Prevention of obesity

The prevention of obesity can be addressed on two levels:

  • Individual strategies
  • Public health strategies

In terms of public health, healthcare professionals have a part to play in lobbying for initiatives to:

  • Facilitate healthier travel (e.g. walking and cycling to work or school)
  • Promote more active recreation in society
  • Facilitate better access to healthy foods
  • Promote sport and physical recreation in schools
  • Improve opportunities to lead a healthier lifestyle

The importance of making physical activity a part of our daily routine cannot be overemphasised. Countries such as Denmark, where there are a greater number of cycling lanes, have a lower prevalence of obesity than the UK. A 14-year study conducted in Denmark also found that those who cycled daily (at least 3 hours per week) had a 40% lower mortality rate than those who took a sedentary route to work.40

‘Colorado on the Move’ is an innovative public health initiative developed by the Centre for Human Nutrition at the University of Colorado. The aim was to provide a simple message to all Colorado residents to increase their activity levels by walking an additional 2000 steps per day and to decrease their calorie intake by eating 100 calories fewer per day. Pedometers were made available for purchase through their website. The response to this weight gain prevention programme surpassed all expectations in terms of the response from the local population and the scheme has now expanded to ‘America on the Move’ (http://www.americaonthemove.org/). In addition to the development of innovative programmes similar to the ‘America on the Move’ initiative, prevention of obesity calls for an increase in the amount of collaborative work across many public agencies from the NHS to schools, planning authorities to the transport sector. The food industry should also be regulated to ensure responsible advertising and use of promotional material, particularly that aimed at children. Food products often use animated characters that will appeal to children. In Sweden where food adverts are tightly regulated, the levels of childhood obesity are less than in other parts of Europe.

On a one-to-one basis, health professionals should monitor high-risk situations in which obesity can develop and work supportively with individuals to ensure appropriate intervention.

In summary, obesity is a chronic, lifelong condition that requires a long-term model of care. It can be a frustrating problem for both patient and health professional alike, and it can lead to negative expectations on both sides. Experience tells us that the most difficult aspect of obesity management is the ability to sustain weight lost in the long term. From the outset, emphasis should be placed on long-term weight management strategies.