Implementation support toolkit
Equitable care
The challenge
Overweight and obesity rates are highest in the most deprived quintile, according to data from Health Survey for England in 2021. Data from Health Survey for England between 2011 and 2019 indicated variation in the prevalence of overweight and obesity in adults by ethnicity, showing different patterns for men and women.
People with severe mental illness were 1.8 times more likely than the general population to live with obesity, according to figures published by Public Health England in 2018.
The prevalence of obesity in people with learning difficulties was 37% compared with 30.1% for the general population, according to figures published by Public Health England in 2020.
The NICE Health Inequalities Briefing on obesity provides more details on the risk factors and wider determinants of obesity, as well as inequalities in relation to prevalence, access to, and experience of, obesity management services.
What support is available
Severe mental illness
NHS England's guidance on improving the physical health of people living with severe mental illness includes a range of health advice including tailored weight management, oral health checks and physical activity assessments. A case study on achieving a healthier weight for people living with severe mental illness is also available.
Rethink Mental Illness' guidance on physical activity and mental health may also be helpful to adults affected by mental illness.
The Royal College of Psychiatrists' intervention framework for people experiencing psychosis and schizophrenia applies to adults and young people. It includes information on assessment, monitoring and care planning around weight and body mass index (BMI).
Learning disabilities
A case study from Somerset NHS Foundation Trust outlines the process of setting up a specialist service for obesity management medications as part of its specialist obesity management service. It demonstrates how the trust has further adapted its service to meet the needs of people with learning disabilities, neurodiversity and genetic causes of obesity.
East London NHS Foundation Trust's quality improvement project on weight management shows how the trust increased BMI monitoring for people with learning disabilities.
The following information from the British Dietetic Association (BDA) may help when offering dietary support to people with a learning disability:
The BDA also has a child and adolescent mental health (CAMHS) specialist subgroup where registered dietitians can access resources to support them in giving dietary advice.
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