WOD Map

Weight is a very complex issue, and solving it is not as simple as telling people to move more and eat better or by putting everyone on a diet. As well as our individual biology, genetics and behaviour, there are many more factors that affect our weight. For example, how much money we have, where we live, our culture and our family. In decades of public health intervention, nothing has worked in the way we had hoped, including dieting and education.

So, we have taken a different approach! We want to stop blaming individuals and claiming the problem is simply lack of knowledge or willpower. We will support people, value and accept them, and work hard to make their lives fairer.

Our vision is to create an environment where everybody in Doncaster is fully able to pursue their own health goals and are fully supported to do so by society, without judgement or assumptions. They feel valued as an individual just the way they are. Compassion is at the heart of how we move together towards a healthier society for future generations.

To realise our vision, we need to change the way we think, talk and feel about weight and health, and bring everyone along with us.

What have we done so far?

In 2020, we began our Compassionate Journey at Doncaster Council.

This started with building an evidence base through a scoping literature review, developing our Compassionate vision and principles, including what we want to adopt and what we want to reject, mapping the approach locally and embedding our principles into other streams of work. Read more about this here: Doncaster's Compassionate Approach to Weight

We know that a lot of different settings are looking to implement more Compassionate approaches to weight and health, so we set-up a Practice Group, which brings together colleagues from across the country who are passionate about ending weight stigma. The group provides peer support, shares learning, and changes perspectives about obesity.

From November 2021 to January 2022, we ran a public consultation to inform the development of our compassionate approach. This consultation included two public surveys:

Survey 1 asked questions about food, eating, and physical activity, to understand the local factors that influence how decisions are made regarding health and wellbeing.

Survey 2 asked questions about experiences of weight management and weight stigma to understand local attitudes and beliefs about weight and health.

The feedback from the survey has helped to inform our services at Doncaster Council moving forward, and more details can be found on our ‘You said, we did’ webpage.

Using the community insight gathered by our public consultation, we have developed a Compassionate New Year communications campaign. We know that the New Year can be a great time to make an impact for our residents, but we also know that it can feel like there is a lot of pressure to change our lives overnight. Resolutions are a journey of wellbeing goals, not just for January. Sometimes, we blame ourselves for giving up on a resolution – but maybe it is the resolution that’s not working! This year, we provided our residents with positive messages, alternative inspiration, and support through our website, social media pages and in-person engagement, and created a set of resources which promote self-compassion when creating resolutions or goals.

What does 2023 look like?

Continuing our journey to change perspectives in 2023, on the back of our Compassionate New Year campaign, we have further public messaging campaigns in the works, as well as developing a toolkit of training and resources to support professionals to implement a Compassionate approach practically!

For World Obesity Day 2023, on the 4th of March we will be keeping the momentum going from our public engagement and releasing tailored comms to start the conversation with our residents about weight stigma. As part of this, we will also be spotlighting the lived experiences of our community, by sharing a case study from a Doncaster resident, about their experience of weight stigma and the Compassionate Approach!

Get Involved

If you are a health and wellbeing professional interested in implementing a more Compassionate approach to weight and challenging weight stigma in your setting, consider joining our Practice Group to learn from colleagues across the country. Get in touch with us by email: compassionate@doncaster.gov.uk

The Nigerian Obesity Cohort Program is a prequalification pathway to SCOPE Certification for interested clinical medical students in Nigeria.

The program involves completing Step 1 (the Core Learning Path of 8 modules), Step 2 (a minimum of 16 additional modules), and subsequently, Step 3 (clinical postings and a case report on obesity management). On successful completion of the SCOPE program and upon qualification as a medical doctor, the students will be awarded a SCOPE Certificate.

The pilot program is happening in the South-south zone of Nigeria and comprises 26 students. Over 90% have completed Steps 1 and 2 and are currently engaged in clinical postings. Registration scholarships were awarded by the World Obesity Federation (WOF) to students who successfully completed Steps 1 and 2. Since beginning Step 3, the students have been actively promoting obesity education and management and have contributed videos for the World Obesity Day celebrations in 2022.

This program was borne out of an initial desire to provide in-depth knowledge and skills in obesity management to resident doctors in Nigeria, irrespective of their area of specialization. The strategy was to leverage the doctor-patient relationship to begin to tackle obesity in a society where it appears to be culturally and socially acceptable. Generally, our patients do not see their overweight or obesity as a disease requiring medical attention; however, the doctor-patient relationship provides an opportunity for the SCOPE certified doctor to counsel and address obesity issues when such patients seek treatment for other conditions.

It was a challenge to promote and generate interest in obesity education among the resident doctors. During the post-implementation stage, we re-evaluated and changed the strategy to involve clinical medical students soon to be qualified as doctors, with the intention of addressing some of the challenges we encountered with the resident doctors.

The program so far has been successful. Moving forward, the plan is that highly motivated, committed, and successful students within this pilot program will be identified and selected as ‘Youth Ambassadors’ to promote obesity education and SCOPE certification in other medical schools in the country. To make the program sustainable, we plan to promote it in the medical institution and enroll subsequent sets of interested medical students.

Watch the student videos here.

Alina has lived with overweight and obesity since adolescence, and for twenty years was not offered appropriate support. Then she found her local patient organisation and became an advocate. Here is her story.

Transcript:

Hello, my name is Alina Constantin. I live in Bordeaux, France, and I have lived with overweight and obesity since my adolescence.

My obesity is linked to metabolic syndrome and insulin resistance.

My pre-obesity became obesity in my twenties, although I tried having a healthy lifestyle, including physical activity and dietary control, as we were advised back then.

I felt alone for more than twenty years, because I had environmental challenges and I did not receive appropriate medical support, since my obesity was considered a choice, more of a moral failure and lack of willpower. This led to internalised stigma, preventing me to seek medical assistance on a long run.

So, today I advocate for lifetime obesity management.

I first found support in a local patient organisation, four years ago. We mainly offer moral support and adapted physical activity for people living with obesity in our region.

I also joined the Ligue Contre l’Obésité, which is a French national obesity organisation, in order to contribute to communication and advocacy programmes.

I am also very proud to be a member of ECPO – which stands for European Coalition for People Living with Obesity – and support collective action throughout Europe.

I can only say, I never feel alone anymore.

The World Obesity Day is the perfect occasion to showcase actions from all advocates and stakeholders addressing the major public health issue that obesity is, as well as stigma for people living with obesity.

France has yet to recognise obesity as a chronic relapsing disease, and therefore, provide the necessary means for research and offer the appropriate treatment for all people concerned. Pre-obesity and obesity concern 45% of the French population.

I hope people feel empowered to live their best life with obesity and come join the patient organisations all over the world. It is a great place to start and feel connected.

The most important thing I learned from experience was that I had to act in order to contribute to change mentalities that took a toll on me in the past.

Like this year’s slogan says, “Everybody needs to act.”

Thank you for watching this video. Bye.

By Alina Constantin.

The Ligue Contre l'Obésité is holding the Connected Challenge, showcasing more than 75 local events in France and overseas territories. Find out more on their dedicated website: https://journeemondialecontrelobesite.com.

Dr Ada Cuevas of the Centro Avanzado de Medicina Metabólica y Nutrición (Cammyn) in Chile speaks to Melyna about her experience of living with obesity and facing weight stigma. Watch their interview below (in Spanish).

Transcript (in English)

Dr Cuevas: Hi Melyna

Melyna: Hello dear Ada

Dra. Ada Cuevas: First of all, I want to thank you for agreeing to participate in this important worldwide day; World Obesity Day. We are striving to recognize obesity as a disease and that patients living with obesity are respected.

Melyna: I am very grateful and honored to have been invited. I am pleased to be able to share my personal experience and how I have lived with excess weight, and hopefully this can help other people.

Dr Cuevas: Of course, thank you very much. World Obesity Day is celebrated around the world and the World Obesity Federation is working hard for this day. So, you will be a part of this campaign of the World Obesity Federation!

Dr Cuevas: Tell me Melyna, at what age did you start having problems with being overweight or living with obesity?

Melyna: Since a very early age, and in adolescence I already had a few kilos on me, and after becoming a mother it got out of hand without [my] realizing it. I began to have problems like depression and other emotional problems and that led me to weigh up to 120 kilograms.

Dr Cuevas: What you say is so important, because often people – and unfortunately some healthcare professionals – blame it on the fact that someone "eats a lot" or "is lazy [and] doesn't move". It is good that you have mentioned those other aspects that people do not know as causes of obesity.

Melyna: Many people discriminate against us, thinking that the only thing we like doing is eating and eating. In reality, eating is like a drug, and we are addicted to eating. But there is a reason why we are eating.

Dr Cuevas: Yes, there is a reason…

Melyna: We eat for our sorrows, our joys, happiness, or any emotion that we have, we regulate them with food. When we invite our family, we welcome them with a table full of food. When we are sad at a wake, we also have to have food. So, we eat for the sake of our emotions, and unfortunately, we don't have access to psychologists. Many times, we do not know how to act and that is what makes us gain this weight.

Dr Cuevas: Exactly, deep down it is also important to know that these emotions, for example, sorrow, generate the release of certain hormones in the brain that cause these thoughts of wanting to look for something to calm you down, just as you say, like a drug that calms those emotions of anguish, fear, sorrow, etc. Very clear as you say.

Dr Cuevas:  Do you believe that there is discrimination against people? How this has impacted you in work, emotional aspects, or with your partner?

Melyna: Look, the extra kilos kill you physically, but society kills you before you reach that point, because it closes the doors to work thinking that having excess weight must mean you are stupid, that we cannot understand something or exercise a job or profession just because we have excess weight. That's in the workplace. Now in society, for the bus, you have to pay double tickets; on the bus when you sit down, people don't want to sit next to you. We are everyone's joke, and everyone has to laugh at us. Another example is when a large person enters a room (I prefer to say large person rather than obese or fat), people expect them to turn up in sandals and baggy clothes, and they are shocked when you turn up wearing a short skirt, dressed up with high heels. And why is that? Because “the fat woman” must dress a certain way, according to them. Society begins to shut you off and slowly destroy you. This depression means we end up shut up in our rooms and homes and we don't go out. And this is caused by the way society treats us. We have to be more empathetic, but not in a condescending way where we say, “look at that poor thing”, because being big does not mean being poor, being big is having a big mind too.

Dr Cuevas: Incredible, what a coincidence! You may not know but there is a published study from another country where health professionals doing training in obesity were asked about the characteristics of people living with obesity compared to thin people, and obviously they said that those living with obesity were dumber and lazier. That people living with obesity may be considered stupid caught my attention: one usually hears that they are lazy, but stupid?!

And regarding the double air-ticket that people with obesity were asked to pay some years ago, fortunately that is now prohibited. But clearly, in shared taxis (at least in Chile) the problem persists. In schools, there was also a study in the United States where children were given photos of who they would like their friend to be – a child with an obesity problem or a child with normal weight – and they always chose the child with normal weight to play with and become their best friend. So, it is a problem that comes from childhood.

Melyna: It is something that society tells us; we see the commercials, the television shows, [and] there is always a thin woman, a thin handsome man, those are the models to follow. Today I want to break with that; that's why I give talks with my excess weight – I have my entire community organized and that makes me neither more nor less stupid. It makes me an equal with everyone else.

Dr Cuevas: On the contrary, it makes you very intelligent and innovative. It would be good if you could tell us a little about that important program that you have developed in your community helping people, because curiously and unfortunately in our country, obesity is very prevalent in the most vulnerable areas. People with the lowest incomes are those who have more obesity.

Melyna: In these communities, we do not have access to medicine; it is very scarce. In “Bajos de Mena”, my neighborhood, we are 180,000 inhabitants in three square kilometers. We have two outpatient clinics and in each of them, there are two psychologists. Sometimes psychological care is just limited to receiving some medication for several years. Moreover, the conditions such as diabetes, hypertension and others are treated just with some medications, such as metformin, glibenclamide, or others. But they do not treat the root of the problem, which is obesity. So, what do the doctors do? They give pills for diabetes, but they don't treat me for obesity, which can lead to so many other diseases.

Dr.Cuevas: Of course, obesity leads to hundreds of diseases such as some types of cancer, kidney disease, neurological disease, myocardial infarction, and the list of diseases goes on. So, as you say, we have to fight so that the problem is approached from the root.

Melyna: That’s why we want obesity to be considered as a disease and to be included in "GES" (Chilean public health system) so that we can have access to treatment.

Dr. Cuevas: Fortunately, things are being done worldwide. Big companies are using models that are not the typical underweight female model. We hope that this tendency spreads everywhere and to our country.

Melyna: Many people see this as a war between thin people and large people! But the situation must reflect reality. We would all like to be thin and not burdened with any disease, but this is our reality. We need to have representation of the realities.

Dr Cuevas: Exactly, and we also need for people who have these problems to have access to treatment and for obesity professionals to help them. There are many bad experiences [when] you go to the doctor and he does not give you adequate treatment. I do not know if this has happened to you?

Melyna: It has happened to me many times where they tell me that the solution to obesity is to “shut your mouth". It's easy for them. It is easy to tell an alcoholic to stop drinking, a drug addict to quit drugs. You have to understand that, as I told you at the beginning, we regulate all our emotions with food [and] if it were that easy we would not have this weight. It is not easy to live like this, I have almost two people in my body and my daughter has three people. Look at the discrimination: my daughter wants to adopt and she went through a whole process to adopt a child the last time, but the adoption institution told her that she cannot adopt because "she is obese", and perhaps for that reason she will not be a good mother. You will not love your son because you have obesity? She will not take care of the baby because "she is fat"?

In other words, I'm not going to be able to be a grandmother because I'm overweight? It is this discrimination of society that continues to shut us off. Believe me, that child who is in an institution will not care that his mother has obesity. He wants her to love him, to be taken care of. Even in our desire to become mothers we are discriminated.

Dr Cuevas: Of course, how shocking.

Your experience and that of your daughter is very powerful and well, we hope that this message you are giving, and that this campaign will help us to make a change so that your daughter will never live a bad experience again.

Melyna: And that no one may go through this again. I thank you Ada, because we must make this more public [and] create networks. Many people are locked up in their houses who need a word of encouragement, an image, and to say, "if they can, why can't I?" "Why can't I show myself?" Believe me, we would all like to close our eyes, open them and be thin, [to be] able to pick things up easily, move easily. But today what we invite you to do is close your eyes, open them again and say, “this is who I am, and I love myself as I am”. Go out on the street, walk, begin to get to know each other, talk with others. Often, we do not have easy access to healthcare professionals, but we do have our friends and our neighbours who can support us with our emotions. Thank you very much for this invitation, believe me, it will do a lot of people a lot of good.

Dra. Ada Thank you very much Melyna and congratulations.

For World Obesity Day 2022, the Brazilian Obesity Panel convened obesity experts and organizations to share their experiences in preventing and controlling obesity in Brazil. This is one of their stories.

I am a nutritionist responsible for the Food and Nutrition Technical Area (ATAN) in Quissamã. I coordinate the implantation, follow-up, monitoring, and implementation of the care line for overweight and obesity, in partnership with the Family Health Strategy. The goal is to create an integrated care network that promotes behaviour change and adherence to healthy lifestyle habits.

What was the objective of this project?

Obesity is a public health problem and needs to be monitored so that we can act in an integrated manner to reverse this epidemic. From this starting point, we began the implementation of the municipal system ‘VICTOR’, with the objective of mapping users with obesity and its comorbidities by health unit. BMI, waist risk, presence of comorbidities, consultations, and professionals consulted were included in the system. This facilitated the identification of users and strengthened their support network.

Obesity is complex, and health teams need to be aware and trained to receive health unit users and make the appropriate referrals. The implementation of the system allowed each ESF team to identify those at higher risk according to BMI and comorbidities, as well as individuals who were not being followed up but who, through an active search, were welcomed and referred to the unit. It also made it possible to visualize the number of consultations and professional follow-ups, to better diagnose each user's needs.

What was the methodology used?

The Line of Care was implemented in August 2019. It was built with a steering group using a participatory approach encouraging joint production of knowledge and teamwork, where the existing and necessary actions were mapped. After its implementation, the whole team and sectors were trained and informed about the implementation, flows, and protocols.

After this, we started the monitoring, using SISVAN as a guiding tool for the nutritional profile of the population. It was possible to map the number and degree of obesity per health unit, but we felt the need for a more detailed tool with information that could help us to act in a more incisive way to reduce obesity. Together with a technical specialist responsible for the municipal VICTOR system, we discussed how to implement the system so that it would be possible to produce information relevant to the fight against obesity.

What were the results obtained?

The municipal VICTOR system that exports data to the E-SUS (health notification system) was implemented with the required reports during the year 2021. From the reports generated by the VICTOR system, it was possible to view, by health unit, the nominal list of users at nutritional risk and the risk stratification due to comorbidities. This made it possible to open a specific agenda for these users.

Users who are not yet being followed up are invited to make an appointment at the Family Health Strategy (FHS) and to participate in the educational activities that take place monthly in the health unit.

This new tool allowed a careful look at this population, as well as the definition of work strategies in each territory to capture, monitor and receive these users. In addition to monitoring users at nutritional risk, we have the chance to intervene to prevent the worsening of health in other individuals with lower health risk.

How have these results impacted the lives of people with obesity?

What was possible to verify is that the implementation of the line of care has enabled a careful and humanized look at these users who are in compromised health. Nutritional surveillance is a fundamental tool for these groups of people at risk to be noticed. The data made available by the system impacted the teams and made them aware of the problem.

The importance of welcoming and referring users is fundamental for success in changing individual behaviour. We know that many still do not consider obesity as a disease, and stigma and bullying is still very clear to see.

These tools aim to support managers and health professionals in the process of organization and evaluation of nutritional care, and to support the planning of actions related to health promotion. The permanent analysis of the population's health situation will lead to the organization and execution of practices more adequate to face the problems.

By Alba Abreu.

When Dana Rosser started dating her husband 26 years ago, he weighed 460 lbs. She learned very quickly that people with obesity have many challenges – and realised that there was little support available for their loved ones and supporters. So she decided to write a book on the subject. Here is her story.

Transcript:

Hi, my name is Dana Rosser and I’m from Orlando, Florida. My experience with obesity started 26 years ago when I started dating my husband. At that time, he weighed 460 lbs.

I was introduced to obesity based on how people treated me for being with him. You see, my husband is a world-renowned laparoscopic surgeon, and people thought that I was with him because of the fame and fortune. So, I was judged for being with someone who was severely obese.

After we married, I learned very quickly that people who suffer with severe obesity have so many challenges. One action that I would like to see more is for their loved ones or supporters to have more support.

When I was seeking support for dealing with my husband, I couldn’t find any. So, I decided to write a book entitled ‘Through Thick and Thin: Facing Obesity through the Eyes of a Loved One’.

That’s my action. I couldn’t find support, there were no books out there for me to read, no support groups for me to attend, so I took it upon myself and wrote a book for loved ones – for supporters like me.

I support World Obesity Day because it is an amazing organisation. It’s such an important day to bring more awareness to the disease of obesity, because obesity truly is a disease; it’s a chronic disease.

By becoming more aware that it is a disease, I think that people will have more compassion in the world. So that’s my ‘why’. Thank you!

For World Obesity Day 2022, the Brazilian Obesity Panel convened obesity experts and organizations to share their experiences in preventing and controlling obesity in Brazil. This is one of their stories.

I am an advocacy analyst at the Instituto Desiderata, and I work as a political liaison person on the issue of child and adolescent obesity. I’ve been working on a legislative advocacy project to pass and implement a law to fight childhood obesity in the municipality of Rio de Janeiro.

What was the objective of the project?

The project aims to approve a law, in the municipality of Rio de Janeiro, that institutes actions to combat childhood and youth obesity, by regulating food environments and protecting the right of children and adolescents to health and adequate and healthy food.

The Project of Law (PL) 1662/2019 provides for the following actions: restricting the offer of sugary drinks and ultra-processed foods in public and private schools; regulating the display of ultra-processed foods in commercial establishments, ensuring that they are positioned above children’s line of sight on racks and shelves (from one meter high); implementing breast milk collection and packaging rooms in companies. In this way, the PL provides for the regulation of strategic points in the containment of the growing numbers of obesity in children and adolescents.

What was the methodology used?

Integrated advocacy actions were implemented for the approval of the bill in question. Initially, the legislative house was mapped, and a profile of each parliamentarian was gathered in order to define advocacy strategies and identify potential supporters.

Next, we carried out an advocacy face-to-face with the parliamentarians and their advisors. To subsidize the advocacy and support the councillors in their decision-making about the PL, technical documents were elaborated (notes, technical sheets, and amendments).

Also, because we understand communication as a fundamental ally for social mobilization, we started, in parallel, a mobilization campaign in support of the approval of the PL, with dissemination of information to the population, providing a more comprehensive look at the various factors that contribute to the development of childhood obesity and youth and advertising pieces that invited society to sign the online petition for the approval of the project.

What were the results?

The advocacy actions were fundamental in raising the awareness of 30 of the 51 councillors, enabling the PL to be put on the agenda and approved in the first discussion with 30 votes in favour and 10 against. It is noteworthy that the votes in favour came from members of different party legends and ideological fields, indicating that the advocacy strategy was right and that the importance of the issue goes beyond political disputes.

Our advocacy strategy also made it possible for the issue of childhood obesity and the need for regulation of food environments to gain notoriety in vehicles of great local and national reach, with publication of articles and interviews, including in the Chamber's internal circulation channel, whose audience is members of Congress and their advisors. On social networks, the campaign reached 8 million people, which generated 48.7 thousand visits to our page and 6.3 thousand signatures in support of the petition.

How have these results impacted the lives of people living with obesity?

All the actions described here are part of an effort to implement measures that provide healthy environments for children and adolescents as a way to promote healthy eating habits and contain, in the medium and long term, the advance of obesity rates in the city of Rio de Janeiro.

Studies are conclusive in pointing out that environmental and public policy interventions are the most promising strategies for improving the health of the entire population. Thus, promoting awareness of parts of society, including the school community, parliamentarians, and the Municipal Department of Education of the city of Rio de Janeiro, of the relevance of the issue, contributes in an important way to the promotion of adequate and healthy eating and the prevention of obesity in children and adolescents.

By Fabíola Leal.

Find out more about the Instituto Desiderata.

For World Obesity Day 2022, the Brazilian Obesity Panel convened obesity experts and organizations to share their experiences in preventing and controlling obesity in Brazil. This is one of their stories.

I am a Social Worker of the Bariatric and Metabolic Surgery Program at Hospital Universitário Cassiano Antonio Moraes (HUCAM) and Coordinator of the Extension Project to share the knowledge of our multidisciplinary team.

Obesity is a chronic disease of multifactorial causes. With this in mind, we created an extension project to share the knowledge of the multidisciplinary team of the bariatric surgery program about the management of pre- and post-operative patients in all related areas within the network of care for obese individuals. Each member of the team is responsible for preparing a web lecture and deliver it via Telehealth. 12 web lectures have already been given via Telehealth, reaching more than 21,200 views.

What was the objective of this project?

Our general objective was to train professionals from the multidisciplinary team in primary and secondary care in the four macro-regions of Espirito Santo (Metropolitan, Northern, Northwestern, and Southern macro-regions) in the management of the treatment of individuals with obesity.
Specifically, we wanted to:

• Improve primary care in the line of health care for obese and overweight patients.
• Share the necessary knowledge for the standard management of the post-bariatric patient in all related areas (nutrition, psychology and medicine, among others) with the network of care for the obese individual.
• Strengthen the Health Care Network for People with Chronic Diseases, with respect to the organization of the prevention and treatment of overweight and obesity.
• Promote a better relationship and integration among the three levels of health care at HUS (primary, secondary, and tertiary care).

What was the methodology used?

For the execution of the project, we held a series of study group meetings. Academics of nutrition, psychology, medicine, social service, physical education, physiotherapy and nursing did a bibliographic survey, searching for scientific articles, books, dissertations and theses that relate the following topics: obesity, bariatric surgery, multi-professional team, integral attention, humanized care, health education. They made notes of all the material read for later group discussions. Weekly meetings are held with the students to discuss the texts, providing the group with a theoretical foundation to carry out the project's activities. We disseminate the extension project to the state and municipalities of Espírito Santo, through the Councils of Municipal Health Secretaries (COSEMS) and the Regional InterManagerial Commission (CIR). We also used the Telehealth service of the Cassiano Antônio Moraes University Hospital (HUCAM).

What were the results?

The project resulted in an extension course for health professionals and students with the theme "Fundamentals of Bariatric and Metabolic Surgery: Multi-professional Approach"; a presentation at the IX Integrated Journey of Extension and Culture; participation in the Obesity Prevention Walk of the Cariacica/Spirito Santo City Hall and several web lectures on the theme aimed at health professionals.

How have these results impacted the lives of people with obesity?

Through training professionals in the management of obesity and encouraging more humanized care, it is possible to provide patients with obesity and overweight with access to information for a better lifestyle, improved self-esteem and self-knowledge of a healthy life, as well as the treatment of obesity and related comorbidities.

By Ana Paula Ribeiro Ferreira.

With the Stephanie Alexander Kitchen Garden Program action is everything. Making real food fun has been at the heart of the Stephanie Alexander Kitchen Garden Program since its inception over twenty years ago – initiated by cook and restaurateur Stephanie Alexander AO as a way of combatting childhood obesity. Rather than good and bad foods, green or red traffic lights, it’s all about joy and pleasure and positive messages. Pleasurable food education in fact. 'Learning to live a good food life is the one of the most accessible ways anybody, child or adult, can bring joy to their life.' – Stephanie Alexander AO.

This World Obesity Day – when we know that today’s children and young people may have a shorter life expectancy than their parents, state-wide curricula are failing to deliver effective food education, and the economic impact of obesity is increasingly burdensome – everybody really does need to act. The Kitchen Garden Program enables action by giving children and young people the tools to grow, harvest, prepare and share fresh, seasonal and delicious food.

This early intervention, through fun, hands-on activities at early childhood services, primary and secondary schools, delivers huge benefits in terms of food literacy. Teaching children and young people how food is grown connects them to nature and the world around them, giving insight into food systems and sustainability, and practical skills for the future.

Schools and services are supported and guided to deliver pleasurable food education to their children, students, young people. Through resources that link to curriculum and learning outcomes, personalised support, professional development and a community of practice, each school or service can draw on the supports and different models on which to envisage, implement and sustain their own unique kitchen garden program.

And the effects ripple beyond the school and service gate. Not only do children and young people take skills and knowledge – and a joy for food – with them through life, but families and communities are also influenced by the program. For Jennifer Green, principal at Queanbeyan High School, NSW, it’s a way of 'Developing skills in growing food and expanding the palate of students', as well as ensuring future food security for low SES families and ‘encouraging healthier lives due to increased nutrition'.

Likewise for Caroline Lawson, kitchen garden specialist at Benarkin State School: 'I saw the potential of the program to make a significant difference to the education and lives of all the students in our small one teacher school. The school was in a low socio-economic area and children were struggling to engage.' 'The highlight has always been the pleasure the children receive from this program. They tell me so, their faces beam, they are full of energy. I love the fact that the program is so inclusive, and every kid, regardless of background, size, shape or anything else can be fully engaged with this program.' – Stephanie Alexander AO.

The joy and enthusiasm children take in the program is evident. One kitchen garden specialist responding to a recent survey said: 'Students are really the word of mouth with how much they love the program. They talk to their parents and extended families about their successes. Students love to tell me about what they have cooked at home.' A Year 5 student at Little Hampton Primary School likewise enthuses: 'I have been lucky enough to be able to do the kitchen garden program at my school since Year 3, I enjoy it so much, it is my favourite lesson and I look forward to it every week! I love all of the skills it has taught me, like growing fresh produce in our school garden and then turning it into yummy food in the kitchen. I have learnt about recycling, looking after the environment, the importance of bees and insects in the garden, knife safety and so much more.'

The Stephanie Alexander Kitchen Garden Program’s tried and trusted recipe of pleasurable food education makes it easy for everyone to act. From the smallest of children, through to grandparent volunteers, from local councils supporting the program in their area to corporate partners. It is said it takes a village to care for a child, and the health and wellbeing of the next generation is being shored up by the actions of many participating in this beloved and effective program. A program designed to make food fun, take away shameful talk about food, and encourage activity and action.

By Stephanie Alexander.

I'm a clinical dietitian and nutritionist. Currently, I'm investigating the potential role of community pharmacists in obesity, nutrition, and diet-related NCDs management and their contributions to food systems transition to improve diets and health.

With the increased focus on obesity as a health epidemic and the NHS long-term commitments relating to obesity, community pharmacists are in an ideal position to promote healthy diets, help the government in its obesity strategy by offering weight management services, educate people about adopting a healthy dietary pattern and motivate people to make behavioural change. The intervention ideas for community pharmacist (CP) involvement in obesity are as follows:

• CP-led interactive healthy nutrition education within a school environment to help support healthier communities in the future through comprehensive nutrition education
• CP referrals to social prescribing pathways for nutrition/healthy diets related programmes
• Healthy Living Pharmacies: CP-led services for obesity and diet-related NCDs management and implementation of campaigns for the promotion of healthy diets

In order to implement the best practice models, we will be conducting semi-structured interviews with key stakeholders to co-create and co-design feasible interventions and to adopt a systemic and a life-course approach.

Story by Gizem Acar

UCL School of Pharmacy and Medway School of Pharmacy, UK.