Support family, quality of life and play when treating obesity in children and adolescents

Future clinical guidelines for treating obesity in children and teenagers should reflect contemporary research addressing quality of life, behaviour change and family-oriented treatments that support nutrition and play.

That’s according to a new study led by RSCI University of Medicine and Health Sciences, which highlights the need for clinical guidelines to incorporate new evidence about treatments – such as exercise therapy, sleep therapy, medications and surgery – and ways to address family poverty, deprivation, access to healthy food and safe places to play.

The research, published in the journal Frontiers in Nutrition examined the main recommendations from nine international guidelines for treating obesity in children and adolescents and is available as a free full text here

The current clinical guidelines for treating obesity in children and teenagers provide recommendations relating to evidence-based approaches to treating obesity in the early years of life.

The researchers say that further information and guidance is needed around how health professionals are trained to assess and treat child and adolescent obesity, optimal ways to address obesity-related stigma and bias, the use of clinical staging for obesity severity and how treatment success should be defined.

They also say that the existing guidelines lack recommendations related to managing limitations in physical fitness or to the transition of adolescents with obesity into adult healthcare services.

“Obesity is a chronic disease that is negatively affecting the physical and mental health of increasing numbers of children worldwide, and rates of obesity are increasing particularly quickly among young people from low-income households,”

“We need to prioritise access to quality care for children who have health complications related to obesity in order to improve their quality of life and slow down or reverse breathing difficulties, joint pain, non-alcoholic fatty liver disease and early type 2 diabetes. Clinical guidelines exist to guide general practitioners (GPs) and other health and social care professionals on how to help children and their families, but to date no-one had looked at these guidelines in a systematic way.”

Dr Louise Tully, RCSI School of Physiotherapy

“For the first time in Ireland we are seeing direct investment in healthcare services for child and adolescent obesity through the HSE’s Obesity National Clinical Programme.

Our clinical guideline work will support health professionals and policy makers, ensuring the design and implementation of obesity services are guided by scientific evidence. Our work also identified clear gaps within existing clinical guidelines for childhood obesity and will help researchers to develop future studies with significant impact for children, families and the health system.”

Senior author on the study and Principal Investigator of the RCSI Obesity Research and Care Group, Dr Grace O’Malley highlights the timeliness of this work.

The researchers systematically reviewed and analysed nine high-quality guidelines. They compared similarities and differences between these guidelines and recommendations, and identified gaps in the current evidence.

“We found that family-orientated treatments are recommended as the first steps of treatment for childhood obesity and that different approaches are needed as the child develops into an adolescent. Unfortunately, very little research to date has focused on the importance of adolescent health and the transition services required for adolescents moving from paediatric healthcare into adult healthcare,”

says Dr O’Malley, who holds a joint position at RCSI and Children’s Health Ireland Child and Adolescent Obesity Service.

 

“Treatment should address a number of different factors in the child’s life to support high-quality nutrition, child development, play, sleep and family dynamics while being delivered by a range of health professionals with training in obesity care.”

The study also identified that a greater emphasis is needed regarding managing complications of obesity, improving quality of life and addressing the practical or social barriers to care, such as food insecurity, limited cooking skills, inadequate housing, and access to safe, fun and age-appropriate active play.

‘Guidelines for Treating Child and Adolescent Obesity: A Systematic Review’ is published as an open access article in Frontiers in Nutrition.

This work will be shared through open access platforms, health professional networks, scientific associations, patient advocacy groups and with health policy makers in Ireland and across the world through our collaborators and stakeholders in obesity research, clinical practice, media and advocacy.

The study was a collaboration between RCSI University of Medicine and Health Sciences, Children’s Health Ireland, University College Dublin, St Vincent’s University Hospital, Dublin, St Columcille’s Hospital Weight Management Service, Loughlinstown, University of Limerick and University Hospital Limerick. The research received funding from the Department of Health – Sláintecare Integration Fund, the Health Research Board, and the HSE Health and Wellbeing Division.

Diagram outlining Approaches to paediatric obesity management for which there was general agreement across included guidelines from high income countries.
(Cite: Tully et al.,2022) Diagram outlining Approaches to paediatric obesity management for which there was general agreement across included guidelines from high income countries.

RCSI School of Physiotherapy: Obesity Research and Care Group

Following two years of virtual only events, the 29th European Congress on Obesity (ECO) was a blended event with both online and attendance in person options in Maastricht, The Netherlands.  The 4-day hybrid event was hosted by The European Association for the Study of Obesity (EASO) in conjunction with the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). The ECO provides a platform for individuals working in the field of obesity and those affected by obesity to convene, share insight, learn together and establish stronger relations across communities, organisations and countries worldwide.

Members of the RCSI Obesity Research and Care Group actively participated throughout the congress presenting the most recent developments in their work and chairing relevant sessions. Principal Investigator Dr. Grace O’Malley and Researcher Niamh Arthurs participated in policy workshops at ECO, contributing to insight and discussion on national plans for obesity and implementation from policy to practice.

Niamh Arthurs presented on behalf of the RCSI Group’s Sláintecare childhood obesity project in a guided poster presentation, that detailed the process involved in developing the online free and CPD accredited childhood obesity training programme for health professionals in Ireland.

Dr. Louise Tully, Post-doctoral Researcher in the RCSI Obesity Research and Care Group delivered an oral presentation on findings from an HRB-sponsored APA project addressing capacity building for childhood obesity management in the Irish health system. She outlined results of a systematic review on clinical practice guidelines for treating child and adolescent obesity. We were very proud of Dr. Tully who won the ‘The EASO Best Thesis Award 2022’ in a highly competitive process (Please read here). Following presentations from the top three scoring theses, Dr. Tully achieved this prestigious award from the EASO Early Career Network (Details here) for her RCSI StAR-funded Ph.D. on the use of digital healthcare for children with obesity. The use of digital healthcare and telemedicine is a topic of importance to health systems globally, particularly since the emergence of the COVID-19 pandemic. Dr. Tully specifically investigated user perspectives on barriers and facilitators for implementing paediatric telehealth, the role of mobile health (mHealth) in paediatric obesity management, healthcare utilisation costs for children with obesity and a cost analysis of delivering mHealth interventions compared to face-to-face care.

Dr. Maeve O’Brien Post-doctoral Researcher from the RCSI Obesity Research and Care Group presented details on the development of a communication toolkit for primary care health professionals working in childhood obesity management. This project is funded by EASO and is a collaboration with the RCSI SIM Centre for Simulation, Education and Research.

All of the conference presentations are published and represent ongoing work from the Group and other collaborators including public patient representatives.

Involving the lived experience was a pivotal feature of each day of the congress. The importance of people-first language was emphasised by delegates choosing to wear a green ribbon stating ‘I’m People First’ on their congress lanyard. In addition, the blinded abstract review process screened for the use of people-first language by submitting authors. Public-patient representatives were welcomed and actively involved in the congress as equal partners including the chairing of sessions, presenting, co-authors on posters and abstracts and as a powerful reminder that obesity affects real life and people.

ECO2022 closed with the announcement that the 30th European Congress on Obesity will be in Dublin from May 17th-20th 2023, Chaired by Dr. Grace O’Malley from RCSI Physiotherapy. Plans and preparations are already in place and after winning this bid as the host country, The Association for the Study of Obesity on the Island of Ireland (ASOI) will ensure ‘céad míle fáilte’ (a hundred thousand welcomes) to all who attend ECO2023.

Ministers welcome 2022 funding for Health Professional Training on Childhood Obesity on European and World Obesity Day 2022

The Minister for Health, Stephen Donnelly TD and the Minister of State with responsibility for Public Health, Well Being and National Drugs Strategy, Frank Feighan TD have welcomed the extension of funding for the Sláintecare Integration Fund project – Childhood Obesity Training in Primary Care into 2022.

One in four children in Ireland are living with overweight or obesity and 1.8% of children have severe obesity. Children living with obesity have a higher risk of adult diseases such as stroke, cardiovascular disease and about 11 different cancers. They also are at risk of other childhood health complications and illnesses. At present, most health professionals do not receive any specific training on childhood obesity.

Facilitating Integration of Childhood Obesity Services in Primary Care through Education was piloted from funding provided through the Sláintecare Integration Fund.  Funding for the continuation of the project in 2022 is being provided by Healthy Ireland. The project aims to equip health professionals with knowledge, skills and confidence to help and support children who have obesity around the country.

The project is a collaboration between RCSI School of Physiotherapy, the Child and Adolescent Obesity Service in Children’s Health Ireland at Temple Street, UCD, GP representatives, the Irish Coalition of People with Obesity and the Association for the Study of Obesity on the Island of Ireland.

Minister Feighan said: “As Minister for Public Health and Well Being, I am keenly aware that disadvantaged children have double the risk of developing obesity. When families look for clinical support to help their children, it is imperative that our health service offers the right help, and that that help is respectful and sensitive.”

“I am delighted that the voices of children who currently have obesity, their families, as well as adults who had obesity as children, have been central to designing the modules that make up this training programme.”

“The theme for World Obesity Day 2022 is ‘Everybody Needs to Act’, and through this training, we are empowering health professionals to act sensitively but decisively to ensure better health outcomes for children in their adult lives.”

The collaborative project is led by Dr. Grace O’Malley of the RCSI Obesity Research and Care Group and Clinical Lead of the W82GO Child and Adolescent Obesity Service in CHI at Temple Street. Collaborating with health professionals including, Professor Clodagh O’Gorman, Foundation Chair & Professor of Paediatrics, University of Limerick the project team aims to build health professional engagement and experience, to enhance knowledge, to address perceived communication barriers and low confidence, and to establish a community of practice.

They had initially aimed to provide training for 75 health professionals through 2020. However, the planned deliverables were exceeded with over 1100 health professionals registered for training and over 750 hours of training completed to date.

Minister Donnelly said: “The innovation the team have brought to this project is uplifting to see, and the results speak for themselves with participants reporting that self-assessed knowledge of childhood obesity has increased 100%.”

“I am delighted to announce that my Department is providing funding for 2022 through Healthy Ireland and I look forward to seeing the outcomes of the next phase of this project as the team aims to move from building health professional knowledge to developing clinical and communication skills, and how to apply them.”

Watch the Sláintecare webinar “Enhancing capacity & skills for the management of chronic conditions” from 18th November 2022 here.

Minister Donnelly further stated: “As children move through their lives to adulthood, they will encounter many healthcare professionals. Community healthcare is a very important part of this care for young people with Public Health Nurses, GPs, Community Dietitians, Community Physiotherapists all having an important role to play.

“The delivery of this free, high-quality training allows health professionals to develop their knowledge and aims to improve access to care for children and adolescents with obesity. By improving training, the project facilitates health professionals to provide children and families with a better patient experience including less stigmatising attitudes from health professionals.”

The LANDSCAPE study team want to hear from healthcare professionals and managers in Ireland who see children and adolescents in their daily practice

The Royal College of Surgeons in Ireland (RCSI University of Medicine and Health Sciences) in collaboration with the Health Service Executive (HSE), are recruiting health professionals and managers from all disciplines, who work in Ireland, to complete an online survey and/or take part in an online focus group on current childhood obesity treatment services in Ireland.

Aims and further details

The aim of this work is to map currently available services and practices in relation to caring for children with obesity and their complications. It is envisaged that this will help develop an understanding of how these services and practices may differ across the country and in various settings in Ireland. It may also provide valuable insight on the potential barriers and enablers for the provision of obesity treatment services in Ireland and identifying the supports needed.

The online survey takes approximately 15-25 minutes to complete, depending on the level to which the health professional or healthcare manager cares for children and adolescents with obesity in their daily practice, either for weight management specifically or for treatment of other conditions. Survey participants will also have the opportunity to add any information that they feel is important and the opportunity to express an interest in participating in a focus group which is also part of this project. Please see further details on the LANDSCAPE focus groups via the participant information sheet available here.

Please access the survey here

For the next part of this study, we will later be undertaking focus groups with healthcare professionals also. You can register your interest for the online focus groups hereThese are open to all health professionals and managers, including those who complete the survey or not. 

All views and participation will be greatly appreciated. Participants can choose to take part in both the survey and focus group or just one of these options.

This work and its analysis will be completely anonymous.

 Obesity in children

Nearly 20% of children in Ireland are living with overweight or obesity1 with 7% estimated to have obesity2 and 1.5% estimated to have severe obesity3. When children develop obesity they can have difficulties with their physical and mental health including: high blood pressure; painful joints; breathing difficulties; anxiety and early development of other diseases.

International health research4 and clinical guidelines5 recommend that children with obesity are offered treatment early in their life in an effort to reduce health complications and the risk of future disease. Evidence based treatment should be available to children in their community and in children’s hospitals depending on the severity of their obesity.

In Ireland we do not know whether children with obesity can get treatment and if they can, where treatment is offered, what it involves and how children and their parents feel about the treatment they receive. We also do not know what health professionals believe is important for their local context in order to offer quality treatment for childhood obesity.

Previous related work

In 2020 the Obesity Research and Care Group at RCSI conducted the Sláintecare needs assessment survey among healthcare professionals in Ireland which related to the provision of health professional training and education for childhood obesity. The Childhood Obesity LANDSCAPE Project follows on from that work with the aim of furthering knowledge on factors that can facilitate or hamper the provision and access to treatment services for children and adolescents with obesity. Completing this survey and taking part in this focus group will enable our research group to delve deeper into the experiences and insights of health professionals and healthcare managers so that services can be improved in an informed and collaborative manner.

The Childhood Obesity LANDSCAPE Project has been funded by the Health Research Board of Ireland’s Applied Partnership Award and the Health Service Executive. Dr Grace O’Malley, RCSI is the principal investigator, and Sarah O’Brien, HSE is the lead knowledge user.

For further information in relation to this survey, please see the Survey Participant Information Sheet available here

For further information in relation to this focus group, please complete the Focus Group Expression of Interest Form available here and the Focus Group Participant Information Sheet available here. If you leave your contact information and consent to being invited, you will be provided with more information about this part of the project in due course.

 

References:

1Mitchell L, Bel-Serrat S, Stanley I, Hegarty T, McCann L, Mehegan J, Murrin C, Heinen M, Kelleher C. (2020). The Childhood Obesity Surveillance Initiative (COSI) in the Republic of Ireland – Findings from 2018 and 2019.

2Layte R, McCrory C. Growing Up in Ireland – National Longitudinal Study of Children: Overweight and Obesity Among 9-Year-Olds. Dublin, Stationery Office; November 2011.

3Bel Serrat S, Heinen MM, O’Malley G, Mehegan J, Murrin C, Kelleher CK. Trends in the prevalence of childhood obesity and morbid obesity in the Republic of Ireland – The Childhood Obesity Surveillance Initiative in 2008, 2010, 2012 and 2015. Obesity Facts 2018;11(Suppl 1):43. DOI:10.1159/000497797.

4Ells, L.J., Rees, K., Brown, T. et al. Interventions for treating children and adolescents with overweight and obesity: an overview of Cochrane reviews. Int J Obes 2018;42, 1823–1833. https://doi.org/10.1038/s41366-018-0230-y.

5National Clinical Guideline Centre (UK). Obesity: Identification, Assessment and Management of Overweight and Obesity in Children, Young People and Adults. NICE clinical guidance 189. London: National Institute for Health and Care Excellence (UK); November 2014.

Young lady with red hair, glasses, vibrant green short sleeved top, black jeans smiling and holding a clipboard while giving a thumbs up!

28th European Congress on Obesity 2021

The 28th European Congress on Obesity (ECO) was held virtually as a 4-day online learning platform in Summer 2021. Members of the RCSI Sláintecare team presented their latest research on obesity and chaired sessions throughout the congress. This included the ‘Physical Fitness and Physical Activity’ session chaired by Dr Grace O’Malley on Day 2 of the congress which focused on ‘Childhood and Adolescent Obesity’. Mckenzie Dow (PhD Candidate) provided insight on the ‘Growing Up in Ireland’ data in relation to self-concept across Body Mass Index (BMI) categories and the need to think about protective factors that may be in place to maintain positive self-concept for children with obesity and at risk of low self-concept.

Dr O’Malley also highlighted important aspects of eHealth for children living with obesity including the necessity of documenting adverse events, safety and cost in all trials and treating patients as humans with their own preferences related to monitoring health outcomes beyond BMI. Furthermore, Dr O’Malley described how to capture meaningful data for modelling overweight and obesity outcomes and how perceptions of treatment can differ amongst service-users; outlining the significance of asking service-users about the meaning of treatment to them in order to inform personalised care.

Louise Tully, another member of the RCSI Obesity Care and Research Group presented her work on Barriers and facilitators for implementing paediatric telehealth: rapid review of user perspectives (Full paper available Here). Ms Tully’s research emphasised the need to assess accessibility and practicality of paediatric telehealth interventions with all users before implementation and to ensure that nobody loses access to care through digitalisation of services. This work was complemented by patient representatives who provided their views on how digital technologies have helped during the Covid-19 lockdowns to include those who cannot travel to appointments or support meetings due to physical issues and how delivering online services can help overcome some financial barriers of face-to-face appointments.

The European Association for the Study of Obesity (EASO) as organisers of ECO actively encouraged the use of people first language. Anyone submitting an abstract to the congress had to first read and accept an abstract submission briefing note on person first language. Included in this briefing was the definition:
Person-first language is the standard for respectfully addressing people with chronic diseases, rather than labelling them by their illness. Whatever disease a person may have, it may not define them as persons or individuals. So rather than saying “obese people” we should rephrase this term aspeople with obesity”.

The patient’s voice was well represented and welcomed throughout the congress with many sessions featuring people with obesity as presenters or panelists. The European Coalition for People living with Obesity (ECPO) delivered several sessions aimed at empowering congress delegates to advocate for those with obesity and ensure the patient perspective is represented in research, policy and guidelines. Additionally, raising awareness and knowledge of the harmful impact of weight bias and stigma was a clear and resounding message throughout.

Communication workshops during the congress were valuable opportunities for healthcare professionals, researchers and other delegates to develop knowledge about discussing weight and obesity. Dr Michael Crotty a General Practitioner (GP) from Ireland, conducted role play examples of a GP communicating about weight in the clinical setting with ECPO patient representatives Susie Birney (Ireland) and Andrew Healing (UK). The Communicating Science Workshop which also featured Dr Michael Crotty offered excellent insight and information on developing translational science tools to support engagement and uptake of information, tailoring scientific messages for public engagement, becoming a public figure in communicating science and getting messages across in broadcast media.

EASO hope to host ECO as an in-person event in 2022 in Maastricht, the Netherlands.
Further details about ECO2021 can be viewed here

Launch of our online training course for health professionals

To mark World Obesity Day 2021, the Sláintecare Childhood Obesity team are thrilled to launch our online training course for health professionals. The course consists of an introductory module (1 hour) and four advanced modules (1 hour each) and is provided for free to health professionals in Ireland thanks to support from a Sláintecare Integration Fund. On completion of the modules CPD points are awarded by RCSI.

The project is led by Dr. Grace O’Malley from the RCSI Obesity Research and Care Group. She commented, “I am so delighted that we are able to provide some concrete support for health professionals interested in child and adolescent obesity and we were honoured to work with the Irish Coalition for People Living with Obesity (ICPO) to develop our course. We hope that we can build on this work to improve knowledge and clinical skills so that children and adolescents with obesity in Ireland can access quality care in every county”.

The project team consisted of health professionals from medicine, nursing, dietetics, physiotherapy and psychology in addition to health researchers, educators and eLearning specialists. The course was developed in collaboration with the W82GO Child and Adolescent Weight Management Service in Children’s Health Ireland at Temple Street, LearnUpon, the Association for the Study of Obesity on the Island of Ireland, the Department of Health in New South Wales and the Children’s Hospital at Westmead, Sydney.

Those interested in taking the course should visit the training page to access the course.

Needs Assessment Training Survey

Sláintecare Childhood Obesity would like to thank the 715 responders to date who have completed our Training Needs Assessment Survey. This survey was designed to assess the attitudes, needs and confidence of health professionals in Ireland in addressing childhood obesity. The findings of this survey will be used to design and develop an online childhood obesity training course informed by clinical guidelines for health professionals and deliver this free of charge to Irish health professionals.

This survey was disseminated from July 2020 at events including the RCPI Obesity Summer School (August 2020) and ECOICO2020 (September 2020). It was also circulated through written and electronic communications to professional bodies and organisations representing the various multidiscipline professions and through online platforms such as Twitter, LinkedIn and relevant organisation websites and newsletters.

Image 1 below conveys the total number (n=) and the overall percentage of respondents from various healthcare disciplines who have completed the survey to date. Nurses at 21% (n=132) have contributed the most responses to the survey, followed by physiotherapists at 16% (n=103), other at 13% (n=81), Physician/doctor self-employed e.g.GP at 11% (n=71),  dietitians at 10% (n=66), physician/doctor employed by the HSE at 8% (n=52), occupational therapists at 5% (n=34), psychologists at 5% (n=29), clinical manager at 4% (n=28), clinical psychologists at 2% (n=14), social workers at 2% (n=12), speech and language therapists at 1% (n=7) and administrators at 1% (n=4). Other includes pharmacists, psychotherapists, dental surgeons, dentists, orthodontists, primary healthcare coordinators, health promotion officers, mental health coordinators, community health workers, environmental health officers, family support workers and paediatric researchers.

: Percentages (and total number) of survey respondents from multidiscipline professions

Image 1: Percentages (and total number) of survey respondents from multidiscipline professions

Image 2 (Below) illustrates the counties in Ireland represented to date by survey responses. Responses have been collected by all 26 counties and every Community Healthcare Organisation (CHO) in the Republic of Ireland. Dublin is the area most represented with 39.71% (n=243), followed by Cork with 9.31% (n=57), Galway 5.56% (n=34), Tipperary 4.58% (n=28), Mayo 3.92% (n=24), Louth 3.59% (n=22), Wexford 3.27% (n=20), Wicklow 3.27% (n=20), Limerick 2.78% (n=17), Kerry 2.61% (n=16), Donegal 2.29% (n=14), Sligo 2.29% (n=14), Kilkenny 2.12% (n=13), Laois 1.96% (n=12), Waterford 1.63% (n=10), Cavan 1.31% (n=8), Kildare 1.31% (n=8), Meath 1.31% (n=8), Offaly 1.31% (n=8), Carlow 1.14% (n=7), Clare 1.14% (n=7), Monaghan 1.14% (n=7), Westmeath 1.14% (n=7), Roscommon 0.82% (n=5), Leitrim 0.33% (n=2) and Longford 0.16% (n=1).

Proportion of counties in Ireland represented by survey respondents

Image 2: Proportion of counties in Ireland represented by survey respondents

There is still time to complete this survey and provide greater representation for your healthcare profession or indeed the county that you live or work in and to have your views heard on childhood obesity training in Ireland. Please complete and share this survey at: https://www.surveymonkey.com/r/RCSIobesity

All-island Obesity Action Forum webinar

The All-island Obesity Action Forum in association with safefood, and the Associations for the Study of Obesity in Ireland (ASOI) and UK Northern Ireland regional group (ASO NI) hosted an online webinar on the 10th of November 2020 titled: ‘The hidden influencer – tackling marketing of unhealthy food to children in today’s digital world.’ The event highlighted the latest evidence on the impact of food and drink marketing to children and young people. It also called upon specific areas for action.

The effect these ads have on children are certainly not to be underestimated

Ms Diane Charlton from the Irish Coalition for People Living with Obesity (ICPO)

The event commenced with the crucial voice of Ms Diane Charlton from the Irish Coalition for People Living with Obesity (ICPO) who shared a parent’s perspective on the impact of marketing unhealthy food to children. Ms Charlton provided key insights on the lasting effects of targeted marketing to children, and the “unhelpful feelings of guilt and shame” it leaves when such marketing leads to consumption of the products. Ms Charlton also emphasised that “the effect these ads have on children are certainly not to be underestimated” and the challenges that digital marketing presents for parents.

Dr Mimi-Tatlow-Golden followed with the most recent evidence on the effectiveness and impact of marketing and in particular digital marketing of unhealthy food to children in Ireland and around the world. She concluded with the inevitable – that advertising of unhealthy food boosts sales and consumption and that advertising to those most vulnerable must be regulated. It was clear that trying to educate and ‘nudge’ healthy choices is impotent in countering the power of advertising of unhealthy foods.

Dr Mimi-Tatlow-Golden on Global Research

Dr Mimi-Tatlow-Golden’s presentation highlighted:

Consumptions studies: Children and teens eat more after viewing ads for unhealthy foods, compared to non-foods or healthy food

  • Holiday camps – TV & game ads (Norman et al 2018a, 2018b)
  • YouTube influencer promotion (Cotes et al 2018a, 2018b)
  • Ads on websites and social media (Buchanan et al 2017 & others)
  • Advergames studies (Folkvord et al)

Exposure and power studies
(Extensive advertising, many platforms)
Conclusions:

  • brands employ strategies to target adolescents and particularly encourage their engagement and increase virality
  • food brands aimed at children are dominated by unhealthy items
  • children (including adolescents) interact with food marketing on digital and social media
  • it results in eating more food (and more unhealthy items)

Dr João Breda from the World Health Organisation outlined national policy options and the WHO/Europe monitoring framework, known as CLICK to assist member states in monitoring digital marketing of unhealthy products to children.

Dr João Breda from the World Health Organisation on Digital Marketing

Dr Dr João Breda’s presentation highlighted the WHO/Europe CLICK framework:

  • We need to be innovative to face the challenge, otherwise, we will be in the same position in five years.
  • CLICK was developed as a futuristic framework, but today several Member States are using it, including an App developed by the NCD office, Moscow.
  • We are piloting it and also undertaking a large validation study in Canada.
  • We have a workshop with six countries piloting CLICK in November. Member States can learn from the experience of others and make the best choice for them.
  • European Regions plans to lead the way to face the challenge of digital marketing, that will include choosing some innovative methods out of our comfort zone if we are to be successful.
  • We hope other countries and regions will also prioritise the issue to face the increasing global challenge.

Dr Frans Folkvord from Tilburg University, The Netherlands discussed how marketing techniques can be used to promote healthy foods. One interesting stance was the influence of the subconscious on behaviour, particularly decision making with subconscious activation of marketing cues and the need

for advertising literacy to make rational decisions. A key message from Dr Folkvord is the necessity for regulation of product placement.

Image of Healthy Foods

The final speaker was Ms Ursula O’Dwyer who provided an overview of the ‘Best ReMap’ work, a European project that Ireland and Portugal are leading.

Presentations and key insights from the event can be sourced here

European and International virtual congress

The European and International virtual congress on obesity (ECOICO2020) emphasised the importance and the necessity of providing adequate training to healthcare professionals on obesity to its 3000+ delegates. Members of the RCSI Sláintecare team presented research and chaired sessions throughout the 4-day congress from the 1st-4th September 2020. The patient’s voice was crucial in raising the issue of weight bias and stigma that exists in healthcare settings.

Research highlighted that there are low levels of healthcare professional training in obesity care. Additionally, lack of healthcare professional training was ranked 2nd globally as a perceived barrier to adequate obesity treatment across 68 countries. Speakers also provided suggestions for training in obesity care. Ideally, training should be inter-disciplinary, encourage continuous and integrated learning and be available online and evaluated. Another suggestion provided was to develop or adapt existing e-learning training packages to be culturally and locally relevant. RCSI with Sláintecare facilitated inter-professional training at ECOICO2020 and are currently developing an e-training course in childhood obesity for healthcare professionals in Ireland.

The Second Annual Obesity Summer School 2020

The HSE Obesity Management Clinical Programme with the Royal College of Physicians of Ireland successfully hosted the second Obesity Summer School which took place as an online event on the 27th of August 2020. This event presented a valuable opportunity for healthcare professionals and the public to gain further understanding and knowledge of obesity and enhance their clinical practice and interactions with those living or affected by obesity.

Dr Grace O’Malley (Obesity Research and Care Group at RCSI and MDT Clinical Lead for the W82GO Child and Adolescent Weight Management Service at Children’s Health Ireland at Temple Street), provided really practical tips for healthcare professionals when communicating with children and their parents/guardians about growth, weight and obesity. Dr O’Malley emphasised trust and empathy as fundamental underpinnings in therapeutic relationships and the importance of discussing growth using appropriate and non-stigmatising language. Communication approaches for example case scenarios were also described and useful resources highlighted. Dr O’Malley encouraged healthcare professionals attending the event to complete our online training needs survey at https://www.surveymonkey.com/r/JB3TR3M and promoted its significance in order to enable this Sláintecare integration fund project with RCSI to build and improve access to training and education in the area of childhood obesity for healthcare professionals in Ireland.

WOF Scope School Global

The World Obesity Federation (WOF) recently hosted its second online SCOPE (Strategic Centre for Obesity Professional Education) School Global in conjunction with the 2nd UAE Obesity Conference addressing the theme of ‘Obesity Across the Lifespan’ from October 22nd-24th 2020. It involved an exceptional line up of speakers from the UAE, GCC, UK and USA including Dr Donna Ryan (Past-President of the World Obesity Federation) and Professor Caroline Apovian (Director, Nutrition and Weight Management Center, Boston Medical Center and Professor of Medicine and Paediatrics, Boston University School of Medicine).

The expert speakers provided key insights on the role of physical activity and appetite regulation in prevention efforts.

Attendees (who were healthcare professionals) were provided with the opportunity to develop a greater understanding of the aetiology and risk factors for obesity, including the current prevalence globally and the association between obesity and its comorbidities (cancer, diabetes, NASH) and the link between COVID-19 and obesity. Additionally, the expert speakers provided key insights on the role of physical activity and appetite regulation in prevention efforts, the complications for patients living with obesity and means of managing the disease. The overall aim of this 3-day school was to equip a healthcare professional (HCP) audience with the knowledge and skills to manage patients presenting with obesity more effectively and to conduct comprehensive initial assessments.

The lack of training for HCPs in obesity management and its knock-on impact on people living with obesity and society were clearly described. This further emphasises the pivotal need for HCP training opportunities globally.

The necessity for HCPs to recognise and treat obesity as a disease was another strongly communicated message and signifies the crucial support and efforts needed by HCPS with wider societal impact to end stigmatisation.