Lambeth Specialist Healthy
Weight Project
Vanessa Impey- Paediatrician
Deborah Thompson- Specialist Dietitian
Prevalence of obesity by Local Authority
Year 6 children (age 10-11 years) resident in London, NCMP 2009/10
Low prevalence
High prevalence
http://www.noo.org.uk/visualisation/eatlas
© NOO 2011
Child obesity: BMI ≥ 95th centile of the UK90 growth reference
Childrens Weight:Lambeth Context



NCMP data - Levels of obesity (2010/11)
Reception - 11.6%
Year 6 - 24%


Consistently above average for London and
England for both age groups.
Lambeth Specialist Healthy Weight
Project




4
5
Aims for a change in how we deliver a
healthy weight service
A whole system or integrated approach
Systemic Family Therapy principles and
practice
Families as resourceful
Principles and practice - examples
working
non
with the whole family in mind
judgmental
wider
contextual and social factors - communities and
cultures
reaching
out - bridging hospital and clinic
multi
disciplinary and multi agency - joined up
working between health, family, activity and diet
team
5
6
learning - what are our beliefs and experiences
relating to health and diet?
The process of our work









Working as part of the Lambeth Healthy Weight Care
Pathway
Initial referral
Two initial home visits / appointments
Full assessment including health checks
Plan and set up goals
Weekly sessions until three month review
3 month review includes height/weight checks along
with some re-evaluations
Appointment frequency to be assessed at this point
Until 6 month review
Physical Activities - aims




Encourage and support families to make
changes to current activity levels.
Identify local community sessions activity
sessions for families.
Promote the long term benefits of regular
physical activity.
Assess children's cardiovascular responses
to exercise over project time frame.
Dietetic Therapy





Aim of dietetic therapy:
To assess nutritional status
To identify the main dietary causes of weightgain
To provide nutritional education
To support family with making dietary
changes
Paediatric input




Full health and medical check
Screening out underlying causes
Looking at the impact of obesity on the child
Blood tests taken
Family Therapy input





The team works under a systemic umbrella.
Connecting medical, physical, dietetic and
emotional/psychological/, mental health
issues
Family patterns and underlying issues can be
worked with
Experiences of health and health care
professionals
Seeing weight issues as having a ‘logic’
within a family.
Case Examples include:

Working with the impact of:

parental mental health issues
parental experiences of violence
learning difficulties
bereavement
significant child mental health issues




Success and challenges









12
appointment attendance improved
engaging with families where other services don’t
higher referral of children with special needs
referrals to other services including adult community services
referrals of families which appear to fall between gaps
success in dietetics, physical health and parenting strategies all
identified in quarterly reports
families referred for medical investigations as necessary which
wouldn’t have been picked up elsewhere
identified children with vitamin deficiencies
Changes in personnel
Making connnections :







Social services were contacted and asked to cascade down
Links were made with consultants at St Thomas’s
Increased links with paediatricians at the Mary Sheridan Centre
Links were made with dieticians in Lambeth (Community) and
at St Thomas
Links have been made with GP surgeries at Clapham Common
, Mawby Clinic Gracefield Gardens and meetings arranged to
discuss the project in more detail
Team members are taking in project posters to schools when
they visit
The team gave out fliers at Gracefield Gardens Anniversary day
and made some links with other health professionals
Referrals to the service: how you
can work with us




Identify families where children are aged
between 4-12 with a BMI of over 98.
Where there are psychosocial issues or other
complexities
Where families may have tried a Tier 2
service. If not, would that be helpful now :
Ready Steady Go instead?
Families must agree to a referral
Any Questions