Lambeth Specialist Healthy Weight Project

Vanessa Impey- Paediatrician

Deborah Thompson- Specialist Dietitian

Prevalence of obesity by Local AuthorityYear 6 children (age 10-11 years) resident in London, NCMP 2009/10

Low prevalence

High prevalence

Child obesity: BMI ≥ 95th centile of the UK90 growth reference

© NOO 2011

http://www.noo.org.uk/visualisation/eatlas

Childrens Weight:Lambeth Context

NCMP data - Levels of obesity (2010/11) Reception - 11.6% Year 6 - 24% Consistently above average for London and

England for both age groups.

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Lambeth Specialist Healthy Weight Project

Aims for a change in how we deliver a healthy weight service

A whole system or integrated approach Systemic Family Therapy principles and

practice Families as resourceful

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Principles and practice - examples

working with the whole family in mind

non judgmental

wider contextual and social factors - communities and cultures

reaching out - bridging hospital and clinic

multi disciplinary and multi agency - joined up working between health, family, activity and diet

team learning - what are our beliefs and experiences relating to health and diet?

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The process of our work

Working as part of the Lambeth Healthy Weight Care Pathway

Initial referral Two initial home visits / appointments Full assessment including health checks Plan and set up goals Weekly sessions until three month review 3 month review includes height/weight checks along

with some re-evaluations Appointment frequency to be assessed at this point Until 6 month review

Physical Activities - aims

Encourage and support families to make changes to current activity levels.

Identify local community sessions activity sessions for families.

Promote the long term benefits of regular physical activity.

Assess children's cardiovascular responses to exercise over project time frame.

Dietetic Therapy

Aim of dietetic therapy: To assess nutritional status To identify the main dietary causes of weight-

gain To provide nutritional education To support family with making dietary

changes

Paediatric input

Full health and medical check Screening out underlying causes Looking at the impact of obesity on the child Blood tests taken

Family Therapy input

The team works under a systemic umbrella. Connecting medical, physical, dietetic and

emotional/psychological/, mental health issues

Family patterns and underlying issues can be worked with

Experiences of health and health care professionals

Seeing weight issues as having a ‘logic’ within a family.

Case Examples include:

Working with the impact of:

parental mental health issues parental experiences of violence learning difficulties bereavement significant child mental health issues

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Success and challenges

appointment attendance improved engaging with families where other services don’t higher referral of children with special needs referrals to other services including adult community services referrals of families which appear to fall between gaps success in dietetics, physical health and parenting strategies all

identified in quarterly reports families referred for medical investigations as necessary which

wouldn’t have been picked up elsewhere identified children with vitamin deficiencies Changes in personnel

Making connnections :

Social services were contacted and asked to cascade down Links were made with consultants at St Thomas’s Increased links with paediatricians at the Mary Sheridan Centre Links were made with dieticians in Lambeth (Community) and

at St Thomas Links have been made with GP surgeries at Clapham Common

, Mawby Clinic Gracefield Gardens and meetings arranged to discuss the project in more detail

Team members are taking in project posters to schools when they visit

The team gave out fliers at Gracefield Gardens Anniversary day and made some links with other health professionals

Referrals to the service: how you can work with us

Identify families where children are aged between 4-12 with a BMI of over 98.

Where there are psychosocial issues or other complexities

Where families may have tried a Tier 2 service. If not, would that be helpful now : Ready Steady Go instead?

Families must agree to a referral

Any Questions