HC Deb 08 July 2003 vol 408 cc778-80W
Chris Grayling

To ask the Secretary of State for Health what obesity management treatments are available on the NHS; and what plans the Government have to increase these. [118965]

Miss Melanie Johnson

The National Institute for Clinical Excellence (NICE) has issued guidance on the anti-obesity drugs orlistat and sibutramine, treatment with which should be accompanied by specific concomitant advice, support and counselling on diet, physical activity and behavioural strategies. In July 2002 NICE also issued guidance which confirmed that surgical intervention was an appropriate treatment in some cases for the treatment of morbid obesity, when other options have proved unsuccessful. There are also 10 national health service obesity clinics in England.

In 2001, the Department of Health published a National Quality Assurance Framework on Exercise Referral Systems. The document offers guidance to primary care and fitness professionals, who work together to offer tailored exercise and physical activity programmes to patients whose health would benefit from increased exercise.

National service frameworks (NSFs) have been introduced—for example, for coronary heart disease (CHD), cancer, older people, diabetes and mental health—which set out the national standards that should be expected for treatment and services. The forthcoming NSF for children will address the health and social care needs of all children and will include the promotion of healthy eating and physical activity. Under the new arrangements for the NHS as outlined in "Shifting the Balance of Power", primary care trusts (PCTs) allocate funding from their own devolved budgets to deliver national targets and milestones and to meet local priorities.

The NHS Priorities and Planning Framework for 2003–06 includes targets on reducing CHD and diabetes. One of these targets requires practice-based registers and systematic treatment regimes, including appropriate advice on diet, physical activity and smoking, to cover the majority of patients at high risk of coronary heart disease, particularly those with hypertension, diabetes and a body mass index greater than 30 (i.e. people who are obese).

NICE and the Health Development Agency are also undertaking collaborative work to develop guidance on the identification, prevention and management of obesity and maintenance of weight reduction.

Chris Grayling

To ask the Secretary of State for Health (1) what steps the Government take to inform the public about weight loss options; [118967]

(2) what information the Government issues regarding proven and unproven weight loss programmes; [118968]

(3) what research the Government have undertaken to evaluate the different weight loss programmes available in the commercial market; [118969]

(4) what research the Government have undertaken into the long-term effects of commercial weight loss programmes. [118970]

Miss Melanie Johnson

An evidence-based approach is being taken to tackle the prevention and management of obesity.

The Health Development Agency (HDA) will publish its review of effective interventions for the prevention and treatment of obesity later this year. A systematic review carried out by the University of York in 1997 indicated that effective interventions for obesity include diet, physical activity and behavioural strategies for adults in combination where possible. The health technology assessment programme, a national programme of research established and funded by the Department of Health research and development programme, currently includes a systematic review of obesity treatments which will update the 1997 review, publication of which is expected in January 2004. Commercial programmes which meet the inclusion criteria of these reviews will be assessed.

The National Institute for Clinical Excellence (NICE), collaborating with the HDA, have been tasked by the Department to develop guidance on the identification, prevention and management of obesity and maintenance of weight reduction.

Novel diets can be a variation of a "very low calorie diet" (VLCD): one which provides approximately less than 800 calories per day. A Committee on Medical Aspects of Food and Nutrition Policy (COMA 1987) report on VLCDs highlighted that a major criticism of them is that individuals frequently re-gain any weight lost after the diet has ended. A 1998 report by the Royal College of Physicians on the "Clinical management of overweight and obese patients" supported the findings of the COMA panel.

Primary care has a particularly important role in the prevention and management of obesity. Local action is being delivered through the national service frameworks, which aim to improve standards of care, and the Priorities and Planning Framework.

The Department has also funded the British Dietetic Association, as part of their "Weight Wise" campaign, to undertake project work on consumer messages and communication methods relating to weight management. The Department also contributed to the funding of the charity Weight Concern (through a Section 64 grant) to develop a "toolkit" on obesity for health professionals to use with patients in a group setting.

The Food Standards Agency supports projects relating to diet and nutrition and promoting the uptake of a healthy balanced diet in order to maintain a healthy weight throughout life and have an important role in providing consumers with information on healthy eating.