Guest Blog by Matt James, Senior Researcher at 2020health
Whatever types of interventions are introduced to address the obesity challenge, ultimately it is only the individual who can take the necessary steps to eat healthily, keep to a healthy weight or decide to lose weight. Legislation, regulation and education all have their part to play but all of us have apart to play too.
The challenge is how to engage at a personal, local and strategic level to influence positively the affordability, availability and acceptability of food, which in turn will help shape healthy choices and behaviour. What do we need to do to help people make the right choices and take the right steps to losing weight? Just bashing away about losing the pounds, weighing our food and reading confusing food labels isn’t going to cut it. So two things need to be done without delay: Firstly adopting a health in the round approach and secondly developing effective and simple interventions at the personal level.
Adopting a ‘Health in the round’ mentality
Living a healthy lifestyle needs to become more of a priority, both individually and collectively as opposed to solely focusing on weight. There needs to be greater acceptance that people come in different body shapes and sizes and the recognition that some people will struggle with their weight. It is crucial that any interventions used to tackle obesity focus on behavioural change together with appropriate outcome measures.
Individuals need to be educated so that they have a more coherent understanding of food, diet and portion size. The focus needs to shift from a particular diet to ‘our diet’ and an improved understanding of food and what it means to eat a nutritious healthy diet.
Education needs to commence at the earliest possible opportunity and continue with age appropriate learning throughout life. Our health needs change depending on where we are in the life cycle so understanding our dietary needs throughout life and knowing how to make steady long term changes is paramount. Research indicates that the rate of obesity increases with age at least up to 50 or 60 years old (Seidell 2005). That is why one of the recommendations in 2020health’s report ‘Careless eating costs lives’ calls for the commissioning of a health education and prevention strategy which covers all stages of life.
Developing effective and simple interventions
Expectant mothers, parents and children are a particular group of people to focusing on helping and supporting. As highlighted in 2020health’s report, HENRY (Health, Exercise, Nutrition for the Really Young) was first introduced to address the targets stipulated by the UK’s Department of Health’s 2009 publication: Tackling child obesity through the healthy child programme a framework for action has the strongest evidence-base currently available for any UK early intervention to prevent childhood obesity. The initiative effectively collaborates with local partners, including health trusts, local authorities, public health departments, voluntary organisations and universities. The programme was successful as a result of holistic approach, covering training in parenting; family lifestyle habits; nutrition; activity; emotional well-being
Programmes such as HENRY could be drawn out on a larger scale to give young families the best start in life. Children need to be reconnected with the food system and home economics needs to be reintroduced into the curriculum.
Getting the community involved
EPODE, originating in France, an acronym for ‘together let’s beat childhood obesity’ is the largest national obesity network. The EPODE approach endeavours to deliver programmes that create everyday norms and settings for children to eat healthily and play safely and actively. The multi-stakeholder, whole community approach facilitates the development of healthy environments including mapped walking routes, playgrounds and cycle routes.
This illustrates the fact that help needs to be given to people to be more active and enjoy physical activity, make healthy choices and act on what they already know. The advice on physical exercise needs to be clearer.
Community involvement discourages opposition and provides individuals with a value in the local environment. Local government is closely involved and a local figurehead is appointed to pioneer projects and motivate the population. Children are taught about and cooking and reconnected to the food system through farm visits and growing their own food. At risk families are offered individual counselling and the programme is specifically designed for tailoring to the individual requirements of communities.
It is possible that the use of the network framework, and nurturing a positive attitude towards effective change might reap health benefits in communities and bring about a reverse in the current trends of societal divide. This is precisely the thinking behind current Asset-Based Community Development (ABCD) initiatives which use the skills and capacities of local people (community ‘assets’) to build more sustainable communities.
There is a lot to be learned from this innovative, sustainable approach. It not least demonstrates the value of reconnecting children with the food system and food supply, by helping to instil a better understanding of what it means to live healthily.
Pharmacist first: A holistic understanding of health
Similarly, one of the key findings from another 2020health project The Wells Family Challenge: A Pharmacist First Approach found that people do not generally understand the links between the food they are eating, exercise and illness. By forming a good trust-based relationship with the pharmacist, a mentor-type relationship was quickly established with the families, which allowed many of them to gain a holistic understanding and approach to health. This allowed for a greater understanding of how steady changes made over the mid to long term made for a greater impact than changes designed to bring about results. This highlights the value many individuals could find in a coaching relationship to help improve their health literacy.
The focus needs to become more about helping people to understand what constitutes good choice so they can take steps to change their behaviour. Government does have an important role to play in shaping food choices and the environments in which we live so that healthy options are easier to make. But it does start with us all as individuals, lifting the scales from our eyes and taking responsibility for our own health.
Similarly, one of the key closely with their local pharmacists were found to challenge imparted educational value and in so doing provided much more than a service treating coughs and colds and alleviating pressure on GPs to treat minor illnesses; they can actually
Seidell, J.C. 2005. Epidemiology — definition and classification of obesity In: Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz. Clinical obesity in adults and children: In Adults and Children. Blackwell Publishing. pp.3–11