15-16 October 2007, Royal College of Physicians, London
Philip James, Chairman of Global Alliance for Chronic Disease Prevention and President Elect IASO opened the National Obesity Forum Conference 2007 by giving the keynote address. He introduced the two-day conference with a historical overview of earlier Government reports which highlighted the need to tackle obesity. However despite such reports very little change has occurred. He called for a need to change government and individual attitudes to obesity across the globe before it is too late.
This opening speech was followed by many a variety of presentations, each focusing on initiatives in place across the UK, in schools, communities and primary care trusts to help fight, treat and prevent obesity. A representative of The Community Practitioners’ and Health Visitor’s Association (CPHVA) outlined the role of the school nurse in the fight against obesity and overweight via the ‘National Child Measurement Programme’. Paul Sacher presented the Mind Exercise Nutrition Do It (MEND) and Mini-MEND Programmes. Developed in 2001-2003 MEND is a community based programme for overweight and obese children between the age of 7-13 and their families, which combines family involvement, practical education in nutrition, increasing physical activity and behavioural change so as to promote health and fight obesity. Mini-Mend is a new obesity prevention programme currently in development for children aged 2-4 years and is based on the principles of the original MEND programme. Both programmes are designed to deliver sustained improvements in families’ diets, fitness levels and overall health.
Mary Rudolf, Consultant paediatrician at Leeds Primary Care Trust and the University of Leeds pointed out in her presentation that we are born with the natural ability to regulate our food intake, however as we grow up this regulatory ability is challenged daily. It is therefore critical that children of a young age are ‘trained’ to eat well rather than badly. She highlighted that health professionals should not refer to weight gain in children as a sign that they are ‘thriving’, rather it may need to be seen as an early warning sign. She presented the HENRY programme which is funded by the Department of Health and the Glugs project which depicts a lively bunch of animals that are building a health community on Glug Island. This project produces a toolkit for practitioners and contains resources on how to feed children of different ages (www.theglugs.com).
Karen West presented on the Weight Watchers Family Pilot whereby parents are seen as the key in changing their families’ physical activity patterns and improving everyone’s eating habits. Registered Dietitian Lyndel Costain gave an overview of the National Institute for Clinical Excellence (NICE) guidelines on health and also explained many of the terms we commonly hear today such as Diet Trials (Weight Watchers, Rosemary Conley, Atkins, Slim fast), low carbohydrate diets, slimming groups and meal replacements. She stressed that there is a great need for structured meal plans to be in place for people.
Following the break Nicholas Finer’s presentation “The case for broadening the access to effective treatment options” discussed options for people wanting to fight obesity and reduce their weight. He stressed that moderate weight loss and exercise can have benefits to the body which may not necessarily be seen on the weighing scales, but rather may be seen in blood lipid profiles and metabolic effects. He also made reference to the fact that drugs are available for weight management but should not be seen as a magic bullet and that the role of pharmacists is changing, as they are often seen as health professionals who can help with weight loss.
Obesity and polycystic ovarian syndrome (PCOS) was the focus of Adam Balen’s presentation. Obesity has many far reaching consequences and can impact negatively upon PCOS, as well as influence the development of other conditions such as non-alcoholic fatty liver disease (NAFLD) as highlighted by Nimantha de Alwis of the Institute of Cellular Medicine, Newcastle University. NAFLD is the commonest cause of chronic liver disease, while obesity is the commonest risk factor for NAFLD, therefore obesity contributes to NAFLD.
Tuesday’s proceedings began with the keynote address from Kevin Barron MP from the Health Select Committee. He questioned what we are doing now that we should have done five years ago. One reason for such a question is the success of many current initiatives, such as the smoking ban. Initially people feared the introduction of such a ban would fail but now one must question why it was not introduced five years ago considering its success. He concluded by saying he believes the NHS cannot deal with the obesity problem alone, rather a combined effort by the government, parents, and individuals is required.
Industry has taken many steps to try and improve the health and wellbeing of individuals and one such step is clearer labelling of foods. Karen Tonks (Tesco Nutritionist) and Judith Batchelar (Director for Sainsbury’s Brand) presented two of the industry’s food labelling practices as used in their companies - Guidance Daily Amount Labelling and Multiple Traffic Light Labelling respectively. Both presented results from consumer focus group meetings and the reasons why their company has adopted their form of labelling. A survey was carried out after the two presentations using touch-pad voting to see which form of labelling the conference attendees preferred – multiple traffic light labelling was the winner.
Peter Tokes and Harry Moore are recent award winners for their weight loss. Both attended ‘Slimming World’ and managed to loose substantial amounts of weight. During the conference they explained their experiences at Slimming World and how the programme helped them achieve their desired weight. This was followed by a presentation by Neville Rigby, Director of Policy and Public Affairs, who called for clearer labelling on pack, labelling in restaurants, food reformulation and a stop on advertising to children as a means of halting the obesity time bomb. He discussed national and European initiatives such as labelling and reformulation currently in place.
TV and radio presenter Anne Diamond spoke on her battles with weight and obesity and explained how she found society’s attitude to her weight extremely hurtful. She spoke openly about her weight loss surgery and her time in Celebrity Big Brother and Celebrity Fit Club. She has since set up a free weight-loss support website called “Fat Happens” (www.FatHappens.com) which is helping ordinary men and women lose weight with practical and emotional support and advice.
International initiatives and programmes were the focus of the conference after the early morning break. Iceland’s Magnús Scheving gave an extremely exciting presentation of the children’s TV show LazyTown which he created, and the ‘health’ initiatives built around LazyTown. The show is currently aired in 109 countries including the UK and manages to motivate children into a healthy lifestyle without mentioning words commonly used to promote a healthy lifestyle such as healthy, weight or exercise. LazyTown related merchandise includes books whereby children mark what they ate each day with stamps – this acts as an incentive for children to eat healthy foods such as fruit and vegetables daily. The benefits of such initiatives is the children do not see this as healthy eating, they see it as fun and keeping up to date with their favourite TV action heroes. He also highlighted that he has on many occasions spoken to the Health Minister here in the UK to promote LazyTown and it’s associated initiatives.
A French initiative called the ‘Epode’ was presented by Sandarine Raffin. Epode is in place in 127 French cities and has now started in Spain and Belgium also. The principle of the programme is to promote a healthier lifestyle and to have fun while eating and living healthily. Professor Robert Ross’ (McGill University, Canada) presentation “Obesity: the cost of living” focused on messages that need to be communicated. He also felt it is critical to recognise any increase in physical activity as beneficial and not to measure the benefits on the weighing scales alone. He spoke on the difference between physical activity and exercise and stressed it was important the people increase their physical activity. He also stated it is critical to reinforce the message that exercise without weight loss is not failure and that physicians must measure waist circumference when patients present to them, rather than just BMI alone as waist circumference is an extremely telling factor in overall health.
The afternoon session of the National Obesity Forum Conference involved a presentation on the NICE guidelines and recommendations by NICE Implementation Consultant, Steve Sparks. He summarised by saying NICE guidance focuses around prevention however if implemented correctly those who need treatment are also cared for. He also stated that the guidelines are aimed at a variety of influential groups. Jean Hughes a consultant dietitian with Peterborough Primary Care Trust spoke on the need to get mothers breastfeeding their children as a preventative mechanism against obesity as breastfed children control and self regulate their dietary intake which impacts upon their control of food intake later in life. She also stated that practitioners need to realise that just because they feel it is the right time for their patient to go on a diet/treatment, they need to recognise that the time may not suit the patient themselves due to other commitments.
Susan Jebb of the MRC Nutrition Research, highlighted that as individuals we are programmed to eat and are ill equipped to deal with the prevalence of food around us. Focusing on the scientific evidence it shows that reducing the energy density of diets and cutting portion sizes helps people to eat less, however healthy eating is often portrayed as an “extreme sport” rather than a part of normal life – people need to recognise that health is not extreme, but rather is achievable.