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Tackling Obesity and
Overweight Matters in
Health and Social Care
Second Edition
Edited by
Ruth Chambers
and
Paula Stather
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
Second edition published 2022
by CRC Press
6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487–2742
and by CRC Press
4 Park Square, Milton Park,Abingdon, Oxon, OX14 4RN
CRC Press is an imprint of Taylor & Francis Group, LLC
© 2022 Ruth Chambers and Paula Stather
© 2022 Cartoons by John Byrne. http://johnbyrnecartoons.com
First Edition published by Radclife Medical Press ltd 2002
This book contains information obtained from authentic and highly regarded sources.While all reasonable
eforts have been made to publish reliable data and information, neither the authors nor the publisher can
accept any legal responsibility or liability for any errors or omissions that may be made.The publishers wish
to make clear that any views or opinions expressed in this book by individual editors, authors or contributors
are personal to them and do not necessarily refect the views/opinions of the publishers.The information or
guidance contained in this book is intended for use by medical, scientifc or health-care professionals and is
provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of
the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines.
Because of the rapid advances in medical science, any information or advice on dosages, procedures or
diagnoses should be independently verifed.The reader is strongly urged to consult the relevant national drug
formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their
websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book.This
book does not indicate whether a particular treatment is appropriate or suitable for a particular individual.
Ultimately it is the sole responsibility of the medical professional to make his or her own professional
judgements, so as to advise and treat patients appropriately.The authors and publishers have also attempted
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ISBN: 978-1-032-18951-2 (hbk)
ISBN: 978-1-032-18947-5 (pbk)
ISBN: 978-1-003-25712-7 (ebk)
DOI: 10.1201/9781003257127
Typeset in Bembo
by Apex CoVantage, LLC
Contents
Disclaimer vii
Acknowledgements ix
About the Editors xi
About the Contributors xiii
List of Abbreviations xv
Introduction: Focus on Obesity and Overweight as a Priority 1
1 The Scale of the Problem—Overweight and Obesity 7
2 Managing Child Overweight and Obesity 23
3 Managing Adult Overweight and Obesity in Primary Care 33
4 Managing Diabetes and Prediabetes 65
5 Digital Approaches to Weight Management 77
6 Diferent Dietary Approaches 91
7 Alternative Approaches: Behavioural Therapy, Physical
Activity and Other Techniques to Support Planned
Weight Loss 101
8 Drug Therapy for Obesity 123
9 Surgical Treatments of Obesity 133
v
Contents
10 Calculating the Costs of Overweight and Obesity 147
11 Successful Patient Stories—Learning from Them 151
Appendix 1. Shared Management Plan for a Person Who Is
Overweight or Obese and Already Motivated to Reduce
Weight—Signed Up to an Interactive Text Messaging Service 159
Appendix 2. Useful Resources 165
Index 169
vi
Disclaimer
Whilst every efort has been made to include accurate and up-to-date
information about best practices in the management of people who are
overweight or obese and signposted resources such as hyperlinked websites,
knowledge and understanding are constantly evolving and being updated.
Please use the content of this book to learn more about how you can
enhance your delivery of care for weight management and weigh up the
choices, information and guidance for your patients’ or service users’ own
circumstances in your health or care setting. The content is not a substitute
for national advice and guidance from professional or regulatory organisa-
tions. Inclusion of named agencies, websites, companies, services or publi-
cations in this book does not constitute a recommendation or endorsement.
vii
Acknowledgements
We should like to thank the previous contributors to the frst edition of
this book, Obesity and Overweight Matters in Primary Care: Dr Gill Wakley,
Dr Ian Campbell, Dr David Haslam and Dr Peter Stott, and recognise that
we have built on and extended the original material they originally wrote
for this second edition of the book.
ix
About the Editors
Dr Ruth Chambers, FRCGP, MD, OBE
Ruth has been a general practitioner for 40+ years. She is an honorary pro-
fessor at Stafordshire University and also Keele University. Ruth’s previ-
ous research interests have focused on self care, efective ways of working,
stress in health professionals and many other health-related themes in vari-
ous healthcare settings—most recently technology-enabled care services in
the NHS. She is also co-director of Alegre Ltd, the company signposting
‘My Health Kit’ aids. Ruth has worked with the Royal College of General
Practitioners, Department of Health/NHS England and other healthcare
organisations on various projects over the last three decades. Ruth has
written 77 books, mainly for health professionals, but 5 have been for the
general public on stress, heart disease, back pain and assistive technology to
empower people to self-care; 4 of the books have been translated into other
languages—Japanese, Italian and Korean. Ruth has been interested in obe-
sity throughout her career since undertaking original research into adipose
cell size in relation to age of onset of obesity for her frst healthcare degree.
Dr Paula Stather
Paula has previously worked for 21 years in a GP surgery in Stoke-on-Trent
and held a variety of roles, where she gained valuable practical experience
within a primary care setting. She has more recently been working as proj-
ect co-ordinator for an NHS-funded digital reach and digital inclusion
project. This programme of work involves promoting digital transforma-
tion to empower patients to use technology to assist them in managing
their long-term conditions and their self-care.
xi
About the Contributors
Mr Chandra Cheruvu, MS, FRCS (Glasgow), FRCS (England), FAMS
Mr Chandra VN Cheruvu is a consultant bariatric, laparoscopic and upper
gastro-intestinal surgeon at the University Hospital North Midlands where
he has been instrumental in developing a complex variety of advanced
laparoscopic procedures. He also specialises in bariatric, benign upper gas-
trointestinal problems, operating regularly on the oesophagus (gullet) and
stomach. He has had a special interest in keyhole (laparoscopic) surgery
since 1993, and it forms a major part of his practice. He started undertaking
bariatric surgery in 2002. He established the upper GI cancer and bariatric
surgical centres in Stoke-on-Trent. He has considerable clinical research
and teaching interests with Keele University Medical School and has held
many regional and national advisory posts. Mr Chandra Cheruvu is the
author of Chapter 9 in this book relaying best practices in delivering bar-
iatric surgery.
Dr Seyi Ogunmekan, FRCGP
Seyi did his undergraduate medical training in Nigeria before completing
his GP training in Scotland. He has been a GP partner in Stoke-on-Trent
since 2003. Seyi is a GP trainer and clinical teacher with Keele University
Medical School and was awarded the Fellowship of the Royal College of
General Practitioners in 2013 in recognition of his local leadership on dia-
betes matters. Seyi is the GP lead for the local Diabetes Clinical Network
and advises local commissioners on diabetes care. He has co-authored aca-
demic papers which have been published in journals such as the British
Medical Journal and Midlands Medicine. Seyi has helped to devise the popular
Diabetes Question Time educational event for clinicians, which has been
held in Stafordshire twice a year since 2015; he shares his expert insights
xiii
About the Contributors
on diabetes alongside diabetes consultants, diabetes nurses, podiatrists and
dietitians. Seyi loves to communicate key insights on managing diabetes
to patients, too, when speaking on local radio. Dr Seyi Ogunmekan is the
author of Chapter 4 in this book relaying best practices in managing diabe-
tes from the health professional’s perspective.
xiv
Abbreviations
BMI body mass index
BP blood pressure
CBT cognitive behavioural therapy
CHD coronary heart disease
CVD cardiovascular disease
EWL excess weight loss
GDP gross domestic product
GDPR General Data Protection Regulation
gm gram
GP general practitioner
GPS global positioning system
HbA1c glycated haemoglobin
HDL high density lipoprotein
ICS integrated care system
IG information governance
IT information technology
Kcal kilocalorie (1000 kcals equivalent to 4.2 megajoules)
Kg or Kgm kilogram
LDL low-density lipoprotein (cholesterol)
LRYGB laparoscopic Roux-en-Y gastric bypass
LSG laparoscopic sleeve gastrectomy
m metre
mph miles per hour
NAFLD non-alcoholic fatty liver disease
NHS National Health Service
NICE National Institute of Health and Care Excellence
NNT number needed to treat
xv
About the Contributors
OSA obstructive sleep apnoea
PAF population attributable fraction
PCN primary care network
PDP personal development plan
PE physical exercise
QOF Quality and Outcomes Framework
QOL quality of life
RYGB Roux-en-Y gastric bypass
SWOT strengths, weaknesses, opportunities and threats
UK United Kingdom
xvi
Introduction
Focus on Obesity and
Overweight as a Priority
Weight management and, in particular, obesity can often seem like very
emotive topics for clinicians to discuss with their patients, especially if the
patient seems unaware of their overweight status or does not want to dis-
cuss or address it. However, with rates of obesity high and rising, particu-
larly in deprived communities, clinicians need to be able to empower their
overweight and obese patients to self-manage their condition and connect
them with resources and opportunities to access advice about their diet,
nutrition and exercise as well as to arrange appropriate referrals to specialist
weight management, diet programmes and other interventions.
We hope that this book enables you to:
• Understand the complexity of problematic weight and obesity
• Understand the causes of obesity in the context of the wider deter-
minants of health
• Raise your awareness of the approaches you can take with patients
or service users who are overweight or obese to support their long-
term weight loss
• Increase your confdence and capability in delivering good-quality
weight management care for people who are overweight or obese
to move them along the stages of change
The challenges for health and care teams are to help:
• To proactively prevent children and adults from becoming over-
weight and then obese
DOI: 10.1201/9781003257127-1 1
