Last month the National Institute for Health and Care Excellence (NICE) released a new guideline aimed at preventing adults (aged 18 and over) from becoming overweight or obese and the provision of lifestyle weight management programmes for adults who are overweight or obese.
According to Public Health England’s Adult obesity slide set, around a quarter of adults in England are obese, and 42% of men and 33% of women aged 16 or older are overweight. Although overweight and obesity exist in all population groups, obesity is associated with social disadvantage and ethnicity.
Being overweight or obese can lead to chronic and severe medical conditions. The National Obesity Observatory report Obesity and life expectancy estimated that life expectancy is reduced by an average of 2–4 years for people with a BMI of 30–35 kg/m2, and 8–10 years for those with a BMI of 40–50 kg/m2.
Obesity in adults: prevention and lifestyle weight management programmes, published on 19 January, emphasises the need for coordinated weight management programmes with an integrated and person-centred approach. This quality standard is expected to contribute to improvements in the following outcomes:
- excess weight in adult
- physical activity
- time spent being inactive or sedentary
- dietary habits
- mental wellbeing
- health‑related quality of life
- prevalence of obesity‑related comorbidities.
With exercise and movement is the keystone of the scope of physiotherapy practice physiotherapists have a role to play in the prevention and management of obesity. The close contact time that we have with patients also means we are well placed to deliver some of the key the actions and interventions outlined in the guideline. The CSP’s Physiotherapy Works document on Obesity suggests a treatment plan for an obese patient may comprise of:
- provision of personalised lifestyle advice, taking into account individual attitudes, beliefs,circumstances, cultural and social preferences, and readiness to change
- prescription, supervision, and progression of appropriate physical activity to increase muscle strength, flexibility, and endurance, and sustain energy output to enhance and maintain weight loss under safe and controlled conditions
- management of associated conditions such as arthritis, back pain, and other musculoskeletal and chronic conditions, such as heart disease
- co-ordination of comprehensive and sustainable programmes of management in collaboration with service users, other health and social care professionals, and community services.