Obesity is caused by a complex set of personal, social and environmental factors. It can come with a number of associated health consequences, all of which can have a huge impact on the individual, as well as the people around them.
But what impact does obesity have on our local population as a whole, and what part can local services play in addressing this issue?
PHE’s 'Guide to Delivering and Commissioning Tier 2 Adult Weight Management Services' supports local authorities, clinical commissioning groups and providers to develop and deliver weight management services that can help individuals achieve a healthier weight, while potentially contributing towards healthier communities.
Our guide, co-badged by NICE, LGA, ADPH and RCP, helps make the case for evidence-based services that are effective and accessible for users.
Some healthcare professionals are not comfortable discussing weight with patients, while others may doubt the efficacy of such services, meaning some patients might be missing out.
Our guide will help professionals engage with people across the obesity pathway, to ensure those referring into the service and those eligible to access services get all the support and information they need.
What is the impact of obesity?
Being overweight or obese can bring physical, social, emotional and psychosocial problems, which can lead to the onset of preventable long term illness, stigma, discrimination, increased risk of hospitalisation and reduced life expectancy.
This has a direct impact on the community. An overweight or obese population is less likely to be physically active, which can lead to reduced productivity.
It can affect life opportunities and place an increased demand on social care, putting extra pressure on limited services and resources.
Someone who is severely obese is three times more likely to need social care than someone who is a healthy weight, so the need for quality weight management services does not only impact individuals, but also affects public funds and the wider community.
LAs and CCGs are already experiencing the financial implications of obesity and its associated health conditions.
Heavy duty stair-lifts, community bariatric equipment and medical complications are all costly; investing in effective, evidence-based services to help people achieve and maintain a healthier weight can provide a return on investment.
And it's clear that investing in weight management services is beneficial to individuals and the wider community.
Making sure weight management services are evidence-based and tailored to the needs of the local population is essential to their success.
It is also important to engage with the right people so that everyone involved in the weight management journey – from GPs to service users – is given the tools to get the most out of the service.
We designed the Tier 2 guidance to make this process more effective. There are several key ways the guide – and its supporting resources - can help you.
Understanding your local needs
We know obesity is more common among women in deprived areas, some black and minority ethnic groups and people with learning disabilities.
Understanding the unique needs of your local community will help you make the case for investment and will also inform how you design and promote your service.
The guide advises how to use the evidence, how to consult with the people who require weight management services and how to consider your diverse population through an equality assessment.
There are also links to insights into obesity services from service users and commissioners.
Making the case for investment
It is important to make the case for Tier 2 services, to help stakeholders understand the short-term and long-term impact these services can have on your population.
With public bodies working with limited finances and resources, tools such as the PHE Weight Management Economic Assessment Tool will help you demonstrate the value of your services.
Promoting your service
Promoting the service to the general public is important, but engaging with healthcare professionals is integral to driving referrals. The guide provides information on how to market your service to the right people to ensure they are involved in the process and that they have the knowledge and confidence to promote it to their patients and stakeholders. The Let’s Talk About Weight tool can support health professionals to have conversations about weight and refer patients into weight management services.
Design and delivery
The guide provides recommendations and resources to ensure the right people (such as registered dietitians and nutritionists, behaviour change experts and physical activity specialists) and the right techniques (such as behaviour change) are part of the design and delivery, to get the most out the service and to give participants the greatest chance of success.
The guide also comes with a separate resource around Behaviour Change Techniques to consider when designing the service.
Evaluation
Monitoring and evaluating your service is important, both from participants’ point of view to help them track their progress, but also to determine the effectiveness of the programme. The guide provides a minimum dataset and a Capturing Data resource to support the evaluation of services, including how to monitor participants during and after the programme to capture the long-term impact.
Missed opportunities
Tackling obesity remains a huge challenge, both for the individual and for organisations tasked with driving behaviour change.
Weight management interventions such as Tier 2 services for adults have a place in tackling obesity, but these services alone cannot solve the problem.
A whole-systems approach, which considers other factors such as the changing the food environment, facilitating better means of transport and making adaptations to the physical environment can all nudge us to make healthier choices in terms of our diets and physical activity levels. Weight management services are a vital piece of the puzzle.
Weight management services have the support of the public and can add value to your communities when done well – and this guide helps you do just that. The benefits are clear to see and it would be a missed opportunity not to provide services for those most in need - both for the individual and for society as a whole.
3 comments
Comment by Carole Scrafton posted on
This is all fair play for the normal society, but unfortunately for people like myself who has limited mobility as a result of multiple chronic illnesses the weight loss programs are no good.
My GP knows that I cannot undertake the exercise section of the programs so it is pointless referring me. Like thousands of other people with disabling health conditions I have put a lot of weight on due to a combination of factors including: disabilities, lack of proper exercise and side effects of medications. In fact at my final hydrotherapy session a few weeks ago I expressed this to the head of the department who suggested they went away and created a weight management/exercise program for people like me that entailed more appropriate and doable exercises. We don't wish to be overweight we just have no support system to help us do it!
I cannot perform the usual regular exercise programs, go to gym and workout, or go for a jog! I used to be an athlete in fact a long distance runner and have always led an active life until my mid 30's when I even had to give up work. I had always worked manual labour type jobs they helped keep me fit and agile. Now I struggle to walk.
Although I brought this up with my local NHS hydrotherapy head of department it is an issue which affect people all over the UK annd should be highlighted as a 'need to change' subject.
Please help us to conquer weight management/exercise/nutrition issues by creating feasible programs for people with disabilities.
Comment by Blog Editor posted on
Thank you for raising some really valid points. We agree that weight management services shouldn’t be designed in a generic way, as we know know that everyone has different requirements when accessing weight management services.
This is why we designed the guide, so that commissioners and providers have the tools to assess the needs of their population and to tailor services accordingly. The guide recommends that weight management services consider a flexible approach - this could be in relation to different durations, group or individual sessions, content and activities.
The guide explains that services should make reasonable adjustments to enable individuals to access services. This includes undertaking an equality assessment to account for cultural diversity and populations at greater risk, such as people with physical disabilities. It is also important that the service causes no harm, includes appropriate expertise when designing the service and considers patient focussed care. These may include experts such as a registered nutritionist and physical activity specialist.
The guide also encourages weight management services to support individuals to increase physical activity - this can either be through practical sessions embedded and delivered within the service or through supporting and encouraging individuals to increase physical activity within their own lifestyles.
We would like this guide to support commissioners and providers, to ensure that services are accessible for all individuals.
We hope that helps.
Comment by Margaret Paffas posted on
If people that write articles cared more about writing great material like you, more readers would read their content. It's refreshing to find such original content in an otherwise copy-cat world. Thank you so much.
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