Mind over matter when it comes to childhood obesity

Tackling issues such as low self-esteem, depression, anxiety and poor social relationships could be key when dealing with severe adolescent obesity, according to research from Leeds Beckett University.

With the levels of childhood obesity rising, particularly severe obesity, Sheffield based weight management programme, SHINE joined forces with Leeds Beckett researcher, James Nobles to assess the effectiveness of its work using a technique which focuses on emotional problems as well as weight.

SHINE uses a psychosocial intervention method (PSI) which addresses the emotional issues that may be stopping people losing weight, an established Tier 3 programme, it is delivered by specialist providers and targeted at children with more complex, severe obesity.

James Nobles, who led the research, found that SHINE’s PSI method, had been successful when working with 10-17-year-olds.

“Our role has been to retrospectively evaluate participants attending SHINE between 2011 and 2016,” said James.

“We found that SHINE appeared to be effective with 95 per cent of the young people still on the programme at three months, and they had an average BMI reduction of 1.33kg/m2, which is equivalent to a 4 per cent change.

“We noted that anxiety, depression and self-esteem had improved by 50 per cent at three months, 54 per cent at six months and 38 per cent at the nine month mark. These promising results continued to 12 months, with average BMI reductions of 2.41kg/m2 at that time point – a 7 per cent difference.

“We had the data from 435 young people, most of whom had clinical obesity and, or, associated health problems. SHINE collects their BMI and waist circumference at the beginning of the programme and then again at the three, six, nine and 12 month mark.”

James said the programme also took the participant’s psychosocial measurements at the beginning of the programme, these measures included anxiety, depression and self-esteem.

“In light of the recent UK Governments’ Childhood Obesity Plan, we have evidence here to suggest that weight management programmes – when delivered effectively, and in the right setting – can really help young people with obesity.

“We have an estimated 4.5 million children who are overweight or suffer from obesity here in the UK, and the current government plan offers little direct help for those in need. This evaluation showed that PSIs may be able to help young people manage severe obesity and possibly do it to a greater extent than other community-based weight management programmes.”

SHINE Managing Director Kath Sharman, said: “Factors shown to influence obesity include low levels of physical activity, sedentary lifestyles and poor dietary behaviours.

“However, we know that psychosocial factors, such as low self-esteem, depression, anxiety and poor social relationships, often present as underlying causes and attributes of severe obesity

“The SHINE PSI demonstrated positive mean reductions in all measurements across all time points. In contrast to other community-based weight management services, these results suggest that PSIs may be effective in the treatment of severe adolescent obesity, and that further consideration of these interventions is needed.

“Evidence relating to the evaluation of adolescent weight management programmes (WMP) is limited, particularly when assessing those implemented within the UK.

“The National Institute for Health and Care Excellence (NICE) recommends that WMPs focus predominantly on dietary improvement, promotion of physical activity, and behaviour modification. SHINE, while acknowledging the NICE guidelines, goes further to recognise the psychosocial aspects of obesity. A large proportion of the SHINE PSI focuses on developing social relationships, providing techniques for stress management, overcoming bullying, and improving self-esteem. As such, SHINE may be viewed to offer a more holistic approach to weight management than traditional programmes.”

Kath Sharman and James Nobles have worked on a number of additional projects related to SHINE looking at the stepped care approach to obesity and Tier 3 service provision. This study is published in the Journal of Adolescent Health.