Tackling Obesity in England - National Audit Office

TACKLING OBESITY IN ENGLANDPart 4Initiatives across Government toaddress the problem of obesity4.1 Part 2 of this report demonstrates the considerableburden of disease and wider costs to society that resultfrom a high prevalence of obesity in the population.These costs will continue to increase unless action istaken to prevent the prevalence of obesity from risingfurther. As shown in Part 3, treatment to help obesepeople control their weight can significantly reduce therisks of associated disease and improve the quality oflife of those affected. However, as for other chronicconditions, treatment of people who are already obesecan only have a marginal effect on population-wideprevalence, particularly as only a minority of obesepatients who enter treatment achieve and sustain a BMIbelow 30 in the long term. To address prevalence, thereis a need to focus more on those who are at risk but notyet obese. Prevention targeted at children and youngpeople is a key component to the success of such astrategy.4.2 There is a wide range of organisations and groups, bothwithin and outside the public sector, that have animportant influence on the elements of lifestyle -principally diet and physical activity - which affect bodyweight (Figure 17). The Department of Health can havelittle impact acting in isolation, and joined upapproaches are required. The role of the Departmentinvolves liaising with the key representatives of otherGovernment departments in order to advise on policiesand initiatives to improve health, in particular in relationto diet and nutrition, health education, transport andphysical recreation.There is a substantial amount of joinedup working across Government relatedto the prevention of obesity4.4 We interviewed staff in the relevant Governmentdepartments (Appendix 1) to establish the mainmechanisms they used for working together, howeffective collaboration had been, and what the keyoutputs were in terms of jointly-sponsored research,projects and initiatives. We also sought examples oflocal initiatives and joint working, involvingorganisations such as local authorities, healthauthorities, schools, and local providers of health andsocial services, which demonstrated this cross-cuttingapproach.4.5 Overall, we found a substantial amount of co-operativeand cross-departmental work related to obesity. We lookat these activities in paragraphs 4.6-4.64 below under anumber of themes, firstly those addressing thepopulation as a whole:i) promoting active transport;ii)iii)promoting more active recreation in society; andidentifying and promoting healthy patterns ofeating.And secondly, those targeting children and youngpeople:4.3 In this part of our report we examine preventiveinitiatives. We look at how far common objectivesrelevant to prevention of obesity have been adopted andaddressed through joined up working. To do this wehave identified themes where there is the potential for ajoined up approach, and examined the actions takenand outputs achieved. There is limited evidence on theeffectiveness of interventions, but we have used casestudies to illustrate what is possible and as an aid tospreading good practice.iv)equipping young people for a healthy lifestyle;v) promoting a healthy school environment;vi)vii)viii)promoting healthy travel to school;promoting sport and physical recreation inschools; andpromoting healthy eating in schools.We looked in particular for evidence of the maincategories of cross-cutting intervention identified in theCabinet Office report, 'Wiring it up' (2000) 31 .part four31