Welcome!

Weight Management Brief Interventions Training

Friday 12th 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 2050 60% 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

Ethnicity Male Female

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

1993 13% 16% Over 30%

2011 24% 26% Over 70%

Health Survey for England - 2011

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

•91st Centile for overweight

•98th Centile for obese

Children’s BMI Centile Range

Underweight

(children may be healthy at this BMI centile)

Below 2nd BMI centile

Healthy Weight Between 2nd and 90th BMI centiles

Overweight Between 91st and 97th BMI centiles

Very overweight (doctors call this clinically obese)

At or above 98th BMI centile

Prevalence of overweight and obesity in children

YR Children

06-07

Y6 Children

06-07

YR Children

11-12

Y6 Children

11-12

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

06-07

Y6 Children

06-07

YR Children

11-12

Y6 Children

11-12

Overweight 9.7% 12.5% 13.0% 14.0%

Obese 6.9% 14.8% 10.0% 20.0%

Consequences of ObesityConditions 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

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?

• 1st 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. Important b. 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 (91st 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

(0114 2702045)

• 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, e-mail or text• Patient group – diet or physiotherapy group• Groups for pregnant women

Thank you