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Evidence of what works

Background papers: Lifestyle and wider determinants :: Healthy weight :: Obesity :: Evidence of what works

A wide range of evidence-based best practice guidelines have been read and interpreted, such as the NICE guidance on weight management[1] and obesity[2]. For ease of presentation, the best practice recommendations have been categorised into 10 subject areas and summarised.

Commissioning and contracts


• Embed the obesity agenda into all potential local authority and Clinical Commissioning Group (CCG) contracts (i.e. catering, transport)
• Follow standard evaluation frameworks in all interventions and allocate a budget for evaluation
• Ensure family-based, multi-component services are available

Communication and community engagement recommendations


• Gather local residents' views on priorities and recruit champions for the agenda
• Publicise interventions and services that are already underway and newly launched
• Identify barriers for taking up services and remove them where possible

Environment


• The NHS and local authority should act as exemplars in promoting healthy food and drink in their venues
• Utilise planning powers to create places that promote a healthy lifestyle
• Ensure events promote and provide a range of healthy food choices
• Ensure buildings are designed to promote healthy lifestyles
• Promote cycling and other active travel modes and ensure suitable infrastructure is in place
• Ensure the environment around schools promotes activity and healthy eating by addressing vehicle speed, parking and driving, whilst reducing exposure to high calorie foods

Health professionals


• All health professionals should receive training on how to raise obesity related issues, and assess, discuss and take appropriate action on weight management with clients
• All health professional should make every contact count by routinely advising on obesity related issues, including GP staff, midwives, health visitors, and school nurses
• Obesity related advice should be given at key life events by professionals, including pregnancy and child birth, long-term condition diagnosis, and treatment and recovery
• Screening should be routinely undertaken to identify people at risk, ensuring that weight management advice is given and services are signposted
• Care pathways should be modified to include routine obesity advice, support and signposting
• The NHS should support employees to be more active and lead healthier lifestyles
• Implement the Unicef Baby Friendly Initiative standards for breastfeeding in acute and community settings

Leadership and strategy


• Ensure the JSNA and all key Health and Wellbeing Board, CCG, local authority, and partner strategies support the obesity agenda
• Ensure elected members and senior leaders in key organisations champion the obesity agenda

Local authority


• Local assets that support the obesity agenda should be mapped and utilised
• Leisure services should offer an affordable and appropriate range of activity opportunities to all residents
• Establish links with local university colleagues to support the obesity agenda and evaluation

Local support services


• All areas should provide a comprehensive sport system, offering a range of opportunities at different times and locations
• Ensure a comprehensive walking programme is available through supported groups, 1-1 advice, maps and signage
• Provide a comprehensive set of weight management services at all tiers for children and adults

Schools and young people settings


• Early years settings should provide regular opportunities for active play and structured physical activity sessions
• Early years, schools and college settings should prioritise healthy food and create environments that promote physical activity
• Children and young people should learn skills to cycle through bikeability
• Head teachers and senior leaders should act as and identify further champions for the obesity agenda
• School facilities should be utilised as community assets before and after school hours
• Universal free school meals should be available in all schools, with access to free tap water for all
• Food-based and nutrient-based standards for England should be applied to all schools

Training


• Key system leaders and local champions should receive training on the obesity agenda
• Training should be provided for fitness professionals on how to engage priority groups
• Provide training on healthy food preparation to local catering staff and managers
• Provide basic training on healthy food and wider obesity issues to early years and other front line staff working with children
• Weight management delivery staff should continue to develop their professional skills

Workplace health


• The local authority and NHS should act as exemplars by ensuring the environment and internal policies help staff maintain a healthy weight, and offering lifestyle and weight management support to appropriate staff
• New workplaces should be designed to promote active travel
• Workplaces should provide facilities such as showers and bike racks to promote routine activity
• Champions should be identified in all workplaces to promote the obesity agenda


References

[1]   National Institute for Health and Clinical Excellence. Public health guideline [PH47]. Weight management: lifestyle services for overweight or obese children and young people 2013;
[2]   National Institute for Health and Care National. Public health guideline [PH42]. Obesity: working with local communities 2012;