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
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
WATCH IT! is a joint project between East
Leeds PCT and the University of Leeds. It
is funded by Health Action Zone money.
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 childrens
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
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.
further details please phone
Jenny Holland or Sheila Sive, Project Development
Leeds 0113 392 6352