Quality statement 6: Raising awareness of lifestyle weight management programmes

Quality statement

Adults identified as being overweight or obese are given information about local lifestyle weight management programmes.

Rationale

When adults are identified as being overweight or obese it is important that they are given information about local lifestyle weight management programmes. Actively raising the possibility of participation in one of these programmes will support people who choose to take positive action to lose weight by self‑referring to a suitable programme.

Quality measures

Structure

Evidence of local arrangements to give adults who are identified as being overweight or obese information about local lifestyle weight management programmes.

Data source: Local data collection.

Process

Proportion of adults identified as being overweight or obese who are given information about local lifestyle weight management programmes.

Numerator – the number in the denominator who are given information about local weight management programmes.

Denominator – the number of adults identified as being overweight or obese.

Data source: Local data collection. Data on BMI values are included in the Health and Social Care Information Centre care.data extract.

Outcome

a) Number of self‑referrals of overweight or obese adults to lifestyle weight management programmes.

Data source: Local data collection.

b) Obesity prevalence.

Data source: Local data collection.

c) Prevalence of obesity‑related comorbidities.

Data source: Local data collection. The numbers of people with type 2 diabetes, hypertension and coronary heart disease are shown in the Quality and outcomes framework indicators DM001, HYP001 and CHD001.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers provide information about local lifestyle weight management programmes to adults identified as being overweight or obese.

Healthcare professionals (such as GPs, practice nurses, secondary healthcare professionals, dietitians and community pharmacists) ensure that they provide information about local lifestyle weight management programmes to adults identified as being overweight or obese.

Commissioners (such as NHS England, clinical commissioning groups and local authorities) ensure that they commission services that provide information about local lifestyle weight management programmes to adults identified as being overweight or obese.

What the quality statement means for adults

Adults who are overweight or obese are given information about local lifestyle weight management programmes, including what the programmes involve and how to take part.

Source guidance

Definitions of terms used in this quality statement

Adults who are overweight or obese

Adults are assessed to see if they are overweight or obese using their body mass index (BMI). The following table shows the cut‑off points for a healthy weight or being overweight or obese.

Classification

BMI (kg/m 2 )

Healthy weight

18.5–24.9

Overweight

25.0–29.9

Obesity I

30.0–34.9

Obesity II

35.0–39.9

Obesity III

40.0 or more

BMI is a less accurate indicator of adiposity in adults who are highly muscular, so it should be interpreted with caution in this group.

Waist circumference can also be used to assess whether someone is at risk of health problems because they are overweight or obese (up to a BMI of 35 kg/m2). For men, a waist circumference of less than 94 cm is low risk, 94–102 cm is high risk and more than 102 cm is very high risk. For women, a waist circumference of less than 80 cm is low risk, 80–88 cm is high risk and more than 88 cm is very high risk.

Using lower BMI thresholds to trigger action to reduce the risk of conditions such as type 2 diabetes has been recommended for adults of black African, African‑Caribbean or Asian family origin. The lower thresholds are 23 kg/m2 to indicate increased risk and 27.5 kg/m2 to indicate high risk.

[Adapted from Weight management: lifestyle services for overweight or obese adults (NICE guideline PH53)]

Equality and diversity considerations

Service providers and healthcare professionals should take into account the cultural and communication needs of people who are overweight or obese when giving information about lifestyle weight management programmes.

Healthcare professionals should ensure that people of black African, African‑Caribbean or Asian family origin who have higher comorbidity risk factors are given information about lifestyle weight management programmes if they have a BMI of 23 kg/m2 or more.

Providers of lifestyle weight management programmes should have an inclusive approach that encourages people from all backgrounds to participate. This includes using a respectful and non‑judgemental approach to engage people. Particular attention should be given to people who may be less likely to participate, such as people with learning difficulties or mental health problems and those from lower socioeconomic groups.

Providers of lifestyle weight management programmes should be able to meet the specific needs of women who are pregnant, planning to become pregnant or are trying to lose weight after pregnancy.