Many of us enter a new year reflecting on where we have been and our plans for the future. For some, this will mean acknowledging that a couple more kilos have crept on over the past year. Others will have health on their hit list for 2016; resolving to eat better and lose weight could be part of that.
It can be difficult to lose weight and keep it off in the long term. So how can we support communities to avoid weight gain over time?
New research published today in PLOS Medicine suggests that simple lifestyle programs can help prevent weight gain. But GPs, communities and individuals also have a role to play.
It’s OK to aim low
Even a small weight loss can result in positive health impacts. It has been estimated that a 1% reduction in body mass index (BMI) – the equivalent to approximately 1kg for an average adult – across the United States population would avoid 2 million cases of diabetes, 1.5 million cardiovascular diseases, and more than 73,000 cases of cancer.
It is the norm to be overweight or obese in Australia. Figures released last month showed 63% of adults (71% men, 56% women) and 27% of children were in this category in 2014/15. Further, rates of obesity in women in Australasia are growing faster than anywhere else in the world.
Challenging the accepted dogma that we will gain weight as we age was put to a recent meeting of the Queensland Clinical Senate, which helps set the agenda for long-term health strategies. The resolution of the meeting, convened with Health Consumers Queensland, was to focus on preventing weight gain in the community, rather than weight loss, particularly given the problems faced in achieving the latter.
In today’s study, the researchers randomly assigned 649 women in 41 rural Australian towns to either the intervention group or the control group.
Women in the intervention group took part in information sessions, received a personalised self-management plan, were sent monthly text message reminders and undertook a 20-minute phone-based coaching session.
Women in the control group attended a general session on women’s health.
Over 12 months, the women in the towns who received the targeted intervention program lost almost half a kilogram, while those in the control towns gained almost half a kilo.
This shows that delivering programs with community integration, a focus on small changes in behaviour, self-management, and minimal burden on the participants using a mix of personal and electronic modes of delivery, can be feasible, cheap and effective.
Role of GPs
General and nurse practitioners play an important role in providing advice and strategies on healthy and active lifestyles to prevent and manage obesity.
However, a Monash University study, published in The Medical Journal of Australia, found GPs recorded the weight of only 25.8% of a sample of 270,426 patients. Some of the barriers for recording this information are difficulty in approaching the discussion and a perceived lack of available training.
It is important for governments to support all health-care providers to be able to raise the issue of weight control – not just with those who are overweight or obese, but also to encourage those who are a healthy weight to remain in that category.
Guidelines for health professionals already exist, however, better integration with community programs (particularly those which offer social benefits), referral to tailored services and alignment with mass media campaigns are likely to add enormous value at relatively low cost.
There is no single strategy that will address excess weight and obesity in our community. But health professionals are important influencers. Empowering this group with effective, low-intensity strategies and programs is one element of a comprehensive approach to address poor diets and weight issues.
Another key element is to support communities to create healthy environments, to make the healthy choice the easy choice. Schools, workplaces, sports and community centres are all environments that should support healthy eating and active lifestyles.
If communities are funded and empowered, such as through the OPAL (Obesity prevention and lifestyle) program in South Australia and Healthy Together Victoria, they can link into statewide programs but also develop local solutions to solve the unique issues that exist in their catchment.
Recently we saw the funding removed from the National Partnership Agreement on Preventive Health, which provided valuable investment for the implementation of policies and programs to support healthy lifestyles. Funding to support community based initiatives so local populations can engage this issue is critically important, along with the implementation of policies such as reducing junk food marketing to children, mandatory health star labels and taxing sugary drinks.
In the meantime, how can individuals who regularly pledge to get fit and lose weight make sustainable and significant healthy changes, as the women in today’s rural Australia study have done?
Aiming to avoid weight gain is a good starting point, followed by small lifestyle changes, such as:
- walking briskly for at least 30 minutes on most days of the week.
These changes can make a big difference to your risk of weight gain and developing serious health problems in the future.