Support not there for obesity to be tackled
OBESE people are failing to get the support they need from the States, the updated Healthier Weight Strategy has revealed.
But a business case has been submitted to improve services for those struggling most with weight loss.
Health & Social Care has published its 2023-2025 strategy, an update to the 2016-2023 version.
The updated document noted that more than half of islanders were now overweight or obese, with middle-aged men struggling the most with excess weight.
Obesity is broken into tiers, with those requiring specialist clinical services designed to treat complex obesity, involving access to a multidisciplinary team, therapies or weight loss surgery, classed as tiers three and four.
‘Currently there is no tier three or four provision for people in the Bailiwick, apart from that funded privately by individuals,’ the strategy states.
‘The current dietetics-led adult weight management service is a tier two service, focusing on behaviour change advice.
‘However, while this is appropriate for some people, 62% of people referred to the service require, but cannot access, tier three or four support.’
The Health Improvement Commission commissioned an external review of adult weight management services three years ago to inform the development of a business case for tier three and four services.
A business case for a clinical service was submitted in 2022 and the Government Work Plan earmarked £250,000 for both 2024 and 2025 to develop and pilot tier three and four weight management services for two years.
However the strategy warns that the short time-frame and funding shortfall might prevent the establishment of a service.
‘Concerns include the lack of secured longevity of the service, whether it is feasible to begin measuring impact of the service in a short two-year pilot period, and the ethical implications for patients who may begin but not complete tier three and four pathways,’ the strategy states.
‘This is particularly poignant as service users would need to go through tier three before reaching tier four services.
‘Many of these service users would be referred from tier two services and may need to return to these after an initial pilot period, forcing the space freed up in tier two services to again be filled with those who could receive tier three and four services if available.’
The report added that the pilot itself would not be able to meet all needs, with some eligible patients remaining in tier two services.
‘Work is ongoing to scope out whether such a short-term tier three and four service would be appropriate, taking into account the above considerations.’
