Managing obesityManaging obesity

Aim of session:

To highlight the main principles of weight management.

To demonstrate the importance of portion control.

Areas to be coveredAreas to be covered

Definition of overweight and obesity in N.I How big is the problem in N.I? What is causing the problem? What can we do about it? The effect of portion sizes on calorie intake

What’s the problem?What’s the problem?

Obesity =where weight has reached a level where it is detrimental to health.

Obesity increases risk of chronic diseases especially type 2 diabetes, CHD, stroke, some cancers and arthritis.

In children, obesity can lead toIn children, obesity can lead to

risk of CHD as adults Risk of bullying and teasing Negative self image Lack of confidence and low self esteem -

especially adolescents. Lower educational attainment

Measuring obesityMeasuring obesity

Usually measured as Body Mass Index (BMI) BMI= weight (Kg)

height in m2 AdultsReady reckoner or chart helpful for this Healthy weight range 18.5-24.9 Overweight > =25- 29.9 Obese >=30-39.9 Very obese 40 and above

Working out BMIWorking out BMI

Example:

person weighing 80Kg who is 1.65m tall

= BMI =29 kg/m2

=overweight

80kg / 2.72 (1.65m x1.65m)

Adult weight in N.IrelandAdult weight in N.IrelandHSWB survey 2005/6HSWB survey 2005/6

Rates of overweight in children in Rates of overweight in children in N.I.N.I.

Almost 1 in 10 (8%) children aged 2-15 years is obese

(NI Health and Social Wellbeing, 2006/07)

Overweight and obesity in children was projected to rise but appears to have levelled off.

22% of children entering P1 were either overweight or obese (5% of these obese)

(Child Health System, 2004/05)

What’s causing the obesity What’s causing the obesity problem?problem?

Human biology combined with modern living

Societal influencesIndividual psychology

Biology

Activity environment

Individual activityFood

ConsumptionFood Production

Obesogenic EnvironmentObesogenic Environment Modern lifestyle-labour saving devices, TV viewing

and computer games Lack of opportunities to be physically active Increased promotion and availability of snack foods

and fast food. Increasing portion sizes

to name but a few!

What protects against obesity?What protects against obesity?

Breastfeeding until at least 4 months

Good weaning practices

Maintaining healthy weight in pregnancy

What if you are already overweight What if you are already overweight or obese?or obese?

Evidence is for

multi-component interventions

dietary change Physical activity Behaviour change

In children family based interventions are recommended-entire family involved.

SIGN (2010) and NICE guidelines.

Achieving a healthy weightAchieving a healthy weight

Balancing energy in (food eaten)

with Energy out

Safe weight loss targets for Safe weight loss targets for overweight adults overweight adults Aim for 1-2 lbs weight loss per week-

energy intake by approx 500 Kcals per day to achieve weight loss of 0.5kg/ week (1lb)

5% weight loss Aim for weight maintenance as a minimum

i.e. avoid weight gain.

physical activity

Eating well for weight lossEating well for weight loss

Eat regular meals Eat a balanced diet Reduce portion

sizes

Reduce calorie intakeReduce calorie intake

Reduce fat – richest source of calories

1g fat=9Kcals

1g Carbohydrate=4 Kcals

1g Alcohol=7Kcals

Reduce portion sizes

Reduce proportion of foods from high fat and or sugar food group.

Practical advicePractical advice

Choose healthy snacks Watch alcohol Read food labels Choose low calorie drinks Reduce sedentary time Focus on your food! Mindful

eating. At least 5 fruit and veg a day

Portions sizesPortions sizes

Some product portion sizes have increased e.g. Passively eating more! Some products available in smaller portions but

usually as multi packs Share packs available

SignpostingSignpostingLeaflets and resources

Small changes big benefits (public health agency)

Eat well feel well and lose weight (Eastern area health promotion)

Fit families (BCC)

PROGRAMMES in Eastern area

Weigh to health (for adults)

FRESH (for 11-14 year olds)

Useful web sitesUseful web sites

www.bdaweightwise.com www.change4life.org

www.enjoyhealthyeating.org

www.nhs.uk/Livewell/healthy-eating/Pages/Healthyeating.aspx

www.weightconcern.org www.littlesteps.eu

Preventing obesity is a societal challenge, similar to climate change. It requires partnership between government, science , business and civil society.

Foresight report