1. 3 rd March 2015

2. What I hope to cover Who we are What does the service offer Why do we need ‘Healthy Lifestyles – Doncaster’ Why does being heavier than the recommended weight for height matter How can you encourage people to access help

3. Who are we Dietitians Healthy Lifestyle Advisors /Community Food Educators Senior Physical Activity Development Officer Physiotherapist Cognitive Behavioural Psychotherapist

4. Tier 1 Universal Interventions Tier 4 Surgery Tier 3 Specialist Weight Management Services (MDT) Tier 2 Lifestyle Services Lifestyle Services Doncaster Obesity Pathway Bariatric surgery Only offered to children over 12 in exceptional circumstances Multi-disciplinary team Multi-component weight management service Environmental and population wide initiatives. Pre-op assessment Specialist assessment Identification and primary assessment Prevention, reinforcement of healthy eating and physical activity messages

5. Tier 1 – Support in Schools The School Food Plan Nutritional Standards for schools meals – Food other than lunch Talks in Schools Support with food policy/sourcing resources Training Programme/Bespoke Schools Training How to run a cooking club

6. To book a place contact: 01302 366666 ext.3711

7. Tier 2 - Healthy Weight Solutions Healthy lifestyle programme BMI ≥25Kg/m 2 Age ≥18 years 12 weeks FREE FREE VenueDateTime DRI – Learning Library Wednesday 15 th April5:30-6:30pm Bentley MyPlace Thursday 16 th April10:00-11:30am Central Children’s centreThursday 16 th April 10:00-11:30am Rossington Parish Memorial HallFriday 17 th April10:00-11:30am To book a place contact: 01302 366666 ext.3711 0800 9176264 NHS staff Variety of times and venues Long term goals Lifestyle Changes

8. Healthy Lifestyles Doncaster – How does it work Anybody can refer into the service Individual referred or their representative contacted and arranges initial appointment at a time and venue to suit them ( including outside school hours). If they do not wish to access the service a letter will be sent to their GP, and referrer (if known )

9. What is available Following initial appointment people are supported to access what they need including Group - education, activity, psychotherapy, chronic condition management One to one support / advice, face to face, on line and via telephone.

10. Over nutrition an issue for many of the populations on our planet

11. Overnutrition a condition of excess nutrient and energy intake over time. Overnutrition may be regarded as a form of malnutrition when it leads to morbid obesity. feeding, particularly calories, in excess of requirements; leads to obesity, rapid weight gain, and developmental skeletal abnormalities. Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.

12. Locally - Overnutrition In Doncaster there are more adults than the England average who are overweight and obese. Almost a quarter (22.1%) of children aged 4-5 years and over a third (33.6%) of children aged 10-11 years are overweight or very overweight. Taken from Doncaster Council website updated 12 th February 2015

13. National Child Measurement Programme 2013/14 The National Child Measurement Programme (NCMP) measures the height and weight of school children in reception and Year 6 in England every year, which helps in establishing the prevalence of child obesity. In 2013/14: 19.1% of children in Year 6 (age 10-11) were obese. A further 14.4% in Year 6 were overweight. 9.5% of children in Reception (aged 4-5) were obese. A further 13.1% in Reception were overweight. This means a third of those aged 10-11 and over a fifth of those aged 4-5 were overweight or obese.

14. What do we see as healthy

15. Possible health consequences

17. How to raise the issue - Adults These are the kind of open questions that might be asked to adults Are you worried about your weight Are you worried about your health and how your lifestyle might be affecting this Do you have difficulties getting about or doing activities you want to because of your weight or because of health problems you might have Do you feel low in mood, or suffer from low self esteem because of your weight

18. How to raise the issue Studies have shown that parents often have an incorrect perception of their child's weight. [ Doolen J, Alpert PT, Miller SK; Parental disconnect between perceived and actual weight status of children: a metasynthesis of the current research. J Am Acad Nurse Pract. 2009 Mar;21(3):160-6. doi: 10.1111/j.1745-7599.2008.00382.x. Doolen J, Alpert PT, Miller SK http://www.nhs.uk/Tools/Pages/Healthyweightcalculator.aspx "Puppy fat" is a common excuse. Endocrine causes for childhood obesity are rare. It is worth stressing that obesity is a clinical term with health implications rather than just the way somebody looks.

19. How to raise the issue The issue may be raised: 1. If the family expresses concern about the child's weight. Try: "We can measure [child's] weight and see if he or she is overweight for his or her age.“ 2. If the child has weight-related comorbidities. Try: "[Condition] can sometimes be related to a child's weight. I think we should check [child's] weight.“ 3. If the child is visibly overweight. Try: "I see more children these days who are a little overweight. Could we check [child's] weight?"

20. How to raise the issue- This may be the first time that weight has been raised with the family. It is a time to be reassuring and supportive. "By taking action now, we have a chance to improve [child's] health in the future.“ It can be a delicate issue to raise with a parent and this may mark the (good or bad) start to a long therapeutic period. http://www.patient.co.uk/doctor/obesity-in-children

21. Contact us Public Health Dietitians 01302 366666 ext 3711 dietitians@dbh.nhs.uk Healthy Weight Solutions Healthy Lifestyles Doncaster Referrals 0800 9176264 HealthyLifestyles@dbh.nhs.uk Healthy Lifestyles Doncaster

22. Questions