Slimming World’s Approach to Weight Management

Paul SharpeSue Gibson

Overweight & Obesity – scale and cost

Raising the issue of weight with patients

The Slimming World approach

Slimming World on Referral

– Accessing the referral scheme in Bracknell Forest

– Evidence of Success

• The link between alcohol and obesity: new research

Agenda

“People who are overweight or obese have an increased risk of developing Type 2 diabetes, heart disease and certain cancers.

There is no silver bullet to reducing obesity. It is an issue that requires action at national, local, family and individual level.

Local authorities are ideally placed to develop co-ordinated action across their departments, services and partner organisations to tackle overweight and obesity in the local population.”

Diana Grice, Thames Valley Public Health England Centre Director

Scale and Cost

Public Health England (Feb 2014)

Berkshire Districts – levels of overweight and obesity

‘…preventing poor health and promoting healthy living is essential to reduce health inequalities and sustain the NHS for future generations’

Making Every Contact Count

Potential Concerns

How can I talk about a

patient’s weight when

I struggle with my own

weight?

What if they don’t want

to talk about their

weight?

What if I offend

the patient?

Are you heavier

than you’d like to be?

How do you feel

about your weight?

I haven’t checked your

height & weight recently, would you mind if….

I wouldn’t be doing my job properly if I

didn’t check/let you know that…

Suggested questions

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• 50% of nurses believe they are overweight (Nursing Times)– Fears: no credibility, hypocritical

• But research shows patients sometimes feel more comfortable with somebody ‘who understands’

• Health behaviours can be difficult - acknowledge it• Empathy - If it was easy we’d all be a size 12• Self-disclosure – I eat healthily 80% of the time but…!

Own weight

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• Issue patient with referral letter:– Contains info on Slimming World– Dedicated phone number: 01773 546242

• We manage enrolment:– Establish where referral is from – Conversational style– Test readiness to change– Select group and issue joining pack

• Follow up contact after 2-3 weeks• Evaluation questionnaire• Follow up weight at 6 months

Accessing Slimming World on Referral

Support System

• Facilitate behaviour change

• Trained consultants who have all lost weight with Slimming World

• Warm, non-judgemental group environment

• Empowerment

• Self-determined behaviour change

• Set own goals: weight and action targets

• Share practical skills & strategies, including coping with ‘lapses’ and ‘high risk’ situations

• Problem solving

• Praise, recognition, award system

Dietary approach

• Reduces energy intake

• Balanced approach

• Normal everyday foods

• How foods affect appetite

• Energy density of foods

• User friendly practical system

• Feel free and relaxed about food

• Eliminate distress of guilt, deprivation or loss of control

Promotion of Activity

• Facilitate behaviour change

• No matter what starting point

• Why it’s important to me?

• How can I get started?

• Foot out of the door strategies

• Making it a habit

• Build commitment

• Support turning of new skills into a routine

• Recognise commitment with awards

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• Free week once 10% weight loss achieved and maintained for 10 weeks

• Free attendance once personal target achieved (and +/-3lbs)

• May self-fund after referral, no membership fee , max £4.95pw

• Website access continues for further 4 weeks

Maintaining Weight Loss

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60 patients currently in service

Bracknell Forest - results to date

Finished Lost ≥5% Lost ≥10%

% completers

Completers lost ≥5%

Completers lost ≥10%

Average weeks attended

Latest published results

34,271 36% 5.8% 58 55% 9.7% 8.9

Current average(Super Service)

11,210 44.5% 9.1% 65.7 62.1% 13.7 9.4

Bracknell Forest

40 42.5% 17.5% 65.0 53.8 19.2 9.4

Service satisfaction (all schemes)

Data for all schemes (Bracknell Forest only 11 questionnaires completed so far)

Improved self-esteem

Data for all schemes

Dean Worrall• Referred for 7 x 12 weeks by GP in Dudley• Then self-funded• Lost 16st 13.5lbs

Kim Freshwater

• Referred for 12 weeks by GP in Hampshire

• Lost 3st 2lbs• Then self-funded• Total loss 17st 5lbs

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• The UK has the highest prevalence of obesity in Europe1

• It has among the highest proportion of ‘binge drinkers’ in Europe2

• UK’s consumption of alcohol is rising, other countries are reducing3

• These combined issues are placing a huge strain on the NHS:– The cost of treating conditions associated with obesity estimated

at £5.1 billion4 – Treatment costs associated with alcohol estimated at £3.5

billion5.

1. The Press Association (2010). UK tops European obesity league, Health Service Journal.2. TNS Opinion and Social (2010). EU citizens’ attitudes towards alcohol. 3. OECD (2011). Health at a Glance 2011. OECD indicators, OECD publishing.4. The economic burden of ill health due to, diet, physical inactivity, smoking, alcohol and obesity in the UK. Journal of Public Health 33 (4): 527-5355. Secretary of State for the Home Department (2012). The Government’s Alcohol Strategy.

Alcohol and Obesity

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• Currently two separate public health campaigns:– Reducing obesity– Raising awareness of the dangers of excessive drinking and in

particular ‘binge drinking’

• Slimming World’s ‘Tipping Point’ campaign raising awareness of the link between the two.

Alcohol and obesity

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Alcohol provides 7 calories per gram,

therefore….

alcohol consumption within government guidelines provides up to 2,880 / 3,840 calories a week (women/men)

Research has shown that:

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Alcohol Units/Calorie ValuesTypical Units Typical Calories

Wine (175ml, 13% ABV) 2.1 160

Wine (250ml, 13% ABV) 3 228

Beer/Lager (pint, 3.6% ABV) 2 180

Beer/Lager (pint, 5.2% ABV) 3 244

Cider (pint, 4.5% ABV) 2.6 256

Cider (pint, 7.5% ABV) 4.3 386

Alcopop (275ml, 5% ABV) 1.4 192

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• Alcohol consumption can lead to an increase in food intake (stimulates appetite, lowers inhibitions)

• Heavy but less frequent drinkers at greater risk of obesity than low-to-moderate, frequent drinkers

• Higher alcohol intake associated with greater central obesity (carrying excess fat around the stomach), particularly in men

• Alcohol reduces the quality and quantity of sleep which may increase the risk of obesity.

Research has shown that:

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Tipping Point

“The point at which people go on to make unhealthy choices with food and alcohol”

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• The average tipping point is 9.3 units of alcohol, equivalent to 3.7 pints of beer or 3.1 large glasses wine

• 51% of alcohol consumers acknowledge a tipping point with alcohol

• The average additional energy intake = an estimated 4,305 additional calories

• 58% who acknowledge a tipping point report they pass this point at least once on an average weekend

YouGov Survey, 2042 members of UK population

Tipping Point Survey

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• 63% reported being more likely to eat a larger amount

• 57% more likely to snack on a family-sized packet of crisps or nuts

• 58% more likely to order a takeaway

• 65% more likely to rely on convenience food

• 34% more likely to go out for an unplanned meal.

YouGov Survey, 2042 members of UK population

Tipping Point Survey

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People continue to make unhealthy food choices the day after passing their tipping point: average estimated additional intake 2,051 calories

Estimated total additional calorie intake therefore around 6,000

The day after passing their tipping point, 50% cancel planned activity

Tipping Point

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With a 1lb weight gain said to be the equivalent of 3,500 calories…

the reported additional energy intake…..

and decreased energy expenditure:

potential weight gain of 2lbs

Tipping Point

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1. Slimming World calls on Government and health authorities to improve the links between public health campaigns on obesity and alcohol by raising awareness of how drinking too much alcohol can impact on weight-affecting lifestyle behaviours.

2. Slimming World calls on the Government to raise awareness of the calories contained in alcohol by supporting clear labelling on alcoholic drinks.

Key Recommendations

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Thank you for listening