CHILDHOOD OBESITY IN SEFTON

Report to Shadow Health and Wellbeing Board

5th March 2012

The causes of obesity are extremely complex encompassing biology and behaviour and set within a cultural, environmental and social framework.

∗society has altered drastically over the past five decades with major changes in work patterns, transport, food production and food sales.

∗These changes have exposed an underlying biological tendency, possessed by many people, to both put on weight and retain it.

Background

∗ personal responsibility verses the ‘obesogenic

environment’

∗ The Foresight Tackling Obesity Report (2007) identifies

four key determinants of obesity:

∗ Primary appetite control in the brain

∗ The force of dietary habits, keeping individuals from

adopting healthier alternatives

∗ The level of physical activity

∗ The psychological ambivalence experienced by individuals

in making lifestyle choices

∗ Obesity has a life course component - growth patterns in the first few

weeks and months of life affect the risk of later obesity and chronic

disease.

∗ The generational dimension shows that the most significant predictor of

childhood obesity is parental obesity (obesity in a parent increases the risk

of childhood obesity by 10%).

∗ Both of these elements represent significant opportunities to influence

behaviour.

∗ The Foresight Report (2007) predicted that 60% of the UK population will

be classified as clinically obese by 2050 and estimated that the wider costs

of obesity to Sefton are £46m per year - this rises to £85m when

considering overweight and obesity.

Life Course and Generational

component

Nationally

∗The most recent figures (2006) show that, among children aged 2-15, almost one-third –nearly 3 million – are overweight (including obese) (29.7%) and

∗ approximately one-sixth – about 1.5 million – are obese (16%)

(Healthy Weight, Healthy Lives: a toolkit for developing local strategies, 2008)

Scale of the problem

Sefton

∗breastfeeding prevalence remains below

target 28.3% against a target of 30.6%.

∗Obesity in Year R is similar to previous year

(10.3% to 10.4%) and below target (11.8%)

∗Obesity in Year 6 has risen from last year

(19.3% to 20.7%) and is above target

(18.5%)

Scale of the problem

∗ Our current approach to tackling the problem is based on the five ‘Healthy Weight, Healthy Lives’ key themes which are:

∗ Children: healthy growth and healthy weight –focuses on the importance of prevention of obesity from childhood including pre-conception, pregnancy and the early years

∗ Promoting healthier food choices - reducing the consumption of foods that are high in fat, sugar and salt and increasing fruit and vegetable intake

Sefton’s current approach

∗ Building physical activity into our lives – focuses on action to prevent overweight and obesity by everyday participation in physical activity and the promotion of a supportive built environment

∗ Creating incentives for better health – focuses on action to maintain a healthy weight in the workplace by the provision of healthy eating choices and opportunities for physical activity

∗ Personalised support for overweight and obese individuals – focuses on action to manage overweight and obesity through weight management services

∗ See paper for current interventions

Sefton’s current approach

∗ Food production/availability: eradicating trans fats, reducing salt, limiting fast food outlets, restricting advertising, lobbying. Price control

∗ Changing behaviours and the cues for behaviours relating to food, physical activity and physiological and psychosocial factors, but note

∗ Interventions may need to be conducted at individual, local, national and global levels.

∗ Different interventions targeting the same process of behaviour change will be needed across the life course.

Opportunities for intervention

∗ These relate to critical periods of changes in

metabolism (early life, pregnancy, menopause)

∗ times linked to spontaneous changes in

behaviour (leaving home, becoming a parent),

∗ periods of significant shifts in attitudes (peer

group influences, diagnosis of ill health).

Specific opportunities related to life course.

∗ What are the opportunities to engage at each of the age stages within your role?

∗ What opportunities could be cross organisational?

∗ Do we focus on one crucial age range?

∗ Have we got the balance right between prevention/treatment and individual/environment?

∗ What is needed to create a systemic whole systems approach?

∗ How can consistent visioning be organised?

Questions to consider