Centre for Applied Obesity
Tackling obesity through a focus on those most in need
Innovative research impacting international, national and subnational policy and practice of obesity. Focusing on obesity treatment at scale, our work is benefiting 14,000 clients per annum through our weight management programmes.
The Health and Social Care Act (2012) alongside austerity significantly changed the UK healthcare system, driving localism, further austerity, population action and a significant reduction in treatment services.
Our response maintained a focus on increased reach and impact for those most in need of weight management support, whilst embracing relevant emergent areas aligned to institutional strengths / competencies and to challenge actions that are driven predominantly by ideology than evidence.
Our research, from the early 1990s, informed the development of evidence-informed residential weight loss camps, and child and adult weight management services (via MoreLife – a Leeds Beckett University spinout company) that have had a significant impact on obesity across the life course. With the Choosing Health Policy (2004) outlining the importance of community settings and Obesity NICE Guidance (2006) providing limited information to deliver real-world interventions, we focused our attention on realising the collaborative opportunities of weight management provision (MoreLife) delivered at scale within the public health system (local authorities) using appropriate research methodologies (Leeds Beckett University).
For 30 years, our research has focused on increasing the reach and impact of obesity treatment approaches leading to the formation of the Applied Obesity Research Centre (AORC). Since 2010, we have increased our reach to 30,000 people per year accessing our healthy lifestyle services. Then using this scale to advance our understanding of: attrition addressing health inequalities; digital tools workplace settings and influencing national programmes, such as our pilot for the NHS Diabetes Prevention Programme (NDPP) with NHS England and PHE.
During this time, we have also evolved areas important to our primary goal, including:
- Obesity environment
- Identifying what is known about whole systems approaches targeting obesity, other public health areas and areas outside public health, and how they can be implemented in practice
- Weight stigma
- Digital health
- Identifying local actions undertaken to address obesity
- Developing a new approach to address obesity and other complex public health challenges
Mapping actions at a borough-wide level for the first time helped partners ‘see their place’ in the system and how they could contribute to reducing obesity levels. It also revealed how the borough’s efforts to combat obesity had focused mainly on lifestyle and environmental interventions, highlighting the imbalance between these and actions targeting more ‘upstream’ factors like social disadvantage and inequities.
In 2011, we established a spinout subsidiary company MoreLife, to implement sustainable research findings from our researchers whilst supporting the formulation / investigation of emergent real-world questions. Such an approach was recognised by the NHS Chief Executive Officer (2008). Our work was strongly aligned with policy of the time (Choosing Health, NICE Obesity Guidance 2006). However, with the Health and Social Care Act (2012), there was a major shift in UK and European obesity policy / action with a focus on ‘prevention’ replacing rather than complementing obesity treatment. Despite this we continued our focus on treatment whilst embracing relevant emergent opportunities.
Exemplified by a grant awarded to the AORC with Imperial College London and Qatar University for a five-year prospective study assessing the impact of MoreLife treatment services in Qatari young people, we explored the cultural transition of our evidence-based weight management programme in Qatar. Over 500 children accessed this programme with impacts similar to our UK interventions.
We’ve worked with WHO Europe to challenge the EU Action Plan on Childhood Obesity (2014-2020) given its predominant focus on prevention, through publications demonstrating the scale of severe obesity and necessary action to ensure those most in need are appropriately supported.
National /subnational impact
Interventions – Our reach has increased from approximately 1,000 (2010) to over 30,000 people (2020) accessing healthy lifestyle support (14,000 weight management services).
In 2016, we were commissioned to deliver the Suffolk County Council (SCC) Integrated Public Health Service (£39m) ‘OneLife Suffolk’, delivering prevention and targeted healthy lifestyle interventions for adults and children. Our weight management services achieve targets of 5% (clinically significant) weight loss, with 60% of clients from the 40% most deprived communities. In 2019 MoreLife were commissioned through a £7.5m investment to deliver specialist weight management services across Greater Manchester for 12,500 adults and children.
The following emergent areas were also pursued to support our intervention developments and to engage with other relevant and interconnected themes:
Given attrition is a challenge for obesity interventions, we’ve worked with academics from our computing department implementing evidence-based digital tools. With COVID-19 (2020) we transferred 8,000 clients to digital support within a week.
Underpinning our above actions has been regular engagement with key agencies and officials. Our research has led to UK Government policy and practice recommendations:
- Health and Social Care Committee Select inquiry into child obesity
- All-Parliamentary Group on Obesity Report
- Kings Fund report
- The Centre for Social Justice ‘Off the scale’ report
- We believe this has directly informed the Government’s Child Obesity Plans (1-3) and NHS Long Term Plan (with obesity treatment now strongly featured)
Through our interventions we recognised the value of key physical environment metrics to target and support individuals more effectively. Our work also highlighted weaknesses of national policy beliefs / actions, which we felt were distractions to genuine action, for example, policy on food outlet proximity and obesity
Our work is influencing national organisations’ obesity and public health policy, workplaces and education centres and schools (for example, anti-bullying policy). We have developed professional society guidelines on weight stigma and discrimination with Obesity UK (a charity with approximately 20,000 members, co-founded by Professor Gately in 2010) and Association for the Study of Obesity
PHE commissioned AORC to deliver a WSA Obesity (£1m) (2015), we co-developed a process and guide with 90 local authorities across England. Published in July 2019, the WSA guidance and evaluation were launched in a PHE Health Matters webinar. Chaired by Duncan Selbie (Chief Executive of PHE) and including Leeds Beckett University’s Joanna Saunders, over 700 individuals signed up, the largest ever audience for a Health Matters webinar. Since the launch, the guide is also cited within recent PHE guidance on:
- Physical activity - prevention and management of long-term conditions
- Community-centred public health: taking a whole system approach
- Using the planning system to promote healthy weight environments, and Childhood obesity trailblazer programme
To date (1st April 2020) there have been 4,923 downloads of the guide and 985 downloads of the learning report
Outputs and recognition
- Gately PJ, Sahota P, Cooke CB, McKenna J, Radley D, South J, White A, White J, Bagnall AM, Gorse C, Tench R, Riley J. A whole systems approach to tackling obesity, Public Health England, 2015-18. £1,000,000
- Nobles JD, Griffiths C, Pringle A, Gately P. Design Programmes to Maximise Participant Engagement: A Predictive Study of Programme and Participant Characteristics Associated with Engagement in Paediatric Weight Management. Int J Behav Nutr Phys Act13, 76 (2016)
- Kulendran M, King D, Schmidtke KA, Curtis C, Gately P, Darzi A, Vlaev I. The use of commitment techniques to support weight loss maintenance in obese adolescents. Psychol Health. 2016 Nov;31(11):1332-41
- Staniford, L.J., Radley, D., Gately, P., Blackshaw, J., Thompson, L. and Coulton, V. (2020), "Employees' experiences of participating in a workplace-supported weight management service: a qualitative inquiry", International Journal of Workplace Health Management, Vol. 13 No. 2, pp. 203-221
- Bagnall AM, Radley D, Jones R, Gately P, Nobles J, van Dijk M, Blackshaw J, Montel S, Sahota P. Whole systems approaches to obesity and other complex public health challenges: a systematic review. BMC Public Health. 2019;19(1):8
- Nobles J, Christensen A, Butler M, Radley D, Pickering K, Saunders J, Weir C, Sahota P, Gately P. Understanding how Local Authorities in England address obesity: a wider determinants of health perspective. Health Policy. 2019;123(10):998-1003
- Griffiths C, Frearson A, Taylor A, Radley D, Cooke C. A cross sectional study investigating the association between exposure to food outlets and childhood obesity in Leeds, UK Int J Behav Nutr Phys Act11,138 (2014)
- Flint, SW, Nobles, J, Gately, P and Sahota, P (2018) Weight stigma and discrimination: a call to media. The Lancet Diabetes and Endocrinology, 6 (3). pp. 169-170. ISSN 2213-8587
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