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Whole Population Prevention Activity

NOF OBESITY MODEL (version 3.2 Sep 2009) (BMI = Body Mass Index, wc = waist circumference). CHILDREN. ADULTS. Increased risk in children e.g. Type 2 diabetes Tablet controlled T2DM Special circumstances etc. Increased risk in adults e.g.Type 2 diabetes

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Whole Population Prevention Activity

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  1. NOF OBESITY MODEL(version 3.2 Sep 2009) (BMI = Body Mass Index, wc = waist circumference) CHILDREN ADULTS Increased risk in children e.g. Type 2 diabetes Tablet controlled T2DM Special circumstances etc Increased risk in adults e.g.Type 2 diabetes Tablet controlled T2DM Dyslipidaemia South Asian men Established CVD, Sleep apnoea etc TIER 3 Specialist MDT Obesity Service (REFERRAL ONLY) TIER 4 Specialist interventions TIER 1 Primary Activity Population wide basic intervention & prevention TIER 2 Community Weight Management Service (diet/nutrition/lifestyle/exercise education) Examples Bariatric Surgery Very Low Calorie Diets (VLCDs) Examples Carnegie Residential Camps Bariatric surgery PRIMARY CARE SECONDARY CARE COMMUNITY SERVICES COMMERICIAL SECTOR PHARMACY PRIMARY CARE SECONDARY CARE COMMUNITY SERVICES SOCIAL SERVICES Refer to tier 3 or recommend tier 2 as appropriate Refer to tier 3 or recommend tier 2 as appropriate after tier 3 assessment after tier 4 intervention Examples Rotherham Institute for Obesity (RIO) Examples Rotherham Institute for Obesity (RIO) Counterweight after tier 3 intervention if tier 2 intervention exhausted Examples MEND Carnegie Clubs Watch It SHINE If BMI centile > 99.6th centile or > 95th centile with ↑ risk Examples Counterweight Reshape Rotherham Consider alternative methods to engage patients who do not present to healthcare professionals e.g. over the counter options via pharmacists financial incentive programmes on-line diets/support etc. If BMI > 40 or BMI > 30 or wc > 88cm (women) or wc > 102cm (men) with ↑ risk encourage self-referral if referral criteria met after tier 2 intervention Examples GP Health Visitor School Nurse Examples GP Leisure Services Pharmacy Whole Population Prevention Activity e.g. Maternity Matters, UNICEF Baby Friendly, Early Years, Play Path Finder, Healthy Schools, Ministry of Food, Leisure & Green Spaces, Transport & Planning, Workplaces, Built Environment etc Any TIER 3 patient requiring pharmacotherapy will be treated in TIER 3, and this will be reflected in the GP prescribing data for whom the patient is registered NB If patients are considered unsuccessful at any given tier, they automatically progress to the next tier of intervention After intervention, patients progress down through the tiers and back to primary activity (TIER 1) of monitoring and education (every 6-12 months)

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