Research suggests clearer guidance needed on specialist childhood obesity services
With an estimated 2.9% of girls and 3.9% of boys suffering from severe obesity, leading to potential cardiovascular disease, type 2 diabetes and other health conditions, the SHINE (an established Tier 3 weight management programme) and Leeds Beckett led research, suggests there is currently a lack of direction and guidance for these children and young people in accessing specialist Tier 3 obesity services.
The research undertaken by SHINE Managing Director Kath Sharman and Leeds Beckett researcher James Nobles was published this week in the British Journal of Obesity, and assesses who should provide Tier 3 services, what Tier 3 services could look like in practice and asks for clarity on funding such services. Tier 3 services or specialist obesity services refers to programmes delivered by specialist providers and targeted at children with more complex, severe obesity.
Childhood weight management researcher, James Nobles, explained: “Despite the fact that children and young people with severe obesity present with complex needs, positive change is achievable through the provision of various interventions moulded to meet the individual needs of each participant.
“Following the launch of a clinical pathways guide on weight management services in 2014, it is clear that there remains a lack of Tier 3 service provision for childhood weight management services. This research supports the notion of an integrated care pathway for children and young people with obesity and severe obesity, acknowledging that current intervention is not able to always meet the need of complex cases. An integrated care pathway would ensure different provisions are available to those families most in need”
The paper outlines Sheffield-based weight management provider SHINE’s (Self-Help, Independence, Nutrition and Exercise) integrated approach to dealing with children and young people with severe obesity through the provision of Tier 3 programmes. It outlines the benefits of a stepped care approach in a community setting as opposed to a clinically based setting, such a hospitals and speciality obesity units.
In contrast to Tier 2 services, SHINE’s approach placed greater emphasis to issues that may contribute to obesity or prevent weight loss such as emotional eating, stress management and building self-esteem. SHINE’s 12 week programmes are designed so that the participants and their families are empowered to make decisions for themselves rather than directly instructing them on what behaviours to do or not to do. As a result of their programmes 91% of the young people helped by SHINE between September 2011 and May 2013 reduced or maintained their BMI scores after three months of completing the programme.
Kath Sharman, Managing Director, SHINE Health Academy explained: “Working with experts at Leeds Beckett University has enabled us to provide an evidence base to help ‘bridge the gap’ in Tier 3 obesity services for children and young people with complex needs. We now need government and Clinical Commissioning Groups to accept there is a deficit and tackle these problems at a higher level to make a difference for this vulnerable group.”
This paper is the first of a three part series which will detail a stepped care approach to delivering weight management services as well as evaluating the impact of the SHINE programme.
James Nobles has extensive experience in working with and on childhood weight management programmes. This is not only in the capacity as a researcher, but one of a consultancy nature whereby he has worked with a number of programmes to identify areas of improvement and suggest potential programme modifications. Alongside the work in weight management, James additionally has a background in workplace health promotion and public health promotion.
Kath Sharman is a Registered Nurse and Child and Adolescent Therapist, and the founder of SHINE, managing services for severely obese children since 2003. Kath is an Obesity Consultant and Trainer across the UK.