The pandemic has dramatically changed how we live our lives. The impact has been felt across all sectors, including the local weight management, obesity and wellbeing services. Local Authorities (LAs) have had to adapt at fast pace to support their communities.
Our rapid research into weight management services captures innovative local practice and presents insights into how people (adults, children and families) living with overweight and obesity felt during lockdown, plus the support available to them.
The report aims to share learning with LAs across the country, including those which had to stop their behavioural weight management services during lockdown. It forms a set of guiding principles for services, commissioners and service users.
This research is a complementary aspect of PHE’s role in tackling the national health crises we are facing. A recent Public Health England (PHE) report found that being severely overweight increases people’s risk of hospitalisation, Intensive Care Unit admission and death from COVID-19.
With nearly two thirds of the adult population living with overweight or obesity, as well as 1 in 3 children leaving primary school, above a healthy weight, our insights report explores the many health risks and causes of obesity. This has also informed the launch of Better Health, a new national campaign to encourage millions of adults to kick start their health and reduce their risk of serious illness, including COVID-19.
How have services adapted?
LA public health teams working with NHS and other organisations, typically commission, provide and monitor the delivery of local behavioural weight management services. These services provide care and support for people living with overweight or obesity. They also form part of a place based whole systems approach to obesity and promoting a healthier weight. Weight management providers, commissioned by one or more LAs, include social enterprises, private companies, the NHS and charities.
PHE supports LAs by providing evidence and practice based guides and tools. We are also interested in understanding how services support people and our collaborative rapid review into weight management services provides insights into the impact of COVID-19 on people living with obesity.
Lots of LAs and service providers across the country are demonstrating that, while life as we know it may have halted during the pandemic, support has not. Anyone looking for weight, fitness or emotional support in their area can visit their local council website to find out what’s available.
Newcastle City Council
From harnessing the power of digital approaches, to wellbeing projects for all ages, there are many examples of what’s on offer. Newcastle City Council for example, reflected on their service user’s needs and insights on people’s physical activity behaviour. In response, they developed an online platform which delivers daily live activity sessions, plus weekly nutrition messages and fun challenges to increase engagement. The initial barriers to implementation was their limited experience around providing online sessions, as well as participants’ confidence levels around using technology as a learning resource.
The aim was to ensure that, during lockdown, participants were not isolated and could still access information and activity to support their healthier weight journey. Feedback has been hugely positive and individuals not accessing the programme online still receive a weekly phone call.
In the London Borough of Bexley, primary school aged children and their families, targeted from deprived areas, received continued support during lockdown. About 50% of families attending the programme were of Black African ethnicity. Virtual cooking classes, where families cooked together, were found to be very popular and these helped to alleviate the challenges with providing meals to children at home. These were pre-recorded and made available so that other families could download and watch in their own time. This has led to increased attendance because families can access the resources from the comfort of their home without needing to travel. Support packs with recipes and game ideas were developed, along with social media to keep in contact with families and allow for new virtual friendships to be formed during periods of isolation and social distancing.
Service users in Medway were invited to social media sessions and provided with support on behaviour change in relation to weight maintenance, as well as weight loss. Patients who required more specialist support, including psychotherapy sessions, were offered a telephone consultation initially. This later moved onto a virtual platform. Once the learning of new technology and the development of social media were achieved, the advantages of using remote approaches were identified and online courses are currently being piloted for the future. Children’s services also continued online through social media posts and virtual sessions on topics such as introducing solids, keeping active and practical cookery demonstrations. Healthy lifestyle courses will also recommence online.
Suffolk County Council
Suffolk County Council became aware that mental health and wellbeing were being impacted during the pandemic. They considered factors association with living with obesity, investigated ways to support wellbeing and developed the ‘Suffolk Says Campaign’. The campaign provides the opportunity for anyone across the county to give and receive thanks (a key element of wellbeing) and is accessible to all. To date, people of all ages and backgrounds have been sending in messages of thanks, be that to their postman, teachers, healthcare workers, and the police for their continued support during the pandemic.
How do services need to respond to support people living with obesity?
Providing continuity of care and support is helping to provide reassurance to service users. It is also important to ensure that any new or adapted service is carefully monitored so that it does no harm or widen inequalities. Insights from local practice and listening to views of people living with obesity led us to develop a set of pragmatic guiding principles for WMS providers, commissioners and service users:
- Providers should ensure WMS takes a person-centred approach and invite service users to actively participate in adapting the services.
- Commissioners should ensure flexibility in their approach, plus a clear continuity plan to ensure continued service provision in the event of subsequent waves of COVID-19.
- Service users should visit their local authority website or seek advice from their local GP surgery or pharmacy to find out what WMS are available and how to access them.
We have a second phase of activity planned to support these services and as the pandemic continues to evolve, so too will the ways we do things. Some of them will work - and some may need fine tuning. But what is clear is that the commitment to supporting our communities will continue, seeking creative and innovative ways to reach out.