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.
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.
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.