Obesity: identification, assessment and management of overweight and obesity in children, young people and adults [CG189]

Measuring the use of this guidance

Recommendation: 1.1.6.2

Workplaces should provide opportunities for staff to eat a healthy diet and be more physically active, through: • active and continuous promotion of healthy choices in restaurants, hospitality, vending machines and shops for staff and clients, in line with existing Food Standards Agency guidance • working practices and policies, such as active travel policies for staff and visitors • a supportive physical environment, such as improvements to stairwells and providing showers and secure cycle parking • recreational opportunities, such as supporting out-of-hours social activities, lunchtime walks and use of local leisure facilities.

What was measured: Trusts that had healthy food promoted in the staff restaurant

Data collection end: September 2010

61.35%

Number that met the criteria: 173 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that had healthy food promoted for hospitality events

Data collection end: September 2010

50.35%

Number that met the criteria: 142 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that had healthy food promoted in vending machines

Data collection end: September 2010

31.91%

Number that met the criteria: 90 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that had healthy food promoted in shops for staff and clients

Data collection end: September 2010

30.5%

Number that met the criteria: 86 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts provide overweight and obese staff multi-component interventions that address physical activity, eating behaviour and weight reduction together

Data collection end: September 2010

30.5%

Number that met the criteria: 86 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that encourage staff to walk or cycle to external meetings

Data collection end: September 2010

52.84%

Number that met the criteria: 149 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that encourage staff to take the stairs through signage at strategic points and written information

Data collection end: September 2010

47.52%

Number that met the criteria: 134 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that provide information about walking and cycling routes to and from work

Data collection end: September 2010

52.13%

Number that met the criteria: 147 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that provide information about walking and cycling routes around the worksite

Data collection end: September 2010

50.35%

Number that met the criteria: 142 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that encourage staff to take short walks during work breaks

Data collection end: September 2010

61.35%

Number that met the criteria: 173 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

What was measured: Trusts that encourage staff to use local leisure facilities

Data collection end: September 2010

81.91%

Number that met the criteria: 231 / 282

Area covered:	National
Source:	Preece R et al. (2012). Measuring implementation of evidence-based guidance on promoting workers’ health. Occupational medicine, 62(8), 627-631.

Recommendation: 1.2.1

Use clinical judgement to decide when to measure a person's height and weight. Opportunities include registration with a general practice, consultation for related conditions (such as type 2 diabetes and cardiovascular disease) and other routine health checks

What was measured: Proportion of people with HIV who had their body mass index (BMI) recorded in the last year of attendance

Data collection end: December 2013

81%

Area covered:	Local
Source:	Howe BH & E (2015) Obesity in HIV audit and pathway development: Are we addressing an expanding problem? HIV Medicine, Conference (var.pagings): April.

Recommendation: 1.2.2

Use BMI as a practical estimate of adiposity in adults. Interpret BMI with caution because it is not a direct measure of adiposity.

What was measured: Public Health Outcomes Framework indicator 2.12: Proportion of adults classified as overweight or obese using BMI, calculated from the adjusted height and weight variables.

Data collection end: January 2015

64.6%

Area covered:	England
Source:	Sport England - Active people survey

Recommendation: 1.2.2.4

BMI (adjusted for age and gender) is recommended as a practical estimate of overweight in children and young people, but needs to be interpreted with caution because it is not a direct measure of adiposity

What was measured: Children with autism spectrum disorder who had BMI calculated

Number that met the criteria: / 77

Area covered:	Local
Source:	Grylls EK et al (2013) Obesity in Children with Autism Spectrum Disorder Audit. Archives of Disease on Childhood. Vol 98 Suppl 1 pA52

Recommendation: 1.2.3.10

Referral to an appropriate specialist should be considered for children who are overweight or obese and have significant comorbidity or complex needs (for example, learning or educational difficulties).

What was measured: Children with autism spectrum disorder who were referred to the local healthy lifestyle programme

18%

Number that met the criteria: / 77

Area covered:	Local
Source:	Grylls EK et al (2013) Obesity in Children with Autism Spectrum Disorder Audit. Archives of Disease on Childhood. Vol 98 Suppl 1 pA52

What was measured: Overweight children with autism spectrum disorder who were referred to the dietician

86%

Number that met the criteria: / 77

Area covered:	Local
Source:	Grylls EK et al (2013) Obesity in Children with Autism Spectrum Disorder Audit. Archives of Disease on Childhood. Vol 98 Suppl 1 pA52

Recommendation: 1.2.6.1

Bariatric surgery is recommended as a treatment option for people with obesity if all of the following criteria are fulfilled: • they have a BMI of 40 kg/m2 or more, or between 35 kg/m2 and 40 kg/m2and other significant disease (for example, type 2 diabetes or high blood pressure) that could be improved if they lost weight (1) • all appropriate non-surgical measures have been tried but have failed to achieve or maintain adequate, clinically beneficial weight loss for at least 6 months(2) • the person has been receiving or will receive intensive management in a specialist obesity service • the person is generally fit for anaesthesia and surgery • the person commits to the need for long-term follow-up

What was measured: Patient selection in accordance with NICE criteria

Data collection end: August 2010

85.5%

Number that met the criteria: 295 / 345

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Adequate dietetic input, as decided by the assessors, prior to surgery

Data collection end: August 2010

77.5%

Number that met the criteria: 200 / 258

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

Recommendation: 1.2.6.9

Surgery for obesity should be undertaken only by a multidisciplinary team that can provide: - Preoperative assessment, including a risk–benefit analysis that includes preventing complications of obesity, and specialist assessment for eating disorder(s) - Information on the different procedures, including potential weight loss and associated risks - Regular postoperative assessment, including specialist dietetic and surgical follow-up - Management of comorbidities - Psychological support before and after surgery - Information on, or access to, plastic surgery (such as apronectomy) where appropriate - Access to suitable equipment, including scales, theatre tables, Zimmer frames, commodes, hoists, bed frames, pressure-relieving mattresses and seating suitable for patients undergoing bariatric surgery, and staff trained to use them.

What was measured: Number of private units offering multidisciplinary team meeting prior to deciding if patient is ready for surgery

Data collection end: August 2010

29.5%

Number that met the criteria: 18 / 61

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Number of NHS units operating a multidisciplinary team meeting prior to deciding if a patient is ready for surgery

Data collection end: August 2010

86.7%

Number that met the criteria: 39 / 45

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Proportion of patients discussed at MDT

Data collection end: August 2010

66.6%

Number that met the criteria: 251 / 377

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Bariatric surgeon follow up available on site

Data collection end: August 2010

90%

Number that met the criteria: 95 / 105

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Dietician follow up available on site

Data collection end: August 2010

82%

Number that met the criteria: 86 / 105

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Specialist Nurse follow up available on site

Data collection end: August 2010

55%

Number that met the criteria: 58 / 105

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Psychologist / Psychiatrist follow up available on site

Data collection end: August 2010

23%

Number that met the criteria: 24 / 105

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Unit that performs bariatric surgery has appropriate surgical equipment for morbidly obese patients

Data collection end: August 2010

96.2%

Number that met the criteria: 100 / 104

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Unit that performs bariatric surgery has appropriate anaesthetic equipment for morbidly obese patients

Data collection end: August 2010

97.1%

Number that met the criteria: 102 / 105

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Unit that performs bariatric surgery has specialised transfer equipment for morbidly obese patients

Data collection end: August 2010

93.3%

Number that met the criteria: 98 / 105

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

What was measured: Unit that performs bariatric surgery has specialist training in place for care of the morbidly obese patient

Data collection end: August 2010

87.5%

Number that met the criteria: 91 / 104

Area covered:	National
Source:	NCEPOD - Bariatric Surgery: Too Lean a Service?

Recommendation: 1.2.12

Relate BMI measurement in children and young people to the UK 1990 BMI charts to give age- and gender-specific information.

What was measured: Public Health Outcomes Framework indicator 2.06i: Proportion of children aged 4-5 years classified as overweight or obese according to age and sex, using the 1990 growth reference (UK90).

Data collection end: March 2012

22.6%

Data collection end: March 2013

22.2%

Data collection end: March 2014

22.5%

Data collection end: March 2015

21.9%

Area covered:	England
Source:	HSCIC - National Child Measurement

What was measured: Public Health Outcomes Framework indicator 2.06ii: Proportion of children aged 10-11 years classified as overweight or obese according to age and sex, using the 1990 growth reference (UK90).

Data collection end: July 2012

33.9%

Data collection end: July 2013

33.3%

Data collection end: July 2014

33.5%

Data collection end: July 2015

33.2%

Area covered:	England
Source:	Public Health England. Public Health Outcomes Framework

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