TACKLING OBESITY
CUMBRIA HEALTH AND WELLBING BOARD’S ROLE
This briefing for the Health and Wellbeing Board sets out the challenges and
opportunities in tackling obesity in Cumbria, and provides a checklist of issues that the
health and wellbeing board will wish to consider. Investment, prioritisation and
commitment are required at all levels.
Setting the scene
Overweight and obesity represents probably the
most widespread threat to health and wellbeing
in this country.
Overweight and obesity are terms which refer to
an excess accumulation of body fat, to the extent
that health may be impaired. In adults, obesity is
commonly defined as a body mass index (BMI) of
30kg/m2 or over. For children in the UK, the
British 1990 growth reference charts are used to
define weight status which takes into account
children’s weight and height for their age and sex.
The scale of the issue
The Consequences – Why it matters to
individuals, society and the economy
There is now a lot of evidence linking obesity with
a wide range of major health problems. Obesity
reduces life expectancy by an average of 9 years
and is responsible for 9000 premature deaths a
year in England. The health risks for adults with
obesity are stark and can lead to long term
disability.
Compared with a healthy weight man, an obese
man is:
• Five times more likely to develop type 2 diabetes
• Three times more likely to develop cancer of the
colon
• More than two and a half times more likely to
develop high blood pressure – a major risk factor
for stroke and heart disease.
sustainable economic growth and a healthier
Cumbria.
The causes
Energy imbalance is at the root of obesity,
however there are many complex behavioural
and societal factors that combine to contribute to
the causes of obesity. The Foresight report (2007)
identifies the major factors.
7 cross-cutting predominant themes:
• Biology
• Activity environment
• Physical Activity
• Societal influences
• Individual psychology
• Food environment
• Food consumption
What can be done?
An obese woman, compared with a healthy weight
woman, is:
• Almost thirteen times more likely to develop
type 2 diabetes
• More than four times more likely to develop high
blood pressure
• More than three times more likely to have a
heart attack.
As well as these illnesses, obesity and its related
health problems causes a huge financial burden.
•
•
Costs the NHS £5.1 billion per year
Costs the wider economy £16 billion per year
and predicted to rise to £50 billion a year (at
today's prices) by 2050 if left unchecked
(Foresight 2007).
Whilst obesity may traditionally be viewed as an
NHS problem, the economic burden of obesity
shows that healthcare expenditure is a small
proportion of the associated total cost of obesity.
Unless action is taken, the cost of obesity has the
potential to derail the goals of achieving
In recent years there has been a range of
government policies promoting healthy
lifestyles.
The current obesity strategy,
‘Healthy Lives, Healthy People: A call to action
on obesity in England’, set a new target for a
downward trend in excess weight for children
and adults by 2020.
These papers have raised the national concern
about obesity and describe what can be done to
tackle this problem. The evidence is very clear.
Significant action to prevent obesity at a
population level that targets elements of ‘obesity
promoting’ environment (often referred to as the
obesogenic environment) as well as improving
nutrition and physical activity in individuals is
required.
What does work?
Existing NICE guidance indicates the type of
national and local interventions that can be used
to tackle obesity and improve people's diet and
physical activity levels.
Tackling the obesogenic environment: Action at
the individual level is unlikely to succeed unless
there are broadly based societal interventions to
make the healthier choices the easier choices.
Adopting a life course approach: A life course
needed to be adopted – from preconception
through pregnancy, infancy, early years,
childhood, adolescence and teenage years and
through to adulthood preparing for older age.
What is being done – Cumbria’s Healthy
Weight Strategic Framework
The Healthy Weight Strategic framework is
Cumbria’s response to tackling this complex and
far reaching problem. It aims to bring together,
coordinate and focus on the contributions of all
partner organisations across Cumbria, and by
aligning efforts and responsibilities, tackle
unprecedented levels of obesity.
What can the Health and Wellbeing Board
do?
Tackling obesity is complex and requires
coordinated action at every level, from the
individual to society, and across all sectors.
The health and wellbeing board should ensure
that a coherent, community-wide, multi-agency
approach is in place to address obesity
prevention and management. 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, as well as
broader initiatives, such as those to mental
health or prevent harmful drinking.
Cumbria’s four strategic objectives are set out
below with a checklist of issues that the health
and wellbeing board will wish to consider.
Pregnancy, Early Years and Children
Nutrition and other lifestyle factors during pregnancy
and the early years can have profound effects on an
individual’s weight at birth, during childhood, and on
into adulthood and schools and nurseries play a key
role in ensuring healthy behaviors begin early.
•
Breastfeeding
Actively encourage breastfeeding and
baby friendly in all council buildings
and other settings across the county.
• Education and Learning:
Encourage and support local Healthy
Schools Programmes and work with
education to ensure that schools and
nurseries play a key role in ensuring
healthy behaviours begin early.
Ensuring
nutritional
recommendations are met the uptake
and eligibility of free school meals is
monitored.
Support initiatives in schools and
communities to improve children’s
wellbeing and self esteem.
Ensure that there is full participation
in the National Child Measurement
Programme so that trends in child
weight can be reliably monitored.
Make participation in sports and
physical activity more accessible and
attractive by opening up school estate
over and above regular school hours
to facilitate community sports hubs
and active schools.
Weight Management
Access to appropriate leisure opportunities is a key
factor in the prevention and management of obesity,
and local authorities play an important role in the
provision of opportunities for activity at all levels and
stages of an obesity care pathway.
• Leisure and Culture:
Improve access to and facilities for
structured leisure programmes such as
exercise and physical activity referral
schemes.
Improve availability of unstructured
opportunities for physical activity, such as
access to parks and open spaces and safe
play areas for children and young people.
Ensure all opportunities are accessible to
people with limited mobility, including
those who are obese.
Promote the value and benefits of an active
lifestyle.
Utilise Libraries and other local authority
venues that are important sources of
information and improve signposting to
local leisure opportunities and support
services.
Population Settings – The Workplace
Obesogenic Environment
‘Health is created and lived by people within the
settings of their everyday life; where they learn,
work, play and love’ (World Health Organisation,
1986).
The type of housing and the communities in which
people live has an impact on their access to
opportunities to live a healthy and active life.
Increased reliance on the car over the last fifty
years has contributed to a major decline in walking
and cycling and this decline in active travel has
mirrored the increase of obesity.
Obesity can impact on the workplace in a number
of ways and there are significant workplace costs
associated with obesity. Workplaces can provide
the best opportunity to promote healthier living.
•
Workplaces
Supporting Cumbria’s Health, Work and
Wellbeing Charter in all aspects of the
council and partner organisations
§ Healthy Eating:
•
Implement lower speed limits in
residential streets. Speeds above 20 mph
discourage active travel and deter parents
from allowing children to play on their
streets.
Procurement of healthier food and
snacks in all public and staff premises.
Raising awareness of healthy eating
among staff and the public.
•
Removal of vending machines that
offer unhealthy food in council
buildings.
Development of corporate healthy
eating food plan including corporate
hospitality, catering provision, local
sourcing of food, pricing to promote
healthy options.
§ Physical Activity:
Encouragement and incentives for
active travel with development of
travel
plan
(cycling
mileage
expenses/cycle parking/showers).
Actively encourage physical activity in
the workplace and local area
(partnership with local leisure for
subsidised leisure passes/cycle to work
scheme/health walks).
Transport
Ensure local transport plans include
boosting active travel (for example trafficfree routes linking schools to their
communities).
Parks and Green Spaces
Work together to improve the provision of
high quality, local, accessible and safe
green space.
Improve the aesthetics of green space,
alongside appropriate safety and crime
prevention initiatives to encourage people
to use their local green space.
•
Planning and Environment
Ensure
that
health and wellbeing are prioritised and
integrated throughout the planning
system.
Ensure the maintenance of safe walking
and cycling routes to facilitate increased
walking and cycling.
Increased attention to community safety,
e.g. street lighting, which can be a barrier
to people being more active.
Restrict access to unhealthy food choices
by working with existing hot food takeaway and sandwich shops to make their
menus healthier.
Control and restrict the numbers of hot
food takeaways in specific areas, such as
near schools.
Ensure health impact assessments are
conducted to ensure that all parties think
about proposed developments from a
health perspective.
Provide training and support to elected
members and senior officers in order to
secure strong leadership and commitment
to health at all levels and in all policies.
•
Housing
Work with social landlords to provide
more opportunities for people of all ages
to be more active and enjoy the space
outside their homes.
Provide essential housing adaptations and
support in the homes of severely disabled
people to enable them to be more
independent and improve their quality of
life.
Work with other departments to ensure
that obese people in social housing or in
adapted homes have the opportunity to
be physically active through home or
community based physical activity
programmes.
Additional Resources
National Obesity Observatory http://www.noo.org.uk
National Institute for Health and Clinical
Excellence - http://guidance.nice.org.uk
Department of Health Healthy Weight, Healthy
Lives: A Cross Government Strategy for
England – http://www.gov.uk