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The whys and wherefores of
healthy weight
Broxbourne Obesity Summit, 22 October 2013
Jim McManus
Director of Public Health
Key points

•
•
•
•
•
•

Keeping a healthy weight is difficult

•

Many strands of scientific debate and argument

We are ...
Health Profiles for England 2013
Health Profiles 2013
indicators

Measure

Eng
Average

Herts

Broxb

Watford

9 Obese chi...
Broxbourne Wards

MSOA/ Ward
Rosedale

45.7%

27.1%

Goffs Oak

44.6%

18.9%

Bury Green

39.4%

16.9%

38.6%

15.7%

Worm...
Obesity is growing at an alarming rate, with a significant impact
UK Foresight report: By 2050, 60% of men and 50% of
wome...
Health Impacts
•

Health impact of obesity:
– 58% type-2 diabetes
– 21% of heart disease
– 10% of non-smoking related canc...
The Science

•
•
•
•
•

Biology – “hormonal” response to foods
Medicine – treatment regimes of various levels
Psychology –...
Multiple causes
Multiple challenges
Physical
Activity
is not the
answer to
Obesity,
but it is a
part of an
answer
Active Living is Seen as Essential to Good Health, but it is
ONE part, not the whole solution
Why maintaining a healthy weight is so complex
1)

Human biology - genetics plays a part
but does not pre-destine us to be...
Systems thinking on getting to healthy weight
The wider determinants of Health and Local Government functions
(Must adopt ...
it is particularly important to engage parents
Prevalence of obese children by parental obesity
30

% of Obese Children

2...
a new approach is needed, focus on shifting
weight distribution in the population

Underweight
Healthy weight
Overweight
O...
We all have a role to play
What we’re doing currently

•
•
•
•
•
•

Children’s Centres promoting healthy weight in under-5s
Healthy Schools Programme...
Some Key Priorities for Broxbourne and
Hertfordshire
1.

Every child should start and
grow up with a healthy weight

2.

O...
Obesity summit broxbourne 22 oct mcmanus revised
Obesity summit broxbourne 22 oct mcmanus revised
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Obesity summit broxbourne 22 oct mcmanus revised

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The presentation for the summit on Obesity in Broxbourne. Broxbourne is our whole area obesity Pilot for Hertfordshire

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Obesity summit broxbourne 22 oct mcmanus revised

  1. 1. The whys and wherefores of healthy weight Broxbourne Obesity Summit, 22 October 2013 Jim McManus Director of Public Health
  2. 2. Key points • • • • • • Keeping a healthy weight is difficult • Many strands of scientific debate and argument We are failing as a Country and a County Broxbourne Significantly Worse than Herts There are multiple reasons why so many people struggle We need a multifaceted solution The Broxbourne pilot gives us perhaps our best chance at achieving this
  3. 3. Health Profiles for England 2013 Health Profiles 2013 indicators Measure Eng Average Herts Broxb Watford 9 Obese children (Year 6) % 19.2 14.1 17.8 19.1 13 Increasing and higher risk drinking % 22.3 22.9 22.1 22.5 14 Healthy eating adults % 28.7 32.7 27.2 32.2 15 Physically active adults % 56.0 58.2 55.4 58.9 16 Obese adults % 24.2 21.4 26.4 17.3 26 Life expectancy - male years 78.9 80.2 80.8 79.2 27 Life expectancy - female years 82.9 83.8 85.1 82.5 per 100,000 60.9 51.8 53.6 58.7 30 Early deaths: heart disease & stroke Green: Significantly better than Hertfordshire average Amber : Not significantly different from Hertfordshire average Red: Significantly worse than Hertfordshire average
  4. 4. Broxbourne Wards MSOA/ Ward Rosedale 45.7% 27.1% Goffs Oak 44.6% 18.9% Bury Green 39.4% 16.9% 38.6% 15.7% Wormley & Turnford Year 6 (aged 1011) Obese Flamstead End Reception Year (aged 4-5) Excess Weight 37.1% 18.1% MSOA/ Ward Excess Weight Obese Wormley & Turnford 50.0% 24.2% Flamstead End 44.7% 23.5% Bury Green 41.2% 17.6% Rosedale 40.4% 25.0% Rye Park 38.1% 15.9%
  5. 5. Obesity is growing at an alarming rate, with a significant impact UK Foresight report: By 2050, 60% of men and 50% of women could be clinically obese
  6. 6. Health Impacts • Health impact of obesity: – 58% type-2 diabetes – 21% of heart disease – 10% of non-smoking related cancers – 9,000 premature deaths a year in England – Reduces life expectancy by, on average, 9 years. • Costs of obesity: – National Health Service - £4.2bn – Wider economy - £15.8bn – Foresight estimate costs to economy of £50bn by 2050
  7. 7. The Science • • • • • Biology – “hormonal” response to foods Medicine – treatment regimes of various levels Psychology – intra and interpersonal Built Environment – mitigates for being overweight Social Sciences – family and social influences, advertising THERE IS NO ONE ANSWER – THE ISSUE IS BUILDING A WHOLE SYSTEM APPROACH
  8. 8. Multiple causes Multiple challenges
  9. 9. Physical Activity is not the answer to Obesity, but it is a part of an answer
  10. 10. Active Living is Seen as Essential to Good Health, but it is ONE part, not the whole solution
  11. 11. Why maintaining a healthy weight is so complex 1) Human biology - genetics plays a part but does not pre-destine us to be obese 2) Culture/Individual psychology - it is difficult to break habituated unhealthy eating patterns, especially when common to those around us 3) The food environment - there has also been a huge increase in the quantity of quick convenience foods, which tend to be high in saturated fat, salt and sugar. 4) The physical environment - our lives have become increasingly sedentary. For example, the last 2 decades have seen a 10% drop in children walking to school • Levels of public health action needed • • • • • • Social Biological Environmental Behavioural Legislative Structural
  12. 12. Systems thinking on getting to healthy weight The wider determinants of Health and Local Government functions (Must adopt a Lifecourse approach!) The Lives people lead and whether LA functions help or hinder healthy lifestyles (policy, service quality, access, behavioural economics, behavioural sciences) The services people access such as primary care (high quality, easy access, good follow up, behavioural and lifestyle pathways wrap around)
  13. 13. it is particularly important to engage parents Prevalence of obese children by parental obesity 30 % of Obese Children 25 Boys Girls 20 15 10 5 0 No obese parents One parent obese Both parents obese
  14. 14. a new approach is needed, focus on shifting weight distribution in the population Underweight Healthy weight Overweight Obese Average BMI Maximise proportion at a healthy weight Minimise proportion at an unhealthy weight Fewer overweight Fewer underweight Average BMI Fewer obese Reduce average BMI Underweight Healthy weight Overweight Obese Make more people a healthy weight, not just fewer people obese
  15. 15. We all have a role to play
  16. 16. What we’re doing currently • • • • • • Children’s Centres promoting healthy weight in under-5s Healthy Schools Programme, with subsidy to encourage local schools to take part Exercise on Referral Scheme Pilot with Council leisure centres and 4 GP practices Weight Management pilot (WeightWatchers and Slimming World) PlayRangers active play sessions for children, targeted in locations where children most at risk HealthWalks programme
  17. 17. Some Key Priorities for Broxbourne and Hertfordshire 1. Every child should start and grow up with a healthy weight 2. Our food environment should make healthy choices easy 3. Regular physical activity to maintaining healthy weight 4. Good education for all about what keeps us a healthy weight 5. Our physical environment needs to support maintaining a healthy weight www.hertsdirect.org • Remember those levels of action? We need them all • • • • • • Social Biological Behavioural Environmental Legislative Structural

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