Healthy Weight, Healthy Lives
Healthy Weight, Healthy Lives
Tackling obesity in England
Obesity levels are too high, with significant impact on
individuals, the health service and society as a whole
By 2050, if trends continue, 60% of men and 50% of women
could be clinically obese (UK Foresight report)
HEALTH IMPACT
Overweight & obesity forecast trend 2007-2050
• 58% type 2 diabetes
• 21% of heart disease
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• 10% of non-smoking related
cancers
• 9,000 premature deaths a year
in England
• Can reduce life expectancy
and quality of life
COST
• National Health Service - £4.2bn
• Wider economy - £15.8bn
• Foresight estimates by 2050
costs to economy of £50bn
Obesity in adults and children is too high and
forecast to rise, with huge costs to society..
NOW Alternative slide 2050
option
• 60.8% of adults (aged 16+) • Based on current trends
overweight or obese, of these 60% men, 50% women and
24% are obese 25% children will be obese
• 28.6% of children (aged 2-10) • 9 in 10 adults will be
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overweight or obese, of these overweight or obese if we carry
15.4% are obese on as we are
• Cost of overweight and obese • Cost to the NHS forecasted to
individuals to NHS estimated to more than double
be £4.2 billion
• Cost to the wider economy
• Cost to the wider economy is predicted to rise to £50 billion
£16 billion per year
..and to the individual
• risk of diseases, such as cancer, heart disease or Type 2 diabetes
• risk of reduced life expectancy and quality of life
Sources: The Health Survey for England 2007 and Foresight
Foresight developed a system map showing the
multiple determinants of obesity
Optional slide
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Foresight identified four factors driving this trend
and creating an ‘obesogenic’ environment
• Genetics can increase the risk of obesity
HUMAN • Early life experiences including breastfeeding can
BIOLOGY affect a child’s risk of being overweight later
• Difficult to break habituated unhealthy behaviours,
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CULTURE /
especially when these are common to those around us
INDIVIDUAL
PSYCHOLOGY • Obesity and overweight are becoming ‘normal’
• Availability of convenient food has increased
FOOD massively, which tends to be high in saturated fat,
ENVIRONMENT salt and sugar
• Our lives have become increasingly sedentary.
PHYSICAL For example, the last two decades have seen a 10%
ENVIRONMENT drop in children walking to school
The Government has set out an ambitious strategy
Our ambition is to be the first major nation to reverse the rising tide of
obesity and overweight in the population, by enabling everyone to
achieve and maintain a healthy weight.
Our initial focus will be on children: By 2020, we aim to reduce the
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proportion of overweight and obese children to 2000 levels.
• In January 2008 the Government published Healthy Weight, Healthy
Lives: A Cross-Government Strategy for England
• £372 million is being committed over 3 years to implement the strategy
• In April 2009 Healthy Weight, Healthy Lives: One Year On was
published. It reviews progress on the strategy and sets out priorities for
the future.
The strategy sets out action in 5 themes, based on
the evidence provided by Foresight
• Children: healthy growth and healthy weight
> early prevention of weight problems to avoid the ‘conveyor-belt’
effect into adulthood
• Promoting healthier food choices
> reducing the consumption of foods that are high in fat, sugar
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and salt and increasing the consumption of fruit and vegetables
• Building physical activity into our lives
> getting people moving as a normal part of their day
• Creating incentives for better health
> increasing the understanding and value people place on the
long-term impact of decisions
• Personalised advice and support
> complementing preventative care with treatment for those who
already have weight problems
Healthy Weight, Healthy Lives actions to date
include…
• Launching Change4Life, a national movement to bring together community
groups, health professionals, teachers, government departments, supermarkets,
the media etc to help everyone to “eat well, move more and live longer”
• £30m matched investment in 9 ‘Healthy Towns’
• Sending NCMP results to parents and helping PCTs commission services for
overweight and obese children
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• Healthy Food Code of Practice covering our policy on food and health
• £65.9m in PCT allocations in 08/09 to support action on overweight and obesity
• Rises in breastfeeding rates and 3,000 Sure Start Centres providing healthy
living advice and support in pregnancy and early childhood
• 97% of all schools participating in Healthy School programme and 3m children
eating school dinners
• 34% reduction in children’s exposure to TV ads for ‘unhealthy’ food & drink
• £7m to encourage people to walk more and £42m for Cycling Towns
• 3,500 extra play areas across the country
• 80% of LAs signed up for Free Swimming for under 16s and over 60s
First signs that we are having an impact on
child obesity?
Latest figures from the Health Survey for England give an early
indication that the trend in obesity prevalence in children
‘may have begun to flatten out’ (NHS Information Centre)
NCMP 2007/08 data supported this, showing no significant change in
obesity rates between 06/07 and 07/08 at ages 4-5 or 10-11
However, it is still to early to tell if these results are part of a new trend
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The scale and complexity of the challenge means we cannot assume
that the action already taken will be enough and it’s important to
maintain momentum.
Percentage of obese children 2-10 years old
23
21
19
17
15
13
11
9
7
Action over the coming year
Healthy Weight, Healthy Lives: One Year On (April 2009)
builds on the 5 themes from Healthy Weight, Healthy Lives and
demonstrates our commitment to maintaining the momentum in
tackling unhealthy weight.
We will continue our drive to reduce obesity by:
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• helping people to make healthier
choices;
• creating an environment that
promotes healthy weight;
• ensuring effective services are
available for those at risk; and
• strengthening the delivery system.
1. Helping people make healthier choices
In the next 12 months, we plan to help change how people relate to and
understand obesity by giving parents clear information about the
importance of healthy weight and the tools to allow them to make
healthier choices for themselves and their children.
We will:
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• inspire 200,000 families to change behaviour through Change4Life
• extend Change4Life to at-risk adults
• provide new content and tools through the NHS Choices website and
NHS LifeChecks to support people in assessing and managing their
own lifestyle, including maintaining a healthy weight
• examine how NCMP results may best be shared with health
professionals to enable more proactive follow-up where required.
Engaging families with the National Child
Measurement Programme
• Established in 2005, the NCMP weighs and
measures children in Reception year (aged
4-5 years) and Year Six (aged 10-11) in
schools.
• In 2007/08, almost 1 million children were
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measured, approximately 88% of those
eligible.
• About half of all PCTs are now routinely feeding back the results
to parents, as a means to engage them - we expect a rise in the
number of PCTs feeding back in 2009/10.
• Many PCTs are using NCMP data to inform the provision of services
to children and families, such as weight management programmes,
and to target resources.
2. Creating an environment that promotes
healthy weight
It is vital that we continue to act in a wide range of settings to create a
social environment that makes it easier for individuals and families to
maintain a healthy weight.
• do more to support children in early years through a single set of
Children
evidence-based messages on healthy eating and active play
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• use sample surveys and research to collect and track data on
weight status of very young children
• continue to improve environment for school-age children
• raise public understanding of maintaining an appropriate energy
Food choices
balance
• see more fast food and other chain restaurants provide calorie
labelling for consumers at the point of choice
• look to develop a voluntary set of principles to underpin all
forms of promotion and marketing of food and drink to children
• continue to work in partnership with industry to reformulate foods
by reducing levels of saturated fat, salt and sugar
2. Creating an environment that promotes
healthy weight (continued)
• encourage local authorities to deliver active travel initiatives
Physical Activity
through the next round of transport plans
• set up an expert working group to look at sedentary behaviour,
screen time and obesity and advise on messages to families
• evaluate work of Healthy Towns and ensure learning is shared
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• commission robust evidence of how healthy living objectives
are being delivered locally from a spatial perspective
• work to improve the health and wellbeing of public sector
employees, starting with the NHS workforce
Incentives
• support SMEs and non-FTSE companies in the private sector to
adopt the Business HealthCheck Tool.
• look at results of subsidised gym pilots for young people and
consider whether scheme should be rolled-out to other areas
3. Effective services for those at risk
For those currently overweight or obese, we need to provide effective
services that help them to achieve and maintain a healthier weight. Going
forward, we will provide further support to local commissioners in this area,
aligning with the World Class Commissioning agenda.
We will:
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• review and build upon the package of support for commissioning child
weight management services that we have developed in partnership
with PCT colleagues, which includes a commissioning toolkit and a
framework of 'pre-qualified' training providers
• focus on supporting local commissioning of weight management services
for adults
• begin the roll out of NHS Health Checks for all 40–74-year-olds, including
an assessment of BMI and referral into weight management or exercise
programme where necessary for health reasons
• ensure that primary care professionals are better equipped to play
their part in providing advice and referral.
4. Strengthening delivery
We need to ensure that we have a delivery system that prioritises tackling
obesity and has the capability to do so. There is growing momentum and
commitment towards tackling obesity locally and regionally. We want to
continue to support the delivery chain.
We will:
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• provide £69 million to local areas within PCT allocations in 2009/10 to
combat overweight and obesity
• encourage local authorities to use their power to promote or improve the
economic, social or environmental wellbeing of their area
• commission an evaluation of the role of the regulatory environment in
promoting and encouraging physical activity and healthy food choices
• develop a new Obesity Improvement Programme, to strengthen local
capabilities to both prevent and treat overweight and obesity (planned for
summer 2009)
Helping local areas promote healthy weight
We have provided a range of support and guidance
including:
• Child Obesity National Support Teams who
visit local areas and provide intensive support
• a toolkit for developing local strategies
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• guidance on commissioning weight management
services for children and young people
• a directory of obesity training providers
The new Obesity Improvement Programme will provide:
• a one-stop shop website providing best practice and a forum for
sharing information and data
• training support to build capability of the delivery chain
• a national weight management monitoring system to track
availability of local weight management services.
Change4Life – supporting families to maintain
a healthy weight
• We have allocated £75 million to launch a 3 year
social marketing campaign called Change4Life.
• An extensive 18 month research programme helped
us understand families with children under the age of 11 and
their attitudes and behaviours in relation to food and physical activity.
• The Change4Life advertising campaign launched in January 2009.
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The message to the public is Eat Well, Move More, Live Longer.
• The Change4Life website (www.nhs.uk/change4life), helpline
and direct marketing programme will provide ongoing help, advice
and support.
• We will create more opportunities for activity and healthy eating through
building on our Change4Life partnerships across all sectors.
• Some statistics so far
• 68% of mothers have heard of Change4Life and 79% of mothers
said the adverts made them think of their children’s long-term health (Mar 09)
• over 250,000 ‘How are the kids?’ surveys have been completed
• over 90 signed commercial partners including Co-op, Kellogg's and ITV.
Change4Life activity phases 2009
Phase Phase Phase Phase Phase
one two three four five
Role of Supporting
Reframing the Personalising Rooting Inspiring people
marketing people as they
issue of obesity the issue behaviours to change
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change
Sample
marketing
materials
This isn’t about
This isn’t about I know people
how my children
bad parents or I know what to do like me are I can see the
Desired look; it’s about
very fat children to reduce my changing their difference this is
out-take diabetes, cancer
– it’s about my family’s risk lives so I believe making
and heart
children it’s possible
disease
We remain committed to building the evidence base
on tackling obesity
Commissioning research
• Chief scientific advisers set out a framework to guide next
steps - 'Healthy Weight, Healthy Lives: A cross-government
research and surveillance plan for England' (Dec 08).
• Continue to prioritise areas for investigation, and boost
research on obesity, diet, physical activity and environmental
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influences.
Learning through evaluation
• Continue to evaluate key policy activities e.g. evaluation of Healthy
Towns and Change4life on behaviour and health outcomes.
• Work across government to identify additional policy areas and natural
experiments where the impact on obesity and its causes can be
assessed and evaluated.
Supporting infrastructure and coordination
• National Obesity Observatory is established and working to act as a
first point-of-call for information on obesity, its determinants and
interventions.
• The HWHL expert group continues to support policy development.
Conclusion (to be amended audience depending)
In Healthy Weight, Healthy Lives: A cross-
government strategy for England, we
issued a call to action to tackle the most
significant public and personal health
challenge facing us today, and we will
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continue to take that forward through the
commitments in the One Year On report.
Over the last year, we have worked together across society to tackle
obesity, but this public health epidemic needs sustained action if we are
to realise our ambition of everyone being able to maintain a healthier
weight.
www.dh.gov.uk/healthyweight