A Sheffield-based weight management programme, SHINE, and a Leeds Beckett researcher believe there is currently a lack of direction and guidance for severely obese children in young people in accessing specialist Tier 3 obesity services.
Tier 3 services or specialist obesity services refers to programmes delivered by specialist providers and targeted at children with more complex, severe obesity.
The research undertaken by SHINE managing director Kath Sharman and Leeds Beckett researcher James Nobles, published in the British Journal of Obesity, assesses who should provide Tier 3 services, what they could look like in practice and asks for clarity on funding such services.
Nobles aid: “Despite the fact that children and young people with severe obesity present with complex needs, positive change is achievable through the provision of various interventions moulded to meet the individual needs of each participant.
“Following the launch of a clinical pathways guide on weight management services in 2014, it is clear that there remains a lack of Tier 3 service provision for childhood weight management services. This research supports the notion of an integrated care pathway for children and young people with obesity and severe obesity, acknowledging that current intervention is not able to always meet the need of complex cases. An integrated care pathway would ensure different provisions are available to those families most in need”
In contrast to Tier 2 services, SHINE’s approach placed greater emphasis to issues that may contribute to obesity or prevent weight loss such as emotional eating, stress management and building self-esteem. SHINE’s 12 week programmes are designed so that the participants and their families are empowered to make decisions for themselves rather than directly instructing them on what behaviours to do or not to do.
Kath Sharman, managing director, SHINE Health Academy, added: “Working with experts at Leeds Beckett University has enabled us to provide an evidence base to help ‘bridge the gap’ in Tier 3 obesity services for children and young people with complex needs. We now need government and Clinical Commissioning Groups to accept there is a deficit and tackle these problems at a higher level to make a difference for this vulnerable group.”
This paper is the first of a three part series which will detail a stepped care approach to delivering weight management services as well as evaluating the impact of the SHINE programme.