Obesity Epidemic and Health Impacts of Excess Weight

Introduction

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Obesity is one of the major health problems which are severely affecting the lives of people. This is a very complex disease that involves an excessive amount of body fats and it is not a cosmetic issue, it is a type of disease that increases the chances of various other diseases affecting the people like heart diseases, blood pressure, diabetes, and also creates cancerous situations in the body (Chooi et al. 2019). This report will help to analyze the “A Fitter future for all” initiative which is developed to tackle the obesity condition and prevention in the UK (Slainte and Poustie, 2021). The following report will analyze the concepts and the principles of modern public health which underpins this initiative of the government and also explains the key elements of this public health intervention. This report will help in examining several pieces of evidence that support this intervention and also check that whether this intervention can be used in the neighboring countries or not. 

Concepts and principles of modern public health that underpin the chosen initiative

Obesity is continuous to be the most disastrous public health challenge in England and Northern Ireland. Obesity is the condition of increased body fat that increases the chances of diseases that can affect the lives of people and society as a whole (Rodgers and McCluney, 2020). Obesity is a health issue that is affecting not only the lives of the people but also the community and the economy and this is the reason A Fitter Future for all initiative has been developed by the government of the UK to provide the people with the knowledge about the effects of the obesity and help them to reduce the harm which is associated to the obesity and overweight. The Department of Health (DoH) who is in charge of taking care of the public health in Northern Ireland and the UK developed this public health initiative to empower the people of the country to make the health choices by themselves and reduce the risks of obesity and overweight associated diseases (Slainte and Poustie, 2021). This initiative is also developed to create an environment that supports physical fitness and diet which will enhance the wellbeing and health of the people of Northern Ireland (Lyn et al. 2019). The most essential principle of this initiative was the concentration on a healthy lifestyle and healthy diet. According to DoH, a healthy diet is the most important thing for reducing excessive fat in the body and reduce the chances of overweight. 

Concept of low physical activity 

One of the major concepts related to the obesity and health initiative is that there is a huge link between physical inactiveness and chronic diseases as well as the premature death of person this is the reason this public health initiative was developed for the people of the country, to take part in different levels of the physical activities based on the physical condition of their body (Jackson et al. 2021). This is a common principle that risks from physical activities are very low whereas the risks from inactivity are very high. Therefore, the 4 chief medical officers of the UK developed a framework that was included in this initiative which states that a definite amount of physical activity is compulsory for every person depending on their age, weight, and body condition (World Health Organization, 2020). An awareness program was initiated under this public health initiative which was named "Start active, stay active" which determined the physical activities which every person in the country is needed to perform in their day-to-day life (Slainte and Poustie, 2021). The national health agency also started to send push messages to the registered mobile numbers of the people of the country which will directly take them to their official website “Get a life, Get active” which provides useful information related to the physical activity as well as the guidelines which are needed to be maintained for the children, especially for those children who are aging below 5 years as their physical activity and nutrition is very essential (Franco, 2020).

High energy food and low nutrition 

This public health initiative focusses highly on the eating habits of the people as in this modern era eating high-fat food or junk food has become a fashion and these food items are highly filled up with energy which is the main reason behind the development of overeating effects in the human body resulting in overweight or obesity (Blüher, 2019.). The national health agency observed that a change in eating habits is very much necessary for people to avoid the chances of obesity and related diseases. A fitter future for all health initiative focusses on the snacking and processed food eating behavior of the people which can affect their health conditions and this is the reason this public health initiative help the people of the country to make healthier food choices to reduce the harm from overweight or obesity (Wijesinghe et al. 2021). 

Under this initiative, the DoH and UK government launched a campaign that advocated a Whole-school approach for the food items which are provided by the schools to the children. This initiative demonstrates that healthy food is very much necessary for healthy outcomes which is one of the most common health principles and this was developed to address the rise in the obesity level in school-going children. With almost 1 out of 4 children in Northern Ireland suffering from obesity, it was very essential for the national health agency to take care of child obesity as the next generation will be facing high health issues because of obesity and overweight. The special advisory group of Ireland (SAGO) involved in this health initiative stated that it is very essential for the family and the school to understand the portion sizes of the children and manage the junk foods in an effective manner (Slainte and Poustie, 2021). It is also essential to increase the number of processed foods and drinks for the children and encourage them to play and have a good amount of sleep as well as reduce the amount of screen time which is very essential for the children. 

Under this public health initiative, patient motivation is considered to be very important for the people who are suffering from obesity as the doctor or the healthcare provider needs to motivate the patient to lose his or her weight to reduce the risks from obesity which can affect the life of the individual (Hamjane et al. 2020). It is very essential to communicate the benefits of weight loss and the reduction of the risks which can make his or her life better. During this process, the concept of dietary counseling is very essential for the patient as he or she needs to have a proper diet plan which will reduce the amount of unnecessary fat which is taken in and also reduce the chances of overweight. A proper dietary plan in association with a physical activity chart will help the person reduce the weight which is bulked-up due to high fat, and this is one of the major principles of this public health initiative which included these plans to help the individuals reduce the weight as well as reduce the chances of obesity issues in the person (Cook et al. 2017).

Reduction in life expectancy 

The decrease in the life expectancy rate is another issue that is highly affecting the lives of the people in Northern Ireland as it is observed that in Northern Ireland the average life expectancy has reduced to 50 years which is severely affecting the population as the earlier the average life expectancy was 80 years and this reduction in the life if something which creates a situation of worry (Perry et al. 2017). This is also observed that several people each year face early death because of obesity or overweight which increases the chances of heart or chronic diseases and affecting the lives of the people or causing death (Vidra et al. 2019). This is another concept of modern public health that has been able to underpin this initiative of public health in Northern Ireland. It is also observed that most of the people who are suffering from obesity and overweight are dying below the age of 50, this indicates that the condition of obesity is not a sudden situation as in most people due to the unhealthy food habits and lifestyle from the childhood is the reason behind this condition which is affecting the people and making them grow into an overweight person and stay unhealthy rest of their life. 

These are some of the major concepts and principles of the modern public health which has been able to underpin A fitter future for all initiative in the Northern Ireland for increasing the awareness among the people about the obesity and its issues as well as helping the obese people to recover from the issue and have a better life.

Identifying and explaining the key elements of this public health intervention

The health service executive and healthy Ireland (ROI), the department of health (DoH), the national health agency NI and the special advisory group on obesity (SAGO) were the main participants of this public health intervention and were responsible for the development of this “A fitter future for all” public health intervention and these groups are also responsible for the implementation of this public health intervention in the Northern Ireland and also form the strategic basis of this public health campaign (Slainte and Poustie, 2021). 

A fitter future for all is the intervention that was developed to provide the people of Northern Ireland with the idea about what are the health choices which are needed to be made to stay fit and stay healthy. This intervention educates the people about the risks of obesity and the diseases which are related to obesity as well as the ways which can be used for improving the health and wellbeing of the people who are suffering from obesity in Northern Ireland. This public health intervention is developed to create an environment that will support and promote a healthy lifestyle of the people including the proper amount of physical activity as well as a well-maintained diet of the people. A short-term implementation of this intervention was developed for the year 2012-2015 to analyze the short-term outcomes of this public health intervention (www.health-ni.gov.uk, 2015).

The main target of this public health intervention was divided into 2 sections where one is for the adults and the other one is for the children (Slainte and Poustie, 2021).

• For adults, the target of this public health intervention was to have a reduction in the level of obesity by 4% and a reduction in the level of overweight by 3% by the year 2022.

• For children, the target of this public health intervention was to reduce the level of obesity by 3% whereas reducing the level of overweight by 2% (www.health-ni.gov.uk, 2015). 

One of the major key elements of this public health intervention is the two address two main areas,

1) Increase in the percentage of the people who are eating healthy, nutritionally balanced food.

2) To increase the percentage of the population of the which is highly indulged in the physical ac6tivities which are very essential for reducing the effects of obesity and increase a healthy life for the people. 

The government of Ireland invested a total amount of £ 7.2 million for the short-term implementation from 2012-2015 to deal with this major issue of obesity (www.health-ni.gov.uk, 2015). The Department of Health believes that for achieving the long-term outcomes it is very essential for them to start getting positive short-term outcomes from this public health intervention and then try to have long-term results. 

Another major element of this public health intervention is the Active8 program which is for those children who are studying in primary school. This program will help them to understand the need for a healthy lifestyle with the help of an adequate amount of physical activities and a healthy diet. This program is developed to increase the awareness and understanding of the children regarding the interlinkage between physical activities and a healthy diet which will be provided to them with the help of connected learning opportunities through the physical education classes (Slainte and Poustie, 2021). The active8 sports leaders program and the active8 eat-well programs were initiated to support this public health intervention effectively and provide the children with the required amount of support through which they can have a healthy life and avoid the obesity conditions among the children who are the future of the country. 

To evaluate these elements of the public health intervention the Department of health started an Eat, Taste and Grow plan which is used for spreading awareness among the children where they will be provided with knowledge about the food items which are naturally grown in Northern Ireland and how they can maintain a healthy food habit. This plays a very essential role in healthy eating and also provided the healthy eating module to the schools who will introduce them to the family and the children in the orientation plans so that they can have a balanced diet and also provide them with the idea about the ways through which less usage time to the screen and good amount of sleep which can help them to reduce the chances and impact of obesity.

Evidence that supports this intervention and its use in the neighboring country

This is a ten-year obesity prevention health intervention which has been developed by the government of the country in the year 2012 for the people of Northern Ireland to help them avoid the risks of chronic health issues due to obesity (Slainte and Poustie, 2021). One of the major pieces of evidence is the final report of the short-term implementation for the period of 2012-2015 which indicates that almost 53% of the adults in the country have been able to achieve the physical activity guidelines and this evidence also determines that almost 36% of the adults are consuming fruits and vegetables in their diet. This final report of the year 2012-2015 also states that almost 25% of the adults are indulged in the prevalence in the obesity whereas almost 7% of the children are prevalence to the obesity and this indicates that this public health intervention has been able to increase the awareness among the adults as well as among the children related to the issues of obesity and the ways through which they can reduce the effects of obesity on the children and adults (www.health-ni.gov.uk, 2015). The Health Survey Northern Ireland provides the idea about the decrease in the rate of obese people in the last 3 years which is the short-term plan of DoH. This survey determines that there is almost 1-2% of reduction in the impact of obesity on the people which is a short-term win for the government of Northern Ireland (www.health-ni.gov.uk, 2015). 

In the 2015-2016 final report it was observed that there was no increase in the physical activity consideration of the adults, but one percent of the increase was observed in the physical activity consideration of the children as in the new cycle almost 37% of the children started to have physical activities. 2015-2016 was the year which was considered as the first step towards the long-term approach after the short-term success of the A fitter future for all health intervention. It is also observed that almost 26% of the adults are now prevalent to obesity and almost 9% of the children are prevalent to obesity which shows that there is an increase in the success of the obesity and reduction in the rate of obesity (www.health-ni.gov.uk, 2016). 

Another evidence that supports this intervention is the 2019 report which is the last published report of this intervention, which indicates that almost 55% of the adults are considering the physical activity recommendations in their daily lives, and 43% of the adults have indulged in vegetable and fruit-eating habits which is increased in the last few years and indicates that the Department of Health and the government of Northern Ireland are successful in decreasing the effect of the obesity on the lives of the people and increase the awareness of the healthy food and lifestyle (www.health-ni.gov.uk, 2019). This evidence indicates that the implementation of this public health intervention has been very effective for the people of the country especially for the children who are the future of the country. 

This health intervention can be replicated in the neighboring countries as well where the obesity ratio is high and is affecting the lives o the people as well as reducing the average life expectancy of the people in the country. It is observed in the Public Health report of Scotland that almost 32% of the adults who are residing in the most deprived regions of the country where they don’t have proper access to the physical health support of dietary food items are obese whereas almost 20% of the adults in the least deprived regions are also affected due to obesity and this is the reason Scotland is a country whose adults are highly affected due to the obesity and this is the reason this public health intervention would be very useful in Scotland as it will firstly, increase the awareness among the people explaining them about the importance of obesity reduction and issues which can arise due to the obesity (Scotland Public., 2021). This intervention will also provide physical activity support to the people of Scotland for ensuring that they can have an effective physical life which will burn the fat in their body and reduce the effect of obesity in their body. A fitter future for all initiative will also help the government o the country to reach out to those places which are highly deprived and provide them with the guidelines about the need for physical activity and provide them with the support which can help them to have adequate access to the dietary plans which and food items for maintaining and healthy and active lifestyle (Scotland Public., 2021). This indicates that yes, this same intervention can be replicated in the neighboring country Scotland for reducing the effects of obesity there as it was carried out in Northern Ireland.

Discussing ways to evaluate the public health intervention and justification for the method chosen to evaluate this intervention

Two major methods are used for the effective evaluation of the methods which are used for the evaluation of the public health intervention. The randomized control designs and observational studies are two of the major methods to evaluate public health interventions (Craig et al. 2017). 

The randomized control design is the method in which an individual is selected randomly and provided with the intervention or the control treatment which is required, it is also termed as the gold standard of the intervention impact evaluation. It has been observed that in the larger groups this method of evaluation of the intervention is quite helpful as the randomization helps in the maintenance of the balance between the intervention and the group which is about to receive the treatment in an effective manner (Lopez Bernal et al. 2018). This method is considered very effective for the evaluation of the health intervention as it assesses the complex changes in the healthcare services which are delivered to the people in an effective manner and helps the healthcare agency to provide better intervention to the group of people (Kowatsch et al. 2017).

An observational study is another method that is used for the evaluation of the public health intervention effectively. It is a non-randomized process where the exposure to the intervention is provided to the people based on its outcomes and the consequences are removed (Strooband et al. 2018). The idea of this evaluation method is to analyze the impact of the intervention on the group which is non-randomized but based on the observed characteristics. 

To evaluate this intervention, the use of the observational study method will be the best fit as it will support the randomized selection of the treatment group. This public health intervention is for a very large group of people which includes that the adult and the children, as well as this intervention, needs to have the treated and the control group to have equivalent effects which can only be observed in this method of evaluation is used. This is the main reason behind the usage of this method of evaluation for this public health intervention.

Conclusion

This report concludes that obesity is the health issue due to which most of the countries across the globe are highly stressed as it is reducing the effectiveness of the people and also decreasing the average life expectancy of the people. Northern Ireland is the country which is chosen for this report as the people of this country are highly suffering from the issues of obesity and overweight. This report also states that the lack of physical activity and high fat and energy-rich food items are two of the main principles due to which the people of the country are facing the issues of obesity and this is the reason the Department of the health of Northern Ireland has been able to develop a public health intervention named as "A fitter future for all" under which every person of the country will be provided with the guidance about the need for the physical activities and which activities are needed to be performed based on their health condition, height, weight, and age. The children are the prime focus of this intervention as they are the future of the country. This report also concludes the key elements of this public health evaluation as well as provides the evidence which supports this intervention. There are two of the major methods which can be used for the evaluation of a public health evaluation. This report will also provide a clear justification of the method which is chosen to evaluate this public health evaluation.

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