Weight Management
APTUK Virtual Branch (Affiliate APTUK Kent Branch)
Current Government View
Statistics commissioned for Public Health England showed that in 2015, 62.9% of adults were overweight or obese, (67.8% men & 58.1% women).
Public Heath England published its paper, "Sugar Reduction. The Evidence for Action," in October 2015. This has called for manufacturers of food, especially those who have a high sugar content such as sweets and chocolates to reduce the amount of sugar in their products.
There has also been concern over the lack of fitness in both younger and older generation.
In 2011 the Department of Health published Healthy Lives: Healthy People: A call to action on obesity in England.
Its ambition is to achieve:
- a sustained downward trend in level of excess weight in children by 2020
- A downward trend in the level of excess weight averaged across all adults by 2020.
It has a four tier approach.
Tier 4: Specialist medical & surgical for complex obesity, includes preparatory assessments & Bariatric surgery. Commissioned by NHS England.
Tier 3: Primary/Community care referrals for complex & severe obesity whose condition not controlled by medication. Uses specialist multidisciplinary team, Diabetic clinics, Dietetics etc.
Tier 2: Community & primary care through HCP. Use of 12 week weight management programme including slimmer's clubs, sports clubs. Self referral, local authority based.
Tier 1: Primary care & community based prevention. Use of early intervention (self care) via schools, education, leaflets etc.
Community Pharmacies are part of the Tier 2 layer. Nice guidelines provides information on running a Weight Managment Service.
https://www.nice.org.uk/guidance/ph53/chapter/1-recommendations
This workshop will give a brief outline on the steps you will follow to guide a patient through a Weight Management programme. It is based on the CPPE e learning.
https://www.cppe.ac.uk/programme-listings/a-to-z
Try the sugar quiz below, see how good you sugar knowledge is.
System very well.
Methods of Weight Management
Healthy eating
Physical activity
Behavioral strategies
Drug therapy
Surgery
Guide to eating healthly
The Eatwell Guide shows how much of what we eat overall should come from each food group to achieve a healthy, balanced diet.
You don't need to achieve this balance with every meal but try to get the balance right over a day or even a week.
http://www.nhs.uk/Livewell/Goodfood/Pages/the-eatwell-guide.aspx
Eat at least five portions of a variety of fruit and vegetables a day
Most of us still aren't eating enough fruit and vegetables. They should make up over a third of the food we eat each day. Aim to eat at least five portions, (some nutritionists recommend up to 10 portions) of a variety of fruit and veg each day. Choose from fresh, frozen, tinned, dried or juiced.
(Remember that fruit juice and/or smoothies should be limited to no more than a combined total of 150ml per day.)
Fruit and vegetables are a good source of vitamins, minerals and fibre.
Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates. Choose wholegrain where possible
Starchy food should make up just over a third of the food we eat. Choose higher-fibre, wholegrain varieties, such as wholewheat pasta and brown rice, or simply leave skins on potatoes. There are also higher-fibre versions of white bread and pasta.
Starchy foods are a good source of energy and the main source of a range of nutrients in our diet.
Have some dairy or dairy alternatives (such as soya drinks and yoghurts). Choose lower-fat and lower-sugar options
Milk, cheese, yoghurt and fromage frais are good sources of protein and some vitamins, and they're also an important source of calcium, which helps to keep our bones strong. Try to go for lower-fat and lower-sugar products where possible, like 1% fat milk, reduced-fat cheese or plain low-fat yoghurt.
Eat some beans, pulses, fish, eggs, meat and other protein. Aim for at least two portions of fish every week – one of which should be oily, such as salmon or mackerel.
These foods are good sources of protein, vitamins and minerals. Pulses such as beans, peas and lentils are good alternatives to meat because they're lower in fat and higher in fibre and protein, too. Choose lean cuts of meat and mince and eat less red and processed meat like bacon, ham and sausages.
Choose unsaturated oils and spreads and eat in small amounts
Unsaturated fats are healthier fats and include vegetable, rapeseed, olive and sunflower oils.
Remember all types of fat are high in energy and should be eaten sparingly.
Eat foods high in fat, salt and sugar less often and in small amounts
These foods include chocolate, cakes, biscuits, sugary soft drinks, butter, ghee and ice cream.
They're not needed in the diet and so should be eaten less often and in smaller amounts
For more information click on links below
http://www.nhs.uk/Livewell/fitness/Pages/whybeactive.aspx
Guidelines for adults aged 19-64
To stay healthy, adults aged 19-64 should try to be active daily and should do:
- at least 150 minutes of moderate aerobic activity such as cycling or fast walking every week, and
- strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).
OR
- 75 minutes of vigorous aerobic activity, such as running or a game of singles tennis every week, and
- strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).
OR
- A mix of moderate and vigorous aerobic activity every week. For example, two 30-minute runs plus 30 minutes of fast walking equates to 150 minutes of moderate aerobic activity, and
- strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).
A good rule is that one minute of vigorous activity provides the same health benefits as two minutes of moderate activity.
One way to do your recommended 150 minutes of weekly physical activity is to do 30 minutes on 5 days a week.
The next step is to arrange a longer meeting where you can help the client assess their weight and set realistic goals (eg reduction by 5-10% of their body weight).
A realistic goal is 0.5 to 1kg per week, using healthy eating and exercise or becoming more active regime.
It is also the time to assess their BMI & waist circumference.
It is a good idea to offer coping strategies for dealing with lapses and provide regular support meeting.
For more information on cyce of change and how to motivate clients through this cycle click on link below.
http://www.stepupprogram.org/docs/handouts/STEPUP_Stages_of_Change.pdf
The most successful programme is one which put the interests of the person first, allows the client to take decisions for themselves, giving them choices, ideas and is non judgmental.
Case Study Malcolm King
Design your own weight management plan for Malcolm
52 years old, lorry driver. BMI 42kg/m2. waist 96cm
BP: 155/95mmHg.
GP advised Malcom to lose weight, not on medication yet, would prefer not to take tablets.
Often has takeaways/café meals when taking break from driving his lorry.
Partner cooks healthy meals but Malcom has big portions.
Sporty when younger, (cricket, rugby).
Plays footie in garden with sons, gets out of breathe easily.
Occasional cigarette in pub at weekend.
Malcolm has come to the Pharmacy today as he saw your advert for weight management service as he was passing by. His GP told him he must lose weight or start on medication for his high blood pressure.
Try making a week 1 food and fitness plan for Malcolm, using the link below.
http://www.nhs.uk/Tools/Documents/WEIGHT-LOSS-PACK/week-1.pdf
Copyright
APTUK Kent Branch
Contact details: Virtual Branch APTUK
Email: l.j.gallagher@gre.ac.uk
Website: https://www.smore.com/yydwc-virtual-branch-aptuk
Location: Medway, United Kingdom
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Twitter: @AptukB