Overweight and Obese Adults

Overweight and Obese Adults

Introduction

There are discernible trends indicating an increase in the number of overweight and obese adults and children in the UK, although there has been a slowing of rates of increase the numbers still give cause for concern. The potential negative impacts on health outcomes are significant for overweight or obese people. However, these negative health outcomes may be both preventable and controllable through continual attention to healthy eating, and regular and consistent physical activity incorporated into daily life, all factors over which individuals may have control.


Body Mass Index (BMI) is frequently used as an indicator of an individual’s weight status; this is not a perfect measure, as some people with well-toned muscles may have a high BMI, however it is an indicator. A better measure of excess fat is waist circumference, and can be used as an additional measure in people who are overweight (with a BMI of 25 to 29.9) or moderately obese (with a BMI of 30 to 34.9).

 

Generally, men with a waist circumference of 94cm or more and women with a waist circumference of 80cm or more are more likely to develop obesity-related health problems.

National strategies include:

  • Healthy weight, healthy lives - the guidance within this informs and directs local strategies
  • Obesity Management - the guidelines associated with obesity management guide local service provision. Access the strategy here
  • NICE guidance, 2015 - Obesity in children and young people: prevention and lifestyle weight management programmes. This provides information on best practice.  Access the whole guidance here.

According to NICE, the cost of obesity (including that to the NHS) in 2007 was £16 billion, and this figure was set to rise to a staggering £50 billion a year by 2050 if the situation is not improved.


The latest available figures (2011) demonstrate that, in England, 24% of men and 26% of women were obese, with 41% of men and 33% of women being overweight. There have been National initiatives aimed at improving this, for example improvements in food labelling and campaigns aimed at raising awareness of the issues.


Local initiatives are essential to back up national campaigns, for example promoting local activity through encouraging cycling and walking, particularly in new developments, promoting and providing affordable leisure facilities, and supporting local initiatives which impact on healthy eating and reducing alcohol consumption.


Current activities in the Borough

 
In terms of referrals available for Wokingham residents, a short term course which offers both comprehensive healthy eating advice and introductory exercise. Eat 4 health is a free weight management programme for adults over 16 years for people with a BMI greater than 25. Additionally local Health Walks are available, these are free to join, and offer a sociable and inclusive walk which is led by trained volunteers. The routes are varied, and introduce local people to a range of local walks of which they may not have been aware. In conjunction with Sports and Leisure, other targeted services to encourage physical activity are available, through either self-referral or referral through the GP pathway. These include Shine, and Steady Steps for the over 50s age group. Click here for more information about SHINE, Steady Steps and other leisure activities available in the Borough.

Although Wokingham Borough has a lower than England rate of both obese and overweight people, there is no cause for complacency. However, it is possibly a sign that targeted interventions working within the Borough have been effective and that efforts should be continued and expanded to continue this health improvement.


Figure 1 shows the number of adults who are classified as overweight (blue column), obese  (red column) and the sum of these two figures (green column) . This shows that , in Wokingham, the columns on the left hand side, the figures for all these categories are less than the National figures for England (right hand columns).
 
Figure1:

Over 16 obesity

Source:  Public Health Outcomes Framework - Indicator 2.13i: Percentage of physically active adults

 

The local rates for adults being physically active, that is completing at least 150 minutes of moderately intense physical activity a week, show again that the Borough’s population are more active than the England average. Figure 2 below gives the total of people ages 16 or over who are this active, with Wokingham’s population having 10 % more active adults than the England general population in 2012, and 6,2% more active in 2013.

 

Figure 2:

Over 16 physically active

Source:  Public Health Outcomes Framework - Indicator 2.13i: Percentage of physically active adults


The local levels of those classed as physically inactive, that is who complete less than 30 minutes of physical activity per week, show that the Borough has less than the England average. It is likely that the most health gains will be made in targeting this group to become more active, and initiatives like Health Checks Home - NHS Health Check which incorporate motivational interviewing to encourage individuals to take control of their eating, drinking and physical activity levels.

 

Figure 3 shows that Wokingham had 6.4% of its adult population less than the England national figures were inactive in 2013.

 

Figure 3:

Over 16 physically inactive
Source: Public Health Outcomes Framework - Indicator 2.13i: Percentage of physically active adults
The key inequalities are in the two areas of health literacy, where those with the poorest health literacy levels have the worse health outcomes, and access to affordable healthy food. Although the Borough is well served with national food chain outlets, the areas of greatest deprivation within the borough are mainly served by smaller food outlets, the availability of locally grown “pick your own” produce is set to decline with a local producer moving out of the business and local initiatives aimed to raise awareness of healthy eating and growing local produce are slow to progress.
The unmet needs appear to be in connecting local people with the providers of the initiatives, the loop like problem of dates not being confirmed until a crucial number of places on courses is confirmed, and then fall out from a course of participants. The best practice guidelines are for interventions which guide and support people to complete the changes that they wish to make to improve their health and wellbeing. Targeting interventions, such as motivational interviewing and referrals to leisure and weight management services through health checks, aimed at those with highest need may be most effective.

Although obesity and weight management is primarily a concern for Public Health, due to the strong and proven linkages between obesity and serious health conditions, working with all partners to increase the profile of self-management of weight would be beneficial to the Borough’s health status.