Technical Paper 1:
Obesity in Australia: a need for urgent action

4. New initiatives for obesity prevention and control

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UK experience: Change4Life and other initiatives

While small changes may lead to a significant public health impact across the whole population, the community still requires assistance from government and industry to make healthier choices.

The United Kingdom’s Change4Life initiative, which commenced in January 2009, is a multi-pronged approach to encourage behaviour change within the entire population, with strategies including an advertising campaign, website, resources and partnership opportunities where healthy messages and the Change4Life brand are promoted to encourage people to eat well, move more and live longer.² The campaign also includes a children’s health survey.

With the focus on long-term prevention, the initiative aims to target the issue of obesity by highlighting to parents the links between poor diet and sedentary lifestyles and preventable illnesses, as well as their responsibility to ensure their children eat better and are physically active regularly. The initial target is families with young children (aged 0–11). The initiative will establish national, regional and local partners with healthcare professionals, teachers, charities, government agencies, the media, big businesses and community organisations. It supports the United Kingdom’s overall obesity strategy Healthy Weight, Healthy Lives and links into the National Child Measurement Programme. The campaign is expected to cost £75 million over three years.[33]

Financial incentives to help individuals

Financial incentives (including payments and vouchers) for individuals to achieve sustained weight loss and adopt healthy eating and physical activity behaviours are included in the United Kingdom’s cross-government strategy Healthy Weight Healthy Lives. For example, the Well @ Work program (led by the British Heart Foundation with funding from Active England and the Department of Health) is a £1.5 million, two-year program to pilot ways to make England’s workplaces healthier.³ The program has included weight loss competitions offered to employees with rewards of fruit baskets and trophies to teams and store gift vouchers to individuals.

Another scheme aimed at overweight people is being trialled in the United Kingdom by a private health firm for 400 people, with National Health Service backing and funding. Under the scheme, overweight people would sign up to a 13-month slimming program and be paid only if they completed it. They would have seven months to get down to their target weight and would have their weight checked monthly at their GP’s surgery or health clinic. Six months later, they would have to show that they had not put on weight. Payments would increase with the amount of weight lost: a loss of 23kg would be rewarded with the maximum amount of £425 ($865); 13.5kg weight loss would be rewarded with £160, and 7kg with £70⁴ .
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In a range of UK cities, the Department of Health has been funding subsidised gym memberships since April 2009 for 16–22-year-olds who regularly go to the gym over a 12-month period. The pilot will look at the effect that a financial incentive has in recruiting, retaining and affecting behaviour change in young people who are at risk of inactive lifestyles. The Department of Health is commissioning a national evaluation of such incentive schemes (of which there is a range being introduced in the United Kingdom).[34]

US initiative: a partnership to tackle childhood obesity

In February 2009, the US Alliance for a Healthier Generation, a joint initiative of the American Heart Association and the William J. Clinton Foundation, announced the formation of the Alliance Healthcare Initiative, a collaborative effort with national medical associations, leading insurers and employers to offer comprehensive health benefits to children and families for the prevention, assessment and treatment of childhood obesity.

The goal of the initiative is to reimburse health professionals for the provision of obesity-related care and nutrition counselling, and to provide parents with educational and nutritional information for fighting childhood obesity.

Through the program, visits to doctors and registered dietitians will be provided to children as part of their health insurance benefits. The Alliance Healthcare Initiative will also educate parents about childhood obesity and the expanded services available to children as part of the initiative. Doctors will be reimbursed for bringing children back for follow-up visits and for working with them on the adoption of healthy behaviours, while registered dietitians will be reimbursed for providing in-depth nutrition counselling over multiple visits to those children referred by their doctors.
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Participating companies will have access to materials and resources developed by the Alliance to inform parents about childhood obesity prevention and treatment. Several health insurance organisations and major corporations are participants, while the American Academy of Pediatrics and the American Dietetic Association will assist clinicians provide education, improve care coordination, offer resources to eligible families, and help with recruitment of medical professionals. The initiative represents the first time a group of organisations such as this has worked together to provide children with insurance coverage to address obesity, as well as the first time outcomes will be monitored to ensure the benefits are being used.[35]

²See www.dh.gov.uk/en/News/Currentcampaigns/Change4Life/DH_092080.
³See www.bhf.org.uk/thinkfit/index.asp?SecID=1590&secondlevel=1593.
⁴See www.smh.com.au/world/rolls-of-fat-can-lead-to-rolling-in-the-money-20090413-a4t7.html.

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