New obesity advice backs 3% goal

Obese or overweight people are being told that losing as little as 3% of their weight can have significant beneficial effects, in new NHS guidance urging a "respectful and non-judgemental" approach to the problem.

Stigmatising obese and overweight people does not work and can deter them from seeking help, Nice says
Stigmatising obese and overweight people does not work and can deter them from seeking help, Nice says

Stigmatising obese and overweight people with a "for goodness sake pull yourself together" approach does not work and can deter people from seeking help, the National Institute for Health and Care Excellence (Nice) said.

It has also told GPs to identify people who can be referred for weight management programmes such as Weight Watchers in a bid to help them slim down.

Providers of weight loss courses would have to demonstrate that participants maintain their weight loss and their programmes are effective at 12 months or beyond.

Nice said Rosemary Conley, Slimming World and Weight Watchers have been shown to be effective at 12 to 18 months and suggested Public Health England could be a national source of information on programmes suitable for commissioning.

In new guidance, the watchdog acknowledged the difficulties many people faced losing weight and maintaining their weight loss, saying there was "no magic bullet" to the "complex" problem.

It said evidence showed that an effective weight loss programme where participants receive support from "buddies" and advice on lifestyle and behavioural changes can lead to an average 3% weight loss, which if kept off for the long term, will have beneficial health effects.

Carol Weir, guidance developer for Nice and head of service for nutrition and dietetics at Leeds Community Healthcare NHS Trust, said the watchdog recognised the difficulties people faced losing weight and the "significant" effort required to prevent a regain of the weight once lost.

"Obviously, if you need to lose weight, the more weight you lose the better, and the health benefits derive from that, but even a 3% loss, kept up long term, is beneficial and that is why we are recommending sensible changes that can be sustained life long," she said.

She added: "The evidence tells us that the elements of an effective programme are sensible changes to diet, an increase in physical activity that can be sustained in the long term and changing behaviours using a range of techniques and tools, such as setting realistic and achievable weight loss goals, regular weight loss monitoring, a food and physical activity diary, planning ahead, having a buddy, and using a respectful and non-judgemental approach.

"What we found was that an awful lot of people are put off seeking support for their weight because they have either experienced or perceived stigma in the past."

Professor Mike Kelly, director of the centre for public health at Nice, said obesity was costing the British economy and the NHS billions of pounds a year.

Obesity increases the risk of serious conditions including diabetes, heart disease, and some cancers. Prof Kelly said a "staggering" total of 42% of men and 32% of women are overweight and more than a quarter of adults in England are now classified as obese. But he said losing weight was difficult.

"This is difficult, people find it difficult to do," he said.

"It is not something where you can just wake up one morning and say 'I am going to lose 10llbs' - it takes resolve, it takes encouragement, and one of the things about involvement in these programmes is the mutual support from others who try to do the same thing seems to be hugely helpful from a motivational point of view.

"It is not just a question of 'for goodness sake pull yourself together and lose a stone' - it doesn't work like that, what we are trying to acknowledge here is the reality that people carrying excess weight face."

Public health minister Jane Ellison said: "We are determined to get the nation eating more healthily, and we are the first country in Europe to recommend a voluntary scheme giving colour coded nutrition information on the front of food packaging to make it easier for consumers to know what they are buying.

"Those businesses that have already signed up to the scheme account for nearly two thirds of all the food that is sold in the UK. They are all committed to introducing the new labels on all their products by January 2015.

"We are working with industry on reducing calories overall, including from sugar, and many food and soft drink manufacturers and retailers taking sugar out of their products.

"The Scientific Advisory Committee on Nutrition is also doing a review of all carbohydrates. Their report, due later this year, will inform our future thinking."