By Mr Jonathan Temple and Professor Chris Oliver @CyclingSurgeon

Healthcare students across the UK will recognise the profound impact of adult and childhood obesity upon the physical and psychological health and wellbeing of millions of patients and their families. Indeed, obesity and obesity-induced disease represent one of the most significant and important challenges facing our society today.

Facts about the obesity crisis in the UK

Obesity in the UK is killing millions and costing billions. Nearly two thirds of the adult UK population are now either overweight or obese. Moreover, levels of childhood obesity have risen dramatically over recent decades and continue to rise. In 1995, one in every ten children in the UK aged 2-15 yrs old was obese. Now, one child in every six is obese. ^[1,2]

Obesity is associated with an increased risk of cardiovascular disease, hypertension, stroke, type II diabetes, arthritis, infertility, pancreatitis and liver disease, as well as numerous psychiatric disorders, sleep disorders and cancers (including breast, liver and prostate cancer). As levels of adult and childhood obesity continue to rise, the economic burden this places upon the National Health Service (NHS) is unsustainable. ^[3,4,5]

Around one in every eleven deaths in the UK is now linked to being overweight or obese; that’s 30,000 otherwise avoidable deaths each year in the UK alone and 400,000 deaths across the EU. A recent study by the National Audit Office estimated that the annual cost to the NHS of obesity and obesity-related illness is over £5.1bn. ^[6-11]

The need for greater support and education for healthcare professionals

Greater support and provision of specific training for healthcare professionals regarding the severe and lifelong health risks of obesity and obesity-induced disease, in both adults and children, is urgently needed. All healthcare workers should receive training in nutrition, physical activity and obesity to enable them to appropriately advise and confidently engage with patients as well as inspire behavioural change. Conversations between healthcare professionals and patients about the severe health risks associated with obesity and obesity-induced disease improve public awareness.  However, they are not as effective as they could be. We believe that both public and professional perceptions of obesity must change. Obesity should be viewed as a health issue, rather than a judgement call, and should not be the subject to social stigma. Obesity is something that you have; not something that you are.

Our solution: The Obesity Action Campaign

The Obesity Action Campaign is a UK-registered charity, launched out of the House of Lords in 2011 by a group of senior clinicians and academics across the UK. The goal for the charity is to bring together the voices and experiences of patients, families, clinicians, educators, academics and policy-makers to reduce the levels of adult and childhood obesity and therefore improve the health and quality of life of patients and their families in the UK.

Launch of the National Student Health Programme

In November 2016, the Obesity Action Campaign launched its National Student Health Programme (NSHP) to support health schools in the UK to better provide an environment, not only for educational excellence, but also, one that promotes the physical and psychological health and wellbeing of their students. The aim is to ensure that the next generation of healthcare professionals are equipped with the knowledge and skills they need to effectively tackle obesity in both adults and children throughout in their clinical practice.

Since its launch, the NSHP has grown exponentially. Every medical school in London, as well as the University of Edinburgh, is now participating and contributing towards its development. Ultimately, our goal is to (1) create a network that encompasses every health school in the UK and (2) to engage with all healthcare students from the very beginning of their training and beyond graduation.

The objectives of the NSHP are to:

• Coordinate the efforts of universities across the UK and encourage a shared focus on providing an environment not only for educational excellence but also to promote the health and wellbeing of their students.
• Educate and raise awareness of the severe health risks associated with adult and childhood obesity and obesity-induced diseases among the next generation of healthcare professionals, providing them with the knowledge and skills they need to effectively tackle these issues in clinical practice.
• Encourage universities to appoint student and staff health officers who would act as custodians and advocates for the health and wellbeing of their peers.
• Encourage universities to provide students and staff with additional support and greater access to the facilities they need to maintain adequate levels of physical activity, exercise and to eat healthily.
• Create opportunities for healthcare students to get involved in research into the prevention and treatment of obesity-induced diseases in both adults and children.
• Educate healthcare students as to the importance of maintaining a healthy diet and lifestyle while at university and beyond.

• Inspire not just the next generation of healthcare professionals but all university graduates to act as exemplars for healthy living when they leave university and, in time, actively encourage and inspire those around them to do the same.

If you are interested in working with the Obesity Action Campaign or participating in or supporting our National Student Health Programme, please contact jonathan.temple@kcl.ac.uk.

You can follow the Obesity Action Campaign via our website www.obesityac.org and on Twitter @obesityactionuk

Mr Jonathan Temple – Advisor to the Board of Trustees, Obesity Action Campaign, Director & Founder of the National Student Health Programme and Final Year Medical Student, Guy’s King’s & St Thomas’ School of Medical Education, King’s College London

Professor Chris Oliver – Trustee of the Obesity Action Campaign, Honorary Professor of Physical Activity for Health, University of Edinburgh, & Consultant Orthopaedic Surgeon, Royal Edinburgh Infirmary

References

1. Niblett, P. Statistics on obesity, physical activity and diet—England, 2015. http://content.igital.nhs.uk/catalogue/PUB16988/ob…
2. Li J, Temple JL, et al. Recognising and intervening in non-alcoholic fatty liver disease. Independent Nurse. 2016; February Temple J L, Cordero P, Li J, et al. A guide to non-alcoholic fatty liver disease in childhood and adolescence. Int J Mol Sci. 2016;17:947.
3. Cordero P, Li J, Temple JL et al. Chapter 16: Epigenetic mechanisms of maternal obesity effects on the descendants. In: L R Green, R L Hester, eds. Parental Obesity: Intergenerational Programming and Consequences. Springer New York. 2016. p355.
4. Chalasani N, Younossi Z, Lavine J E et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American college of gastroenterology, and the American gastroenterological association. Am J Gastroenterol. 2012;107:811-826.
5. Ratziu V, Bellentani S. Cortez-Pinto H, et al. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol. 2010;53(2):372–384.
6. JR Banegas1*, E Lo ´pez-Garcı ´a1, JL Gutie ´rrez-Fisac1, P Guallar-Castillo ´n1 and F Rodrı ´guez-Artalejo. A simple estimate of mortality attributable to excess weight in the European Union. European Journal of Clinical Nutrition. 2003; 57(201-208)
7. National Audit Office. An Update on the Government’s Approach to Tackling Obesity. Memorandum For The Committee Of Public Accounts; 2012.
8. www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/ health-matters-obesity-and-the-food-environment–2
9. Ng M, Flemming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study. Lancet. 2014;384(9945):766-781.
10. World Health Organization. Obesity and overweight fact sheet. .June 2016. http://www.who.int/mediacentre/factsheets/fs311/en…
11. Public Health England. Measurement of Obesity. 2017. www.noo.org.uk/NOO_about_obesity/measurement