The Reporter
Issue no 485 | 28 October 2002
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WATCH IT! – The new NHS Programme for Overweight <br>
Children and Teenagers in Leeds

A major lack of services for overweight children exists in Leeds, despite its reputation for research in the area of childhood obesity via the APPLES projects and the Carnegie camp. The APPLES team, led by Dr. Mary Rudolf, is now developing and piloting a low cost care programme for overweight young people. The aim is to provide intensive input and support within the NHS for children and their families beyond that possible within existing primary and secondary care. We intend to offer a sustainable programme offering help on a very regular basis.

Weekly ‘surgeries’ are planned in four designated areas in South Leeds - in Rothwell, Beeston, Middleton and Morley. They will run between the hours of 3 and 6 pm, thus giving the opportunity for young people to call in on their way home from school.
Specially trained key workers backed by ready access to paediatric, dietetic, psychology and exercise consultants will staff the sessions. The staff will also work with community services and local leisure centres. The underpinning philosophy will be to aim for relatively modest changes in weight while establishing sustainable changes in lifestyle. This could have a better long-term impact than radical programmes that give rapid results but are difficult to sustain.

Children and teenagers will be able to refer themselves. However recruitment will also be via other channels such as professional referral, school nurse or teacher recommendation. Each child will be assessed, weighed and measured and will receive an individualised management plan focusing on a healthy balanced diet, physical activity and behaviour modification. The focus will be on family change as well as on the individual child, taking into account the thoughts and wishes of the children. Parents and carers will be involved although teenagers may also be seen on their own. Where appropriate or if desired the children will be introduced to each other, and group work about diet, activity and healthy lifestyles may also be included.

WATCH IT! is a joint project between East Leeds PCT and the University of Leeds. It is funded by Health Action Zone money.

What is new about the project.

Up until now successful projects at other centres have been dependant on highly trained staff at significant expense. A survey of representatives from general practice, school nursing, dietitians and health visitors in Leeds has shown that these professions have neither the time nor the resources to devote to the management of childhood obesity in those patients who have no other medical problems, thus the WATCH IT!

Project would test the feasibility of employing individuals with backgrounds not necessarily in the health professions, and training them to the task.

The project will attempt to not only address diet, but also to change the children’s activity levels. Exercise advice will be given but the children will be encouraged to maintain a ‘background activity’, such as walking to school or town, getting up to change TV channels and using stairs instead of escalators or lifts.

Lastly, traditionally medical services are seen as paying inadequate attention to the users’ views. The foundation of this project will be an adequate consultation process with a strong focus on the children themselves. We shall listen to their opinions, ideas and suggestions and construct the sort of service that they, their families and their community wish to have.How the project come about
The idea came out of the APPLES project that was run in Leeds in 1996 (research leader - Dr. Mary Rudolf). This was a randomised controlled trial researching ways to reduce obesity risk factors. Nearly 700 children, aged between seven and 11 and spread throughout ten primary schools, participated in the original study. This trial, which involved teachers and parents, examined the diets, nutrition and lifestyle of the children involved. It showed that 1 in 3 eleven year olds were overweight and 1 in 5 were obese. This increase in obesity started around the age of 9 years.

The children were contacted five years later in 2001. 500 were targeted and 65% responded, providing the basis for APPLES II. The youngsters were weighed and measured and also had dental and bone density examinations. The results showed a further increase in obesity measures over the years.

The APPLES Team appreciated that there were significant numbers of children who needed help in tackling their weight problem, and determined to try to provide a solution, while maintaining its interest in preventive work. WATCH IT has received pilot funding to develop the programme, and the next step is to test its effectiveness through a rigorously conducted randomised controlled trial.

For further details please phone
Jenny Holland or Sheila Sive, Project Development Managers
Leeds 0113 392 6352


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