Implementation of NICE guidance on obesity:

1
Implementation of NICE guidance on obesity The
evidence base Dr Adrienne Cullum Centre for
Public Health Excellence, NICE
NICE clinical guideline 43
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Obesity guidance publications for health
professionals

• Quick reference guide 1
• for LA, schools and early year providers,
  workplaces and the public
• Quick reference guide 2
• for the NHS
• NICE guideline
• recommendations, priorities for implementation,
  care pathways and public health map
• Full guideline
• includes detailed background information,
  methods, evidence statements and evidence reviews

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Guidance content

• Adults and children aged 2 years and older
• Public health
• maintaining weight and preventing overweight
  management in non clinical settings
• NHS settings and community settings including
  pre-school, school, workplace
• Recommendations to the public
• Clinical management
• identification and assessment in primary and
  secondary care
• Management - lifestyle, drugs and surgery
• Local action not national policy

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Evidence base

• Systematic approach but not systematic reviews
• Consider all types of evidence, quantitative and
  qualitative
• Issues
• Plethora of initiatives
• Few UK based studies
• Range of settings but few studies in standard
  service settings
• Research design
• Paucity of data
• Children
• BMEG and vulnerable groups
• Cost effectiveness
• National initiatives implemented locally

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Overarching themes

• Public health and clinical action
• evidence for effectiveness of public health
  interventions including costs
• Effectiveness interventions
• address diet and activity (lifestyle and reduce
  sedentary behaviour)
• parental involvement for children
• multi-faceted approach
• long term
• tailored
• Role beyond NHS strategic action by LAs,
  schools, workplaces etc

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Recommendation for early years settings

• Minimise sedentary activities during play time,
  provide regular opportunities for enjoyable
  active play and structured physical activity
  sessions
• Implement Department for Education and Skills,
  Food Standards Agency and Caroline Walker Trust
  (see www.cwt.org.uk) guidance on food procurement
  and healthy catering

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Recommendation for schools

• Head teachers and chairs of governors, in
  collaboration with parents and pupils, should
  ensure school policies help children to eat a
  healthy diet, be physically active and maintain a
  healthy weight.
• This includes policies relating to
• building layout and recreational spaces
• catering (including vending machines)
• taught curriculum (including PE)
• travel plans
• NHSS

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Recommendation for local authorities

• Work with local partners to create and manage
  more safe spaces for incidental and planned
  physical activity, addressing as a priority any
  concerns around safety, crime and inclusion, by
• providing facilities (eg cycle routes, safe play
  areas)
• making streets cleaner and safer (eg traffic
  calming)
• ensuring building design encourage activity
  (stairs)
• tailored information and support