Public Health Intervention Plan for Obesity in the UK

This paper provides a public health intervention plan for obesity in the UK, focusing on prevention and maintenance. It discusses the types of interventions, their necessity, and ethical implications. The plan includes actions to promote healthy food and physical activity. The interventions are evidence-based and address the 5 models of health promotion. The paper concludes by highlighting the effectiveness of preventive strategies in reducing obesity prevalence.

Introduction
This paper is going to provide a public health intervention plan helpful for the people in UK
suffering from issues related to obesity. After analyzing data from previous statistics, it will
focus on the decision to take public health action and in this purpose it will also provide a
public health intervention plan as per the requirement. The paper will also discuss the types
of interventions along with its necessity for the health disorder, and at the same time it will
put a closer look on the mismatches if any. Discussing in brief about the history and
background of the policy or intervention, it will state what ethical implications are required to
follow to execute the plan. Finally the paper will conclude summarising the main points
precisely. People in UK suffer from various kinds of health disorders and one of them is
obesity. It has become one of the greatest concerns among the people of the country as well
as it has become an increasing threat for the healthcare industry. This rapidly growing public
health problem is a chronic disorder impacts the lives of people. Excessive fat accumulation
in the body is one of the leading causes of obesity (Lloyd et al. 2018). The specific health
disorder contributes in many other health issues such as osteoarthritis, coronary heart disease,
diabetes and many more. It is also responsible for the increasing risk of certain kind of
cancers and other extremely serious life-threatening health issues. Various reasons are
considered as the leading causes of obesity. It never happens overnight, but rather, it
gradually develops over the time. Poor and unbalanced diet, lack of physical activity, genetics
and some other medical reasons play major role in the contribution to the occurrence of the
health disorder (Wilkie et al. 2016). Even, people who living in an environment that
facilitates high energy-intake also a leading cause of obesity (Brehm and D'Alessio 2014).
Background

Obesity is termed as the condition that is associated with excess body fat. It can be measured
by calculating the body mass index (BMI), dividing weight in kilograms by height in metres
squared. A person with a body mass index of 30 and over is classified as obese (nhs.uk.
2016). However, according to literature, BMI is just a score and it cannot provide profound
insight into the biology of obesity and its co-morbidity(Müller, Braun, Enderle and Bosy-
Westphal 2016).
The topic of this assignment is obesity and it is widely associated with the public of UK. The
way, in which the health disorder is increasing among the people of the country, it can easily
be termed as the topic related to the public health concern.
Prevalence of obesity is increasing at an alarming rate in UK and some statistics show that
two thirds of the adults and quarter of children between the age group of 2 and 10 years are
overweight and suffering from various health issues related to obesity (Lobstein et al. 2015).
It is generally found that the obese children are more likely to become an overweight adult
after growing up. Even, analyzing results from studies, researchers expect that by the year
2035, the number of obese people will get doubled (Matthews-King 2018). The recent study
about it indicates a major health risk among the people suffering from obesity. Another
similar report in this regard can be added here to strengthen the evidence on the issue which
is, in the year 2015, the record showed that almost 1.9 million people are suffering from
obesity but in the next two decades, it is expected that it will become close to 5 million
(Department of Health and Social Care 2017). The disorder increases the risk of heart
disease, strokes, diabetes and even cancer. Growth in the number of people affected with
obesity is generally predicted from the annual health report of the country. Various studies
presents the same report that obesity is rising in the UK and it is increasing by 92% which is
quite dangerous for the people and it is a great threat to the healthcare system of UK
(Dearden 2017). However,obesity can be metabolically healthy if the physical condition

including the BP and heart rate is normal argued by some researchers (Skerret 2013)Also,
according to the people of some minority cultures that obesity is healthy and being skinny
can cause various health issues (Sharma 2012).
Obesity is a public health concern and due to this a public health intervention taken as a
preventive measure can work well for the people of the country (Lai 2014). In order to
improve the public health concern, it is important to look upon the factors may be associated
with the prevention of obesity and it will also focus on how awareness can be shared among
the people of the country (Gibson 2016). The public health intervention policy will be
planned in such a way, so that it can decrease the morbidity rate of obesity from the UK. In
this way, it is also possible to reduce the threat to the healthcare system of the country. No
single intervention plan is there for obesity, but a number of interventions and approaches can
be helpful in order to increase the awareness among the people to reduce the rate of obesity-
prevalence (Pienaar 2015). A range of data analysis tool can be helpful to analyse the
background information about the topic and according to the report of statistics, the
intervention plan is generally set. In the next section of the paper, the main public health
intervention plan for the topic obesity in the UK will be thoroughly discussed.
Public health intervention
Type of the intervention
According to the researchers, prevention and maintenance can help people to stay
away from any diseases and obesity is not an exception (Wang et al. 2015). Due to this
reason, the plan is pathogenic, which means, it is highly focussed on the prevention of obesity
and its other health effects. A thorough analysis of the database is highly necessary. Data
found from the detailed literature review will be helpful in organizing the plan in a better
way. The intervention strategy is focused to address the models of health promotion as well.

Evidence
Various professional data and information regarding the public health promotion can
be considered as the main source of evidence. Literature indicates that 5 health promotion
models are there and they are medical, behaviour change, educational, client-centred and
societal change. The health approach will to influence public health through persuasion,
advice as well as instructions (Micallef 2015). A number of current approaches from WHO or
National agencies are involved with the strategic implementation plans that look after the
nutritional status as well as adolescent health to prevent obesity and data from that plans can
be helpful as evidence (Dietz et al. 2015). Number of qualitative as well as quantitative
studies is there in this regard that reflects various intervention strategies to prevent obesity.
Power
When any decision is taken as the public health intervention, it is always made by the
professionals but becomes successful only when support is there from the citizens. In this
health intervention, public support is mostly desired. Single approach will not work well and
due to this reason, multiple approaches will be taken into account as the public health
intervention (Warin et al. 2015). The population based intervention will address the
obesogenic environment. The actions to be taken are listed below.
 Actions to promote healthy food- In order to implement the recommendations
to end the childhood obesity it is important to ensure the nutrition guidelines
as well as information for both adults and children. Childhood care is required
in order to prevent the disease in future and this is why, the preventive
strategies need to be initiated from the childhood. In the provided leaflet of
guidance, there will be information about the consequences of obesity and
overweight. It will consist of the instructions on the prevention of obesity

through the intake of healthy diet. In this regard, Healthy Diet Fact Sheet will
be available as tool containing valuable information. A guide as an approach
to prevent diabetes such as a healthy eating habits and promotion of exercise
etc. for school and university principals will be there so that they can transfer
the information to the children (Adams et al. 2016).
 Actions to promote physical activity- In order to reduce the risk of obesity
among the people of UK, it is important to promote physical activity from the
childhood. It is one of the essential preventive measures of obesity. Guidance
will be provided to the children and adolescence and other people that will
include the effectiveness of physical activity to prevent many harmful
diseases along with the risk of obesity. The guidance will consist of the global
recommendation of physical activity and it must be ensured that every school
will have adequate facilities to promote physical activity. The population-
based guidelines will also contain information about the sleeping pattern as
well as the desired and healthy size of body. Promoting physical activity in
school is highly essential as it is necessary to take preventive actions against
obesity from the early childhood (Micallef 2015). Also awareness among the
people of UK is important and campaigns and agendas must be required in
this regard. The programs will be promoting healthy living habits among
individuals.
All the intervention approaches are effective enough in addressing the 5 model of health
promotions. The first approach is promoting a healthy diet to prevent obesity and in this
purpose, the actions associated with school will be helpful enough in educating the people. At
the same time, it will address a behavioural as well as societal change in medical field which
is contained in the 5 models of health promotion. The specific theory which is underlined in

this approach is the change in behaviour therapy (Stanulewicz, Blake and Griffiths 2017).
The people are suffering from obesity mainly due to their unhealthy food and living habits.
The approaches that will be taken as interventions will be focussing on the change of lifestyle
even from the early childhood as the education program will be started at the school level to
educate the children (Warin et al. 2015). Also the youths of the universities and people from
the region will be considered in the awareness program to promote a healthy eating habits,
exercise and other lifestyle changes in this regard which will be helpful in preventing the
issue.
The type of approaches which is being used are appropriate in order to prevent the main
issues as mentioned at the beginning of the paper. The preventive approaches are considered
as per the need of the patients suffering from such specific health disorder. It will fit well
with the main causal factor as described in the background at the beginning of the paper. The
main cause of obesity is improper food intake, lack of physical activity and many other
diseases (Adams et al. 2016). The interventions are mainly proving and sharing knowledge
regarding the benefits of healthy food intake and inclusion of physical activity in daily
routine. Therefore, it is addressing the main causal factors and it is looking forward to the
prevention of obesity among the people of UK. There is no such mismatch with the topic but
as it is a preventive plan, it will not address the people who are already suffering with this
particular health disorder. But, at the same time the preventive strategies can help them in
maintaining a healthy body mass.
Interventions as per the Ewles and Simnett model is given below:

(Deehan and Wylie, 2018)
This part is addressing comment number 23, written by the student; please add this part in
place of comment number 23 in the final document
The following diagram represents Beattie Model of approach:

(Bo
wden 2016)
This part is addressing comment number 24, written by the student; please add this part in
place of comment number 24 in the final document
For example, some videos can be shown to the children in schools and adolescents in the
workplace to make them aware of the food ingredients which are healthy and which are not.
This part is addressing comment number 25, written by the student; please add this part in
place of comment number 25 in the final document
Various legislative approaches have been taken and one of them is sugar tax. It is a surcharge
on soft drinks and soda. This tax is designed to reduce the excessive consumption of sugary
drink in order to prevent diabetes and obesity related problems. This tax was announced in

the United Kingdom in the year 2016 at a national level. According to the amount of sugar
contained in the drink, the tax is imposed. It has been assumed that this tax will reduce the
number of consumptions. The health campaigners have stated that the tax should be added to
chocolates, sweets and any other confectionary food items in order to reduce their
consumptions.
This part is addressing comment number 26, written by the student; please add this part in
place of comment number 26 in the final document
Researchers found in a study that personal or individual counselling is efficient however,
group counselling can be more cost effective and it will also consume lesser time
comparatively (Phimarn et al. 2016).
This part is addressing comment number 27, written by the student; please add this part in
place of comment number 27 in the final document
In a research, developed many community based strategies in order to address the obesity
needs. The intervention team worked with the communities to implement strategic approach
for the selected framework (Spahr et al. 2016).
Ethics
The preventive strategies used by the physicians might raise various ethical issues. The issues
raised might create barriers to the research as analyzing and understanding of the issue
becomes difficult. At the same time it will also hamper the prevention of the disease. There
can be ethical issue in the primary prevention strategy. In order to reduce the burden of
diabetes and to contain the social as well as the economical cost, there is an urgent need to
consider the public health interventions. Scientific evidence of efficacy is highly required to

be considered before allocating limited healthcare resources. The primary prevention
strategies of diabetes are more likely to be the desirable and cost-effective. If the primary
preventive strategies at the public health level are not taken then the number of uncared and
undiagnosed diabetes patients will increase. The question of dividing the funds between the
primary prevention and the research will raise ethical debates. The lack of motivation, the
bureaucratic controls and corruptions are some factors responsible for the rise of ethical
issues. In this society of having the fascination for technologically intensive as well as
hospital based care is more likely to take precedence over the cost effective measures.
Medical professionals always face ethical dilemmas regarding the economy as the modern
insulin therapies requires high cost but is more helpful in preventing diabetes that the
traditional low cost therapies (Hofmann, Hjelmesæth and Søvik 2013). Gene is a factor in the
occurrence of type II diabetes mellitus and in this type of disease a genetic testing is always
required where the test result of biological members is highly essential. The polygenic nature
of diabetes is a major challenge for the physicians to identify the exact gene source involved
in the disease and thus it requires some new testing and treatments (Philis-Tsimikas and Gallo
2014). Diabetes requires high level of genetic counselling and it causes psychological harm
and emotional impact (Haga 2009). Sometimes, tested individuals might be reluctant in
sharing their personal information to others. Again, those who are willing to share might face
challenges in accurately communicating the results. Sometimes they minimize the
seriousness of the findings. According to British Medical Association, the patients over 12
ages or above have the right to reserve information and without the consent of the owner, any
genetic information can be utilized publicly and also this act prohibits the discrimination of
the healthcare workers and physicians. They are prohibited from requesting or enquiring any
individual to undergo a genetic test without their consent. Secondly a positive result to the
test of diabetes mellitus impacts the normal lifestyle of the entire family. For example, the

adoption of healthy eating habit is easier when the entire family is involved in promoting the
healthy living habits or else it might become an issue. Another issue is the duty of physicians
to disclose the genetic test results to the family members when the patient chooses not to do
so. A number of legal policies are there which prioritizes the patients’ privacy such as Data
Protection Act and others. In these acts, it is unethical to disclose any personal information of
the patients without their consent. Communicating and understanding the issue accurately
might be an ethical challenge for the physicians and misunderstanding the genetics risks
might lead to psychological harms that significantly impacts the life decisions. One of the
most important ethical challenges faced by the healthcare workers while implementing public
health interventions among the diabetic patients is community-related. Individuals might
have different lifestyle according to their specific community standard and convincing them
to adopt new challenges might be challenging. Sometimes, patients with different cultures
might not prefer to have the proper diet intake required to prevent diabetes (Singh, Cinnirella
and Bradley 2012). Again, language could be a major barrier in convincing the patients of
different cultures (Rebolledo and Arellano 2016). Cultural beliefs and values may limit the
use of insulin among the patients of different cultures (Patel et al. 2017). Even, it can also
affect the cultural perspective of any community. In some cultures, lifestyle is different and
the way they live, the food they eat is different. Acquiring a different lifestyle, eating habit
and accessing new ways of physical activity and exercise can be difficult for diabetic patients
of any specific backward community. Lack of knowledge and involvement to the
standardized lifestyle can be a barrier in implementing public health interventions.
Public health interventions invariably raise various ethical issues as they are focused to
influence the lifestyle and views of the people. It will be initiated by a non-governmental
organization with the government support so it will raise some specific ethical concerns
which are related to infringing the privacy of people by interfering into their personal life and

obtaining their personal health data and information (Tsuda 2016). The interventions will be
addressing obesity and thus it may have unintended adverse effects on the psychological
wellbeing of people. In this intervention strategy, schools will be included to share
information related to the prevention of obesity and due to this, informed consent must be
obtained from the participating schools, and universities of UK. Parents of the children might
not accept the procedure of diabetes testing among their children and hence, individual
consent will also be obtained in this regard in order to avoid ethical concerns. The parents of
the children will also be informed and while making the plan, the sources of information such
as various literatures and journals used in the plan will be appropriately referenced. The
schools will be considered as prevention from the early childhood will help them in having a
risk free life in future. However, some selected universities of UK will also be included in
this prevention program.
History and policy of the intervention
Controlling obesity is one of the highest priorities of the public health practitioners and in this
regard, various health campaigns were organized by health agencies in history. In order to
improve the dietary quality of citizens, some community health interventions or approaches
have been taken by many government agencies as well as nongovernmental organizations in
past in UK (Walls et al. 2011). In the year 2011, a module based cocktail approach was
initiated by the researchers as the screening strategy. The most recent approach in this regard
was taken in the year 2013, where the two step screening as well as testing methods have
been revised by the researchers for the ease of functioning. In order to prevent the casual
factors UK has launched NHS diabetes prevention program. The national program of UK
specifies 13 sessions over nine months to provide primary care to the diabetic patients (Penn
et al. 2018). The CCG Improvement and Assessment framework also works together to
improve the condition of patients with diabetes. Future research regarding the issue is highly

recommended. In order to prevent the occurrence of diabetes it is highly necessary to increase
the knowledge among each and every individual and even from the childhood the importance
of healthy living habits should be known.
Conclusion
Obesity is one of the leading causes of many diseases and the rate in which obesity is
increasing in UK is highly concerning. Various strategies are involved in removing this
disorder from the lives of people but preventive strategies are assumed to be highly effective
in omitting the disorder from the people of the country. Even in the past also lots of strategies
and policies have been applied as preventive approaches of the disease. If preventive
strategies are followed from the early childhood, it becomes easier to fight against the health
issue. Keeping this in mind, the public health intervention plan is set. It will provide
information and guidelines about the essential activities to prevent obesity among people and
various schools will be incorporated with the implementation of the strategy in this regard.
This paper consists of the plan which states to promote healthy diet and physical activity in
the lifestyle from the early childhood. The paper provides a clear background about the
public health intervention as well. At the same time, it also provides idea about how ethical
issues can be avoided during the implementation of the plan. The paper provides idea how the
plan can be effective in addressing the causal factor of the background. Finally, it can be said,
if support from government and other citizens are achieved then the plan will be successful in
reaching its goal.

References
Adams, J., Mytton, O., White, M., & Monsivais, P. (2016). Why are some population
interventions for diet and obesity more equitable and effective than others? The role of
individual agency. PLoS medicine, 13(4), e1001990.
Booth, H.P., Prevost, A.T. and Gulliford, M.C., 2015. Access to weight reduction
interventions for overweight and obese patients in UK primary care: population-based cohort
study. BMJ open, 5(1), p.e006642.
Bowden, J., 2016. Health promotion models and approaches. In Health Promotion in
Midwifery (pp. 59-72). Routledge.
Brehm, B.J. and D'Alessio, D.A., 2014. Environmental Factors Influencing Obesity.
In Endotext [Internet]. MDText. com, Inc..
Dearden, L. (2017) UK named most overweight nation in Western Europe as obesity rate
rises faster than US [online]. 11th November. Available from:
https://www.independent.co.uk/news/health/uk-obesity-rate-rising-overweight-worst-
country-western-europe-world-us-ranking-oecd-research-a8049451.html [Accessed 23
December 2018]
Deehan, A. and Wylie, A., 2018. Health Promotion: the challenges, the questions of
definition, discipline status and evidence base. Health Promotion in Medical Education:
From Rhetoric to Action, p.10.
Department of Health and Social Care (2017) Childhood obesity: a plan for action [online].
Available from: https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-
action [Accessed 23 December 2018]

Dietz, W.H., Baur, L.A., Hall, K., Puhl, R.M., Taveras, E.M., Uauy, R. and Kopelman, P.,
2015. Management of obesity: improvement of health-care training and systems for
prevention and care. The Lancet, 385(9986), pp.2521-2533.
Gibson, L.A., 2016. A Public Health Approach to Childhood Obesity: The Role of
Econometrics (Doctoral dissertation, University of Sheffield).
Haga, S.B., 2009. Ethical issues of predictive genetic testing for diabetes.
Hofmann, B., Hjelmesæth, J. and Søvik, T.T., 2013. Moral challenges with surgical treatment
of type 2 diabetes. Journal of diabetes and its complications, 27(6), pp.597-603.
Lai, S.Y., 2014. Addressing Childhood Obesity Through the Built Environment: The
Guadalupe Case Sudy.
Lloyd, J., Creanor, S., Logan, S., Green, C., Dean, S.G., Hillsdon, M., Abraham, C.,
Tomlinson, R., Pearson, V., Taylor, R.S. and Ryan, E., 2018. Effectiveness of the Healthy
Lifestyles Programme (HeLP) to prevent obesity in UK primary-school children: a cluster
randomised controlled trial. The lancet child & adolescent health, 2(1), pp.35-45.
Lobstein, T., Jackson-Leach, R., Moodie, M.L., Hall, K.D., Gortmaker, S.L., Swinburn, B.A.,
James, W.P.T., Wang, Y. and McPherson, K., 2015. Child and adolescent obesity: part of a
bigger picture. The Lancet, 385(9986), pp.2510-2520.
Matthews-King, A. (2018) Morbid obesity in Britain due to double by 2035 as inequality
grows, finds study [online]. 25th May. Available from:
https://www.independent.co.uk/news/health/morbid-obesity-double-britain-poverty-
education-employment-study-a8369731.html [Accessed 23 December 2018]

Micallef, C., 2015. Community development as a possible approach for the management of
diabetes mellitus focusing on physical activity lifestyle changes: A model proposed for
Maltese people with diabetes. International Journal of Community Development, 2(2), pp.30-
40.
Müller, M.J., Braun, W., Enderle, J. and Bosy-Westphal, A., 2016. Beyond BMI: conceptual
issues related to overweight and obese patients. Obesity facts, 9(3), pp.193-205.
Patel, N., Ferrer, H.B., Tyrer, F., Wray, P., Farooqi, A., Davies, M.J. and Khunti, K., 2017.
Barriers and facilitators to healthy lifestyle changes in minority ethnic populations in the UK:
a narrative review. Journal of racial and ethnic health disparities, 4(6), pp.1107-1119.
Penn, L., Rodrigues, A., Haste, A., Marques, M.M., Budig, K., Sainsbury, K., Bell, R.,
Araújo-Soares, V., White, M., Summerbell, C. and Goyder, E., 2018. NHS Diabetes
Prevention Programme in England: formative evaluation of the programme in early phase
implementation. BMJ open, 8(2), p.e019467.
Philis-Tsimikas, A. and Gallo, L.C., 2014. Implementing community-based diabetes
programs: the scripps whittier diabetes institute experience. Current diabetes reports, 14(2),
p.462.
Phimarn, W., Paktipat, P., Pansiri, K., Klabklang, P., Duangjanchot, P., and Tongkul, A.,
(2016) Effect of Weight Control Counseling in Overweight and Obese Young Adults. Indian
Journal of Pharmaceutical Sciences [online]. Decemeber. Available from:
http://www.ijpsonline.com/articles/effect-of-weight-control-counseling-in-overweight-and-
obese-young-adults.html [Accessed 2 April 2019]

Pienaar, A.E., 2015. Prevalence of overweight and obesity among primary school children in
a developing country: NW-CHILD longitudinal data of 6–9-yr-old children in South
Africa. BMC obesity, 2(1), p.2.
Rebolledo, J.A. and Arellano, R., 2016. Cultural differences and considerations when
initiating insulin. Diabetes Spectrum, 29(3), pp.185-190.
Skerret, P.J., 2013 Overweight and healthy: the concept of metabolically healthy obesity
[online]. Available from https://www.health.harvard.edu/blog/overweight-and-healthy-the-
concept-of-metabolically-healthy-obesity-201309246697 [Accessed 02 April 2019].
Sharma, A. M. (2012). Obesity is a sign of good health in some cultures [online]. Available
from: https://www.kevinmd.com/blog/2012/01/obesity-sign-good-health-cultures.html
[Accessed 02 April 2019]
Singh, H., Cinnirella, M. and Bradley, C., 2012. Support systems for and barriers to diabetes
management in South Asians and Whites in the UK: qualitative study of patients’
perspectives. BMJ open, 2(6), p.e001459.
Spahr, C., Wells, A., Christens, B.D., Pollard, E., LaGro Jr, J., Morales, A., Dennis Jr, S.,
Hilgendorf, A., Meinen, A., Korth, A. and Gaddis, J., 2016. Developing a strategy menu for
community-level obesity prevention. WMJ: official publication of the State Medical Society
of Wisconsin, 115(5), p.264.
Stanulewicz, N., Blake, H. and Griffiths, K., 2017. Healthy lifestyle behaviors predict health
promotion attitudes in pre-registered nurses: a questionnaire study.
Tsuda, T., 2016. Recent progress in anti-obesity and anti-diabetes effect of
berries. Antioxidants, 5(2), p.13.

Walls, H.L., Peeters, A., Proietto, J. and McNeil, J.J., 2011. Public health campaigns and
obesity-a critique. BMC Public Health, 11(1), p.136.
Wang, Y., Cai, L., Wu, Y., Wilson, R.F., Weston, C., Fawole, O., Bleich, S.N., Cheskin, L.J.,
Showell, N.N., Lau, B.D. and Chiu, D.T., 2015. What childhood obesity prevention
programmes work? A systematic review and meta‐analysis. Obesity reviews, 16(7), pp.547-
565.
Warin, M., Zivkovic, T., Moore, V., Ward, P.R. and Jones, M., 2015. Short horizons and
obesity futures: Disjunctures between public health interventions and everyday
temporalities. Social Science & Medicine, 128, pp.309-315.
Wilkie, H.J., Standage, M., Gillison, F.B., Cumming, S.P. and Katzmarzyk, P.T., 2016.
Multiple lifestyle behaviours and overweight and obesity among children aged 9–11 years:
results from the UK site of the International Study of Childhood Obesity, Lifestyle and the
Environment. BMJ open, 6(2), p.e010677.