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The Management of Obesity and Overweight

This briefing presents the current evidence from selected good quality systematic reviews and meta-analyses published since 1996. The review will be updated regularly as new evidence becomes available and can be accessed via hda.nhs.uk/evidence. It aims to identify diet, physical activity and behavioural interventions shown to be effective in the management of obesity and overweight, and is intended to inform policy and decision makers, NHS providers, public health physicians and other public health practitioners in the widest sense.

Obesity and overweight are conditions in which weight gain (predominantly fat) has reached the point of endangering health. The prevalence of overweight and obesity has increased rapidly over the past two decades in the developed world and it has been described by the World Health Organization as ‘a global epidemic’ (WHO, 1998). The prevention and management of obesity has
been a national governmental policy concern for a number of years; the Chief Medical Officer’s Annual Report 2002 (Department of Health, 2003) highlighted obesity as ‘the health time bomb’ and recognised that obesity is a growing challenge for government as a
whole.

Since 1980 the prevalence of obesity has nearly trebled in the UK and is continuing to increase. When combining the overweight and obese groups nearly two thirds of men and over half of women were either overweight or obese in 2001 (Joint Health Surveys Unit, 2002). Data from the Health Survey for England (Joint Health Surveys Unit, 2002) revealed that age, education, social class and
prosperity have an important influence on the risk of becoming obese. The prevalence of obesity is also rising in children, regardless of the assessment method used. The Health Survey for England (Joint Health Surveys Unit on behalf of the Department of Health, 2002) reports that a considerable number of children are either overweight or obese – for example, in 2001 8.5% of 6 year olds and 15% of 15 year olds were obese. These findings were based on a body mass index (BMI) above the 95th percentile to represent obese and a BMI above the 85th percentile to represent overweight. The survey also showed that between 1996 and 2001 the proportion of overweight children (aged 6-15 years) increased by 7% and obese children by 3.5%.

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The Management of Obesity and Overweight