-week cookery course. Weekly group activity sessions (circuits & Zumba) Fortnightly personal training sessions. Quarterly health assessments for following 9 months. Attendance activates 3-month free gym membership.

23. Talking About Weight What’s this to do with me?

24. Stages of Change Model (Prochaska & diClemente, 1984)

25. Talking about Weight Families do not seek help if they feel there is not a ‘problem’ Carrying excess weight is not seen as a ‘problem’ Research has highlighted that many parents cannot recognise when their children are overweight Q. Why is poor parental awareness so common?

26. Talking About Weight: Group discussions Q. Why is it so difficult to talk openly about weight? Q. Would you raise the issue of weight? If yes, why? How would you do this in a helpful way – what questions would you ask? If no, why not? Would you do anything else instead?

27. Assessing Readiness to Change Has the child expressed any concerns about their weight or shape? Has the child been teased about their weight or shape? Do any family members have concerns about the child’s weight? How important is weight management at the moment? What elements of the family’s lives need to change in order to tackle the problem?

28. For Those Not Ready to Change Explore reasons Investigate ways to increase motivation: -Potential associated symptoms (sweating, exercise, intolerance, peer pressure, bullying) For those not ready to change, ensure they are given every opportunity to come back (or be referred when ready)

29. Tools to Help Try to use measurements as a guide rather than judging by eye NHS Choices BMI calculator www.nhs.ukwww.nhs.uk If child is in year R or year 6, ask about NCMP results Assess readiness of family Ask about whether weight is an issue for family or use other healthy lifestyle topics CAF useful talking tool to encourage action Change4life helpline is happy to discuss options with families 01634 333 781

30. Thank you Are there any questions?