Obesity: Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children

NICE guidelines [CG43] Published date:

Working with people to prevent and manage overweight and obesity: the issues

Working with people to prevent and manage overweight and obesity: the issues

Preventing and managing overweight and obesity are complex problems, with no easy answers. This guidance offers practical recommendations based on the evidence. But staff working directly with the public also need to be aware of the many factors that could be affecting a person's ability to stay at a healthy weight or succeed in losing weight.

  • People choose whether or not to change their lifestyle or agree to treatment. Assessing their readiness to make changes affects decisions on when or how to offer any intervention.

  • Barriers to lifestyle change should be explored. Possible barriers include:

    • lack of knowledge about buying and cooking food, and how diet and exercise affect health

    • the cost and availability of healthy foods and opportunities for exercise

    • safety concerns, for example about cycling

    • lack of time

    • personal tastes

    • the views of family and community members

    • low levels of fitness, or disabilities

    • low self-esteem and lack of assertiveness.

  • Advice needs to be tailored for different groups. This is particularly important for people from black and minority ethnic groups, vulnerable groups (such as those on low incomes) and people at life stages with increased risk for weight gain (such as during and after pregnancy, at the menopause or when stopping smoking).

Working with children and young adults

  • Treating children for overweight or obesity may stigmatise them and put them at risk of bullying, which in turn can aggravate problem eating. Confidentiality and building self-esteem are particularly important if help is offered at school.

  • Interventions to help children eat a healthy diet and be physically active should develop a positive body image and build self-esteem.

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