Childhood obesity is of epidemic proportions, both in the UK and across the world. Here in the UK, it is estimated that one in three young people (aged 10-11) have overweight or obesity. What’s more, the prevalence is twice as high in the most deprived areas in contrast to those in the least deprived – highlighting a clear link with health and social inequalities. Weight management programmes have been proposed as a means of helping young people and their families with their weight.
Current management options
In the UK, we have a four-tiered approach to preventing and treating obesity. Tier one focuses on primary prevention (aiming to stop the onset of a disease), with tiers two to four making up secondary prevention (management and treatment of a disease). The pathway stipulates that more specialist treatment is provided for children with a greater degree of obesity, insofar that tier two provides generic weight management advice, tier three provides specialist intervention from a multidisciplinary team, and tier four offers intensive treatment, pharmacotherapy, and bariatric surgery.
Psychological support starts to become interwoven into the treatment approach in tier three; their input often to help individuals understand their reasons for eating and establish behaviour change techniques. Psychological support is usually provided in conjunction with that of a specialist physician (e.g. endocrinologist), a dietician/nutritionist, a physical activity specialist and a physiotherapist – collectively making up the multi-disciplinary team. It is thought that this multi-disciplinary team can provide tailored and specialist intervention which will assist individuals who may not have been successful at tier two. Success widely defined by weight loss.
That said, we know that determinants of psychosocial health (e.g. self-worth, social acceptance, relationships) play a leading role in the onset and continuation of weight-related issues. SHINE – a psychosocial intervention for young people with obesity – places equal content distribution on the improvement of lifestyle factors (dietary and physical activity behaviours) and psychosocial factors (those aforementioned).
SHINE Health Academy
SHINE provides young people and their families with up to 15 months of support. The programme is divided into three phases: an initial one-to-one assessment, a stabilisation phase (preventing excess weight gain), and a maintenance phase (prolonged support until 15 months). The stabilisation phase includes a 12-week intervention that aims to help young people in a holistic manner; sessions on social relationships, bullying, stress management to name a few. It also gives the young people advice on how to create and maintain a healthier diet, and how to embed physical activity behaviours into their lifestyles. The maintenance phase goes on to offer multiple 12-week educational programmes (content centred on social relationships, healthy lifestyles, and leisure activities). Phases two and three are complemented with four sessions of supervised physical activity per week.
The interesting and (one of many) unique aspect of SHINE is on the development of psychosocial health. Not only did the programme demonstrate positive weight-related results (average BMI reduction of 1.33kg/m2 after three months – to a 4% change), but anxiety, depression and self-esteem also improved by 50%, 54% and 38% respectively. Furthermore, retention of young people and families in such programmes is challenging, and when we evaluated SHINE a 95% retention rate at three months was observed. Similar programmes usually have an average of 50-60% of participants completing the respective programmes.
We hypothesise that these results are in part attributable to the focus on psychosocial health, with other programme design and delivery factors being of great influence also.
Take home message
Psychosocial interventions, for the purpose of weight management, may prove to be an effective approach to helping young people with overweight and obesity. Obesity is compounded by poor psychosocial health; this must be understood when setting out to provide weight management support. Focusing on holistic health, as opposed to focus only on the direct aetiological factors of obesity, may help improve future weight management provision.
- ResearchGate: https://www.researchgate.net/profile/James_Nobles
- Link to study: http://www.jahonline.org/article/S1054-139X(16)30160-4/fulltext
About the Author
James Nobles is a Research Fellow at Leeds Beckett University. His doctoral research interests include the evaluation of weight management programmes, and more specifically, the identification of factors associated with programme engagement. His wider work is situated within the Whole Systems Obesity project at Leeds Beckett University; a project aiming to help Local Authorities develop a whole system approach to preventing and treating obesity. Email James at J.D.Nobles@leedsbeckett.ac.uk or follow him on Twitter.