NICE has today (28 November 2012) published new public health guidance aiming to encourage different organisations to take action, plan and work together to tackle obesity in their local community.

Obesity not only increases the risk of serious conditions such as diabetes, heart disease and some cancers, but dealing with the long term consequences of obesity costs an estimated £5.1 billion¹ each year, placing a huge strain on the health service. Levels of obesity in England are increasing with over a quarter of the adult population now classed as obese². It is also estimated that these figures could potentially reach 60% for adult men, 50% for adult women and 25% for children by 2050³

Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE, said: “The aim of this new guidance is to help tackle obesity using a ‘community-wide' approach, by encouraging different organisations including local government, community groups and networks to take action and work together to plan and implement their own local strategies to prevent obesity in their community. Ultimately, it is up to individuals to maintain a healthy weight, but there are many community-wide factors that can help them to do this, from the built environment to the language that people use to talk about the issue.

“The recommendations emphasise the importance of working with local people to decide what action to take. People's concerns about their local areas, such as crime or poorly maintained public areas may affect whether they walk or cycle locally, and in turn this can impact on their level of activity which can affect obesity. What works in one locality may not always work in another and interventions need to be tailored for each area,integrating with existing strategies.”

Susan Jebb, Head of Diet and Population Health, Medical Research Council Human Nutrition Research, Cambridge, and the chair of the group that developed the guidance, said: “There are many factors that influence an individual's weight, but the food and drink options available to them shapes people's choices and can have a significant impact on their health. The guidance recommends working with the local community, including businesses to ensure the range and content of the food and drinks they provide give people the opportunity to eat healthily, as well as encouraging businesses to support their employees in actions to prevent obesity.”

Ian Reekie, community representative on the group that developed the guidance: “Effective community based action needs to involve everyone, so the language used to describe that action or activity should make everyone feel included and involved. What we found was that while some people may like to ‘hear it like it is', others may not think that ‘tackling obesity' applies to them, so using that term might discourage involvement. Therefore we have recommended that aiming for a ‘healthier weight' should be used, rather than focusing on preventing or combating obesity as this may be a more acceptable and achievable goal for many people.”

Esther Trenchard-Mabere, Associate Director of Public Health/Consultant in Public Health, NHS Tower Hamlets and guidance developer: “NICE has already produced a range of guidance on the prevention and management of obesity for those working in public health to utilise. What this new guidance contributes is a clear framework for local organisations to work together to put this existing NICE guidance into practice. The recommendations focus on an overarching approach to obesity in local communities, and emphasise the importance of integrating obesity with other local initiatives, such as those to prevent type 2 diabetes or cardiovascular disease and broader regeneration, mental health and environmental strategies.”

Cllr David Rogers, Chairman of the Local Government Association's Community Wellbeing Board, said: “With the transfer of public health to local government next year, councils have a vital role to play in reducing obesity. Councils working more closely with colleagues across the NHS and key community groups can only be a good thing and will help on a range of initiatives such as reforming the planning process to prevent yet more fast food stores opening near schools, working with families in children's centres and other community locations to improve understanding about the importance of affordable, nutritious home cooking, and improving local environments to encourage more people to walk and cycle. By working together we can develop cost effective and locally relevant solutions to improve the health and wellbeing of our communities.”

The new recommendations are aimed at local policy makers, commissioners, managers, practitioners and other professionals across all sectors of the local community.

Recommendations include:

• Activities should be integrated within the joint health and wellbeing strategy and broader regeneration and environmental strategies. Action should also be aligned with other disease-specific prevention and health improvement strategies such as initiatives to prevent type 2 diabetes, cancers, and cardiovascular disease, as well as broader initiatives, such as those to promote good maternal and child nutrition or mental health or prevent harmful drinking.
• Public health teams should identify and work with ‘champions' who have a particular interest or role in preventing obesity in local authority and NHS strategy groups and public, private, community and voluntary sector bodies. This includes, for example, those involved in planning, transport, education and regeneration.
• Local Healthwatch, community involvement and public health teams should engage local people in identifying their priorities in relation to weight issues. For example, residents may feel that issues such as crime, the siting of hot food takeaways or alcohol outlets, the lack of well-maintained green space, pavement parking, speeding, or the lack of a sense of community are their top priorities. Where possible, it should be made explicit that local concerns often can (and do) impact on levels of obesity in the community.
• Public health coordinators, with support from directors of public health, should establish methods for involving business and social enterprises in the implementation of the local obesity strategy. This includes, for example, caterers, leisure providers, weight management groups, the local chamber of commerce, food retailers and workplaces. They should consider developing local activities based on national initiatives to achieve this.
• The guidance is aimed at everyone in a locally defined community but, in particular, vulnerable groups and communities where there is a high percentage of people who are at risk of excess weight gain or who are already overweight or obese. This includes those from particular ethnic or socioeconomic groups, those who are less likely to access services or those with mental or physical disabilities.

Ends

Notes to Editors

References

1. Scarborough et al. 2011

2. The Health and Social Care Information Centre 2012

3. Foresight 2007

About the guidance

4. The guidance will be available on the NICE website from 28 November 2012. Embargoed copies of the guidance are available from the NICE press office on request

5. This guidance does not cover interventions in a particular setting (such as a school or workplace) that do not involve the wider community or wider partnership working.

6. The ongoing structural changes to the public sector, particularly local authorities and the NHS, have been an important consideration in developing the recommendations.

7. A ‘local community' does not necessarily refer to any official, administrative boundary, but to a group of people from the same geographic location. The community may be located in a ward, borough, region or city.

About NICE

8. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health

9. NICE produces guidance in three areas of health:

• public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
• clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

10. NICE produces standards for patient care:

• quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
• Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients

11. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.