Obesity, Community health and Social care in Scotland

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Introduction

World Health Organisation (2011) (WHO) defines someone that is obese as someone who has a Body Mass Index (BMI) of greater than 30. “BMI is measured by a person’s weight in kilograms divided by the square of the person’s height in meters (Kg/M2)” (WHO, 2011). This assignment will look at obesity and how it affects community health and social care; this will be done by looking at local and national policies and guidelines, influences across the lifespan, services and agencies available to help with obesity, and the relevance to nursing practice.

Policies and Guidelines (Local and National)

The Scottish Government has set out a strategy to help prevent obesity; Healthy Eating, Active Living: An action plan to improve diet, increase physical activity and tackle obesity (2008-2011) is a strategy that aims to explain how the Scottish Government will improve Scotland’s diet, and encourage greater exercise in order to establish a base to tackle obesity, and support people to achieve and maintain a healthy weight are targeted mainly towards those at greatest risk of health inequalities (Scottish Government, 2008). A main objective of the strategy is to improve and maintain natural and built environments to encourage a more active lifestyle, providing opportunities for activities like walking, cycling, and swimming with the aim of preventing obesity in Scotland. (Scottish Government, 2008) with in the strategy it also states it aims to “Promote healthy food choices, meal preparation and eating habits by communicating practical achievable steps towards the consumption of a healthier diet.” (Scottish Government, 2008 p.19). Specific action plans will be put into place to support people to make healthier choices including: introducing a cooking bus that will highlight the importance of food and nutrition for schools and communities, It will allow people to develop a better understanding on how to eat healthier and what food can do to your health. (Scottish Government, 2008)

Hungry for Success was developed by the Scottish Government (2003) and introduced nutritional guidelines for school meals. The Scottish Standards indicate that oily fish should be served at least once a week and processed meat products only once a week; Brown bread should always be on offer; and  there should be  at least  two helpings of vegetables and two of fruit on every menu each day (Scottish Government 2003).

The Scottish Intercollegiate Guidelines Network (SIGN, 2010) have released guidelines called: Management of Obesity: A National Clinical Guideline (SIGN 2010). This is after realising that “obesity in Scotland has reached epidemic proportions and its prevalence is increasing. The impact on physical and mental well-being is now recognised at a national level” (SIGN, 2010 P.1) The guideline aims to provide evidence based advice for the prevention and treatment of obesity in the clinical area (SIGN, 2010) It does this  by looking at targets as and evidence based recommendations.  Some recommendations include: weight loss targets should be based on the individual’s comorbidities and risks, rather than their weight alone, and weight management programmes should not exclude patients with binge-eating disorder. (SIGN, 2010)

Within Dumfries and Galloway a strategy has been developed by a multi-agency working group, with the help and support of local communities to help reduce and prevent obesity.  The main aim of the Physical Activity Strategy (2008 – 2011) (Dumfries and Galloway Council, 2008) is to improve the health and wellbeing of the local community through the promotion, provision and support of various physical activity initiatives (Dumfries and Galloway Council, 2008). Within the policy it made clear that obesity levels in Dumfries and Galloway are alarming as the level of obesity and overweight in Dumfries and Galloway has increased from 10% in 1995 to 20.3% in 2007, meaning it has the highest percentage in Scotland (Dumfries and Galloway Council, 2008). The policy states that the rise of obesity means that other diseases such as diabetes are becoming increasingly common, this has a detrimental effect on the economics of the healthcare system; it estimated that Dumfries and Galloway alone spend £5.2 million a year to treat obesity (Dumfries and Galloway Council, 2008).

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Influences across lifespan

When hoping to conceive, being obese can cause complications and reduce the chances of conception by 50% (Ward, 2012). Brewer & Balen (2010) showed how weight loss can lead to a higher chance of conception and that 67 out 87 obese women who lost weight managed to conceive previously they were infertile.

According to a study by Toschke, Montgomery, Pfeiffer et al (2003) smoking while pregnant increases the risk of being obese later in life. Women who are obese during pregnancy increase their risk of disorders that affect the pregnancy outcome, these include: ...

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