Overweight is now a major public health problem in Tayside and, indeed, the whole of Scotland. More than half of the adult population can be classified as overweight or obese (severely overweight), while one in ten children are obese. Men are more likely to be overweight than women and older men are more at risk than younger men. Women from lower socio-economic backgrounds are more likely to be obese than any other group in society.
The Tayside Healthy Weight Strategy seeks to explore the causes of overweight and the health risks linked to this condition. High quality published evidence is reviewed to highlight the interventions which could help prevent and treat overweight. Recommendations are made about the need for extra research where little good information exists. Existing work in policy and service provision in Tayside, and further afield, is acknowledged. Finally, a plan is proposed for tackling the causes of overweight in a range of settings.
Overweight is often described as a multi-factorial condition, in that it has many complex causes. For both adults and children, there is good evidence that the following are risk factors for overweight:
- Low levels of physical activity
Sedentary activities, such as watching TV
Diets which contain a lot of high energy-dense foods (usually fatty foods)
Excessive intakes of alcohol and high energy soft drinks
There is also some evidence to suggest that some additional factors increase the risk of overweight in childhood:
- Maternal smoking during pregnancy
Lack of breast-feeding during the first 6 months of life
Early weaning, particularly before 4 months of age
High protein intakes in early childhood
Overweight parents
The 65,000 adults in Tayside who are obese are more likely to develop serious chronic diseases such as type 2 diabetes, coronary heart disease and some types of cancer. Depression, sleep apnoea and joint problems are also linked with overweight and obesity. Treating the medical consequences of overweight costs the NHS in Scotland £171 million every year, but only a tiny fraction of this is spent on helping people to lose weight. Overweight children are at greater risk from medical conditions such as type 2 diabetes, and can suffer from bullying related to their weight.
A tremendous amount of work has already gone into prevention of overweight in Tayside. Many local initiatives are spin-offs from national programmes. However, much of the prevention focuses on schools with little aimed at the adult population. In the case of treatment, the opposite is true with a number of public and private sector options being available for adults but practically nothing for children. The issue of tackling inequalities is very important and more could be done to prioritise initiatives aimed at overweight people from lower socio-economic groups. Not only is the prevalence of overweight higher in these groups, but the risk of heart disease is greater too.
The available published evidence on preventing and treating overweight is not very compelling, mainly because few high quality studies have been carried out. However, there are some trends that can act as a signpost to public health strategies. These include findings such as:
- Low-fat and low-calorie diets are equally good for weight loss.
Physical activity on its own works better for prevention than treatment.
Combining diet and physical activity is the best option for weight loss and reduces the risk of people developing diabetes and heart disease.
Surgery and approved anti-obesity drugs create clinically significant weight losses but come with a few risks.
Many overweight children benefit from family therapy whereby parents/carers are involved in agreeing and enforcing behavioural change.
Targeting sedentary behaviours is the most effective way to reduce weight.
Integrated school programmes which increase physical activity and encourage healthy eating can prevent overweight.
There are few successful prevention techniques for adults.
Community-based approaches which make healthy choices easier are useful. Hands-on activities involving preparing and cooking healthy food can also help.
The findings from the literature review were used as a basis for developing the concepts underpinning the Strategy. The aim was to “increase the proportion of Tayside residents who maintain a healthy weight throughout their lives”.
Since it would be impossible to target all overweight people in Tayside, five key settings were identified which could be used as starting points for intervention. These were (1) Community, (2) Tayside NHS, (3) Education, (4) Other local authority departments and (5) Other workplaces, and food & beverage businesses. Target groups within each setting were identified. These were groups which need to be prioritised for attention because their risk of overweight or related health problems is the greatest. Included in this list were new mothers, people attempting smoking cessation, overweight people from lower socio-economic groups, children under 10 years of age and girls aged 11 to 16 (specifically for physical activity interventions).
Contents
Executive summary
Glossary of terms used in this report
SECTION 1 – MAKING THE CASE FOR ACTION
Introduction
What causes overweight?
Why is overweight a problem?
Who is affected by overweight
What can be learnt about treatment and prevention from the
published literature?
SECTION 2 – WHAT’S HAPPENING IN TAYSIDE TO PREVENT
AND MANAGE OVERWEIGHT?
Current research in Tayside
Policies and reports to tackle overweight
Prevention of overweight in Tayside
Management of overweight in Tayside
SECTION 3 – STRATEGY RECOMMENDATIONS
Strategy concepts
Recommendations
SECTION 4 – LOOKING TO THE FUTURE
What happens next?
Appendices
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PDF Ebook Tackling overweight and obesity: Tayside Health Board 2005
