خريطة WOD

When Dana Rosser started dating her husband 26 years ago, he weighed 460 lbs. She learned very quickly that people with obesity have many challenges – and realised that there was little support available for their loved ones and supporters. So she decided to write a book on the subject. Here is her story.

نسخه:

Hi, my name is Dana Rosser and I’m from Orlando, Florida. My experience with obesity started 26 years ago when I started dating my husband. At that time, he weighed 460 lbs.

I was introduced to obesity based on how people treated me for being with him. You see, my husband is a world-renowned laparoscopic surgeon, and people thought that I was with him because of the fame and fortune. So, I was judged for being with someone who was severely obese.

After we married, I learned very quickly that people who suffer with severe obesity have so many challenges. One action that I would like to see more is for their loved ones or supporters to have more support.

When I was seeking support for dealing with my husband, I couldn’t find any. So, I decided to write a book entitled ‘Through Thick and Thin: Facing Obesity through the Eyes of a Loved One’.

That’s my action. I couldn’t find support, there were no books out there for me to read, no support groups for me to attend, so I took it upon myself and wrote a book for loved ones – for supporters like me.

I support World Obesity Day because it is an amazing organisation. It’s such an important day to bring more awareness to the disease of obesity, because obesity truly is a disease; it’s a chronic disease.

By becoming more aware that it is a disease, I think that people will have more compassion in the world. So that’s my ‘why’. Thank you!

بمناسبة اليوم العالمي للسمنة 2022 ، دعا فريق السمنة البرازيلي خبراء ومنظمات السمنة لتبادل خبراتهم في الوقاية من السمنة ومكافحتها في البرازيل. هذه واحدة من قصصهم.

I am an advocacy analyst at the Instituto Desiderata, and I work as a political liaison person on the issue of child and adolescent obesity. I’ve been working on a legislative advocacy project to pass and implement a law to fight childhood obesity in the municipality of Rio de Janeiro.

ما هو الهدف من المشروع؟

The project aims to approve a law, in the municipality of Rio de Janeiro, that institutes actions to combat childhood and youth obesity, by regulating food environments and protecting the right of children and adolescents to health and adequate and healthy food.

The Project of Law (PL) 1662/2019 provides for the following actions: restricting the offer of sugary drinks and ultra-processed foods in public and private schools; regulating the display of ultra-processed foods in commercial establishments, ensuring that they are positioned above children’s line of sight on racks and shelves (from one meter high); implementing breast milk collection and packaging rooms in companies. In this way, the PL provides for the regulation of strategic points in the containment of the growing numbers of obesity in children and adolescents.

ما هي المنهجية المستخدمة؟

Integrated advocacy actions were implemented for the approval of the bill in question. Initially, the legislative house was mapped, and a profile of each parliamentarian was gathered in order to define advocacy strategies and identify potential supporters.

Next, we carried out an advocacy face-to-face with the parliamentarians and their advisors. To subsidize the advocacy and support the councillors in their decision-making about the PL, technical documents were elaborated (notes, technical sheets, and amendments).

Also, because we understand communication as a fundamental ally for social mobilization, we started, in parallel, a mobilization campaign in support of the approval of the PL, with dissemination of information to the population, providing a more comprehensive look at the various factors that contribute to the development of childhood obesity and youth and advertising pieces that invited society to sign the online petition for the approval of the project.

What were the results?

The advocacy actions were fundamental in raising the awareness of 30 of the 51 councillors, enabling the PL to be put on the agenda and approved in the first discussion with 30 votes in favour and 10 against. It is noteworthy that the votes in favour came from members of different party legends and ideological fields, indicating that the advocacy strategy was right and that the importance of the issue goes beyond political disputes.

Our advocacy strategy also made it possible for the issue of childhood obesity and the need for regulation of food environments to gain notoriety in vehicles of great local and national reach, with publication of articles and interviews, including in the Chamber's internal circulation channel, whose audience is members of Congress and their advisors. On social networks, the campaign reached 8 million people, which generated 48.7 thousand visits to our page and 6.3 thousand signatures in support of the petition.

How have these results impacted the lives of people living with obesity?

All the actions described here are part of an effort to implement measures that provide healthy environments for children and adolescents as a way to promote healthy eating habits and contain, in the medium and long term, the advance of obesity rates in the city of Rio de Janeiro.

Studies are conclusive in pointing out that environmental and public policy interventions are the most promising strategies for improving the health of the entire population. Thus, promoting awareness of parts of society, including the school community, parliamentarians, and the Municipal Department of Education of the city of Rio de Janeiro, of the relevance of the issue, contributes in an important way to the promotion of adequate and healthy eating and the prevention of obesity in children and adolescents.

By Fabíola Leal.

Find out more about the Instituto Desiderata.

بمناسبة اليوم العالمي للسمنة 2022 ، دعا فريق السمنة البرازيلي خبراء ومنظمات السمنة لتبادل خبراتهم في الوقاية من السمنة ومكافحتها في البرازيل. هذه واحدة من قصصهم.

أنا أخصائي اجتماعي في برنامج جراحة السمنة والأيض في مستشفى جامعة كاسيانو أنطونيو مورايس (HUCAM) ومنسق مشروع التمديد لتبادل المعرفة من فريقنا متعدد التخصصات.

Obesity is a chronic disease of multifactorial causes. With this in mind, we created an extension project to share the knowledge of the multidisciplinary team of the bariatric surgery program about the management of pre- and post-operative patients in all related areas within the network of care for obese individuals. Each member of the team is responsible for preparing a web lecture and deliver it via Telehealth. 12 web lectures have already been given via Telehealth, reaching more than 21,200 views.

What was the objective of this project?

Our general objective was to train professionals from the multidisciplinary team in primary and secondary care in the four macro-regions of Espirito Santo (Metropolitan, Northern, Northwestern, and Southern macro-regions) in the management of the treatment of individuals with obesity.
Specifically, we wanted to:

• Improve primary care in the line of health care for obese and overweight patients.
• Share the necessary knowledge for the standard management of the post-bariatric patient in all related areas (nutrition, psychology and medicine, among others) with the network of care for the obese individual.
• Strengthen the Health Care Network for People with Chronic Diseases, with respect to the organization of the prevention and treatment of overweight and obesity.
• Promote a better relationship and integration among the three levels of health care at HUS (primary, secondary, and tertiary care).

ما هي المنهجية المستخدمة؟

For the execution of the project, we held a series of study group meetings. Academics of nutrition, psychology, medicine, social service, physical education, physiotherapy and nursing did a bibliographic survey, searching for scientific articles, books, dissertations and theses that relate the following topics: obesity, bariatric surgery, multi-professional team, integral attention, humanized care, health education. They made notes of all the material read for later group discussions. Weekly meetings are held with the students to discuss the texts, providing the group with a theoretical foundation to carry out the project's activities. We disseminate the extension project to the state and municipalities of Espírito Santo, through the Councils of Municipal Health Secretaries (COSEMS) and the Regional InterManagerial Commission (CIR). We also used the Telehealth service of the Cassiano Antônio Moraes University Hospital (HUCAM).

What were the results?

The project resulted in an extension course for health professionals and students with the theme "Fundamentals of Bariatric and Metabolic Surgery: Multi-professional Approach"; a presentation at the IX Integrated Journey of Extension and Culture; participation in the Obesity Prevention Walk of the Cariacica/Spirito Santo City Hall and several web lectures on the theme aimed at health professionals.

كيف أثرت هذه النتائج على حياة الأشخاص الذين يعانون من السمنة؟

Through training professionals in the management of obesity and encouraging more humanized care, it is possible to provide patients with obesity and overweight with access to information for a better lifestyle, improved self-esteem and self-knowledge of a healthy life, as well as the treatment of obesity and related comorbidities.

By Ana Paula Ribeiro Ferreira.

With the Stephanie Alexander Kitchen Garden Program action is everything. Making real food fun has been at the heart of the Stephanie Alexander Kitchen Garden Program since its inception over twenty years ago – initiated by cook and restaurateur Stephanie Alexander AO as a way of combatting childhood obesity. Rather than good and bad foods, green or red traffic lights, it’s all about joy and pleasure and positive messages. Pleasurable food education in fact. 'Learning to live a good food life is the one of the most accessible ways anybody, child or adult, can bring joy to their life.' – Stephanie Alexander AO.

This World Obesity Day – when we know that today’s children and young people may have a shorter life expectancy than their parents, state-wide curricula are failing to deliver effective food education, and the economic impact of obesity is increasingly burdensome – everybody really does need to act. The Kitchen Garden Program enables action by giving children and young people the tools to grow, harvest, prepare and share fresh, seasonal and delicious food.

This early intervention, through fun, hands-on activities at early childhood services, primary and secondary schools, delivers huge benefits in terms of food literacy. Teaching children and young people how food is grown connects them to nature and the world around them, giving insight into food systems and sustainability, and practical skills for the future.

Schools and services are supported and guided to deliver pleasurable food education to their children, students, young people. Through resources that link to curriculum and learning outcomes, personalised support, professional development and a community of practice, each school or service can draw on the supports and different models on which to envisage, implement and sustain their own unique kitchen garden program.

And the effects ripple beyond the school and service gate. Not only do children and young people take skills and knowledge – and a joy for food – with them through life, but families and communities are also influenced by the program. For Jennifer Green, principal at Queanbeyan High School, NSW, it’s a way of 'Developing skills in growing food and expanding the palate of students', as well as ensuring future food security for low SES families and ‘encouraging healthier lives due to increased nutrition'.

Likewise for Caroline Lawson, kitchen garden specialist at Benarkin State School: 'I saw the potential of the program to make a significant difference to the education and lives of all the students in our small one teacher school. The school was in a low socio-economic area and children were struggling to engage.' 'The highlight has always been the pleasure the children receive from this program. They tell me so, their faces beam, they are full of energy. I love the fact that the program is so inclusive, and every kid, regardless of background, size, shape or anything else can be fully engaged with this program.' – Stephanie Alexander AO.

The joy and enthusiasm children take in the program is evident. One kitchen garden specialist responding to a recent survey said: 'Students are really the word of mouth with how much they love the program. They talk to their parents and extended families about their successes. Students love to tell me about what they have cooked at home.' A Year 5 student at Little Hampton Primary School likewise enthuses: 'I have been lucky enough to be able to do the kitchen garden program at my school since Year 3, I enjoy it so much, it is my favourite lesson and I look forward to it every week! I love all of the skills it has taught me, like growing fresh produce in our school garden and then turning it into yummy food in the kitchen. I have learnt about recycling, looking after the environment, the importance of bees and insects in the garden, knife safety and so much more.'

The Stephanie Alexander Kitchen Garden Program’s tried and trusted recipe of pleasurable food education makes it easy for everyone to act. From the smallest of children, through to grandparent volunteers, from local councils supporting the program in their area to corporate partners. It is said it takes a village to care for a child, and the health and wellbeing of the next generation is being shored up by the actions of many participating in this beloved and effective program. A program designed to make food fun, take away shameful talk about food, and encourage activity and action.

By Stephanie Alexander.

I'm a clinical dietitian and nutritionist. Currently, I'm investigating the potential role of community pharmacists in obesity, nutrition, and diet-related NCDs management and their contributions to food systems transition to improve diets and health.

With the increased focus on obesity as a health epidemic and the NHS long-term commitments relating to obesity, community pharmacists are in an ideal position to promote healthy diets, help the government in its obesity strategy by offering weight management services, educate people about adopting a healthy dietary pattern and motivate people to make behavioural change. The intervention ideas for community pharmacist (CP) involvement in obesity are as follows:

• CP-led interactive healthy nutrition education within a school environment to help support healthier communities in the future through comprehensive nutrition education
• CP referrals to social prescribing pathways for nutrition/healthy diets related programmes
• Healthy Living Pharmacies: CP-led services for obesity and diet-related NCDs management and implementation of campaigns for the promotion of healthy diets

In order to implement the best practice models, we will be conducting semi-structured interviews with key stakeholders to co-create and co-design feasible interventions and to adopt a systemic and a life-course approach.

Story by Gizem Acar

UCL School of Pharmacy and Medway School of Pharmacy, UK.

Hana experienced problems with her weight since childhood. After going into healthcare, she set up a centre of health and obesity prevention in Slovakia, and is an advocate for people living with obesity. Here is her story.

Transcript

My name is Hana. Since my studies, I have lived in Bratislava, Slovakia. I have had problems with my weight since childhood. At 17, I was on a weight loss course and later on various diets. My childhood obesity was one of the reasons why I focused on studying pharmacy at University in Bratislava. Since 1993 I have owned a private pharmacy in Bratislava where I work with my daughter.

By gradually changing my lifestyle I slowly lost 15kg. After my marriage, my lifestyle changed again; I looked after my family and pharmacy, and I gained 40kgs again. I was aware of my obesity and the health problems it could cause. I saw in my pharmacy patients suffering from obesity and related disease.

I wanted to lose weight in a targeted way, address my unhealthy lifestyle and find out why I gained weight. Therefore, I completed various nutrition courses in the Czech Republic. I gradually reduced my weight by 17kg. With this experience, I set up a centre of health and obesity prevention in Slovakia. It is focused on lectures and consulting activities, and education in preventing overweight and obesity. I represent the Slovak Republic in the ECPO Patients’ Council. I founded an organisation for people with obesity.

In Slovakia obesity is not recognised as a disease. Doctors only treat its consequences. For three years in a row, we have been organising World Obesity Day, Stigma Day, Health Day, obesity education and prevention. I participate in medical congresses with lectures on obesity in our events and projects we cooperate with various organisations in healthcare.

In Slovakia it is important to educate people about nutrition, healthy lifestyles, and obesity prevention. It is also necessary to educate health professionals about obesity and its treatment.

At a global leadership level obesity must be recognised as a chronic disease. Its treatment and patients’ rights to medical care must be ensured. World Obesity Day is a chance to raise awareness about obesity as a disease, how to prevent it and live a healthy lifestyle. The incidence of overweight and obesity is increasing worldwide. It is a global health problem that is important to address.

We have three weapons against obesity: prevention, information, and education. We have only one health, and it is necessary to protect it.

سمح علاج السمنة لدانيال كوستا بالاستعداد لتسلق جبل أكونكاغوا في الأرجنتين. إليكم قصته (باللغة البرتغالية):

يمكنك العثور على مزيد من المعلومات للأشخاص الذين يعانون من السمنة هنا.

بمناسبة اليوم العالمي للسمنة 2022 ، دعا فريق السمنة البرازيلي خبراء ومنظمات السمنة لتبادل خبراتهم في الوقاية من السمنة ومكافحتها في البرازيل. هذه واحدة من قصصهم.

ما هو الهدف من المشروع؟

أنا أخصائي تغذية متخصص في منهجيات التعليم العالي والتعاليم في النظام الصحي الموحد (SUS) ، وأتابع درجة الدكتوراه في UUFBA ، وأدرس التعليم والسمنة. أنا أيضا أستاذ جامعي في مركز العلوم الصحية في UFRB ، وأعمل مع موضوع السمنة والتغذية في الصحة الجماعية في الإجراءات المنظمة في تريبوس الجامعة. لقد كنت أعمل على مشروع لتدريب الوسطاء على العمل في الدورات الصحية في طريقة التعلم عن بعد ، مع التركيز على الموضوع المعقد لظاهرة السمنة.

يتضمن تدريب الوسطاء للعمل في التعليم عن بعد سلسلة من الخطوات التي تتراوح بين تقييم المناهج الدراسية ، إلى المعرفة حول مجال تركيز الدورة ، إلى فهم طريقة التدريس ، إلى تقييم عملية التدريب وتحديد الصلاحيات ونموذج التفاعل للمعلمين والوسطاء. إذا كان هذا التدريب مخصصا لدورة لتأهيل رعاية الأشخاص الذين يعانون من السمنة ، يضاف إلى هذا الطلب التحدي المتمثل في بناء صابورة علمية وتربوية لتوسيع فهم الوسطاء فيما يتعلق ببناء روايات جديدة لهذه الظاهرة المعقدة ومتعددة العوامل.

ما هي المنهجية المستخدمة؟

تم بناء النموذج ومنهجية تدريب الوسطاء وتجربة وتقييم العملية التدريبية التي تم تنفيذها في عام 2021 من قبل 8 أعضاء من لجنة التدريب وخبرة 9 معلمين وسطاء على مدار 6 أشهر. وعقدت اجتماعات افتراضية أسبوعية وكل أسبوعين في مودل/إيه في إيه بمشاركة الضيوف. ونظمت الاجتماعات بلحظة تمهيدية، وعرض للموضوع، ومناقشة موسعة، ودراسة استقصائية ومنهجية للنقاط الرئيسية التي تمت مناقشتها، وتقديم اقتراح لنشاط ما، وملاحظات ختامية.

ما هي النتائج التي تم الحصول عليها؟

في البداية ، بعد اختيار 10 وسطاء ، تم إجراء مسح حول الموضوعات ذات الصلة بعملية التدريب واللازمة لمواءمة المفاهيم النظرية التي تقوم عليها الدورة. وجرى التدريب في خضم جائحة كوفيد-19، حيث بلغ مجموعها 40 اجتماعا افتراضيا غطت مواضيع عزيزة جدا" على تأهيل الرعاية في سياق السمنة في الرعاية الأولية. وتراوحت المناقشات بين التركيبة العالمية للسمنة وسوء التغذية وتغير المناخ؛ والتنوع البيولوجي وتغير المناخ؛ الحياة النشطة الأمن الغذائي والتغذوي؛ نشاط الدهون الجسم والصحة والأراضي ؛ وصمة عار السمنة وأداء المهنيين الصحيين ؛ إلى عمليات الوساطة في التعلم عن بعد. وأبلغ الوسطاء عن ارتياح كبير وعن الاستفادة من الخبرة التدريبية، مما أهلهم لأدائهم التربوي في الدورة المقدمة للمهنيين الصحيين في طريقة التعلم عن بعد. 

كيف أثرت هذه النتائج على حياة الأشخاص الذين يعانون من السمنة؟

وكان ذلك بمثابة عمل لتدريب الوسطاء، الذين رافقوا تدريب 189 مديرا ومهنيا صحيا في دورة التعلم عن بعد التي يقدمها "تأهيل الرعاية للأشخاص الذين يعانون من زيادة الوزن والسمنة في سياق الرعاية الصحية الأولية في ولاية باهيا: دمج البحوث والإرشاد والتدريب (PQCPSO)"، التي تديرها جامعة باهيا الاتحادية (UFBA)، بالشراكة مع جامعة ولاية باهيا (UNEB) ، والجامعة الاتحادية في Recôncavo da Bahia (UFRB) ، وأمانة الصحة في ولاية باهيا (SESAB) وأمانة الصحة البلدية في السلفادور (SMS).

بقلم كارولينا غوسماو ماغالهايس.

تعرف على المزيد حول جامعة باهيا الفيدرالية (UFBA)

بمناسبة اليوم العالمي للسمنة 2022 ، دعا فريق السمنة البرازيلي خبراء ومنظمات السمنة لتبادل خبراتهم في الوقاية من السمنة ومكافحتها في البرازيل. هذه واحدة من قصصهم.

Since 2016, I have been working in Idec's Healthy and Sustainable Food Program, focused on preventing obesity and NCDs. Through lawsuits, research and communication, we advocate for regulatory measures such as banning children's advertising and improving food labelling.

ما هو الهدف من المشروع؟

We were aware of inconsistencies, regulatory failures and difficulty in understanding nutrition labelling for foods in Brazil. The Brazilian model does not allow consumers to adopt healthier food choices. Our objective was to secure the approval of the new nutrition labelling standard for packaged foods to improve consumer understanding and food choices.

Research and analysis of international examples showed that such approval should include specific standards. The front label should be a warning based on the PAHO nutritional profile, indicating high content of total and saturated fat, sodium and sugar, and the presence of sweeteners and trans fat. This information should be placed at the top of the label and other front labelling, claims, or children's advertising should not be included. The nutrition table should be applied on a white background with black lettering to ensure legibility, include mandatory information on total and added sugars, and show nutrition information based on 100g/mL. The implementation timeframe should be as short as possible to ensure clear and adequate food information for the consumer.

ما هي المنهجية المستخدمة؟

Idec participated in the entire labelling regulatory process. Between 2014 and 2016, there were technical meetings of the Brazilian Health Regulatory Agency’s (Anvisa's) WG, to identify the regulatory problems and possible solutions. In 2017, Anvisa received proposals for improving nutrition labelling from various stakeholders, including Idec, which were based on international research and experiences.

In 2018 and 2019, with the opening of the TPS and the CP, Idec sent technical contributions. Throughout the process, Idec participated in technical meetings with Anvisa directors and mobilized partner organizations, in addition to dealing with industry interference. Since 2017, Idec has produced communication campaigns and street actions to raise consumer awareness and pressure Anvisa to act. At the end of the process, because of the delays, Idec filed a lawsuit demanding that Anvisa make a decision. We also participated in international discussions within Codex Alimentarius and MERCOSUR.

What were the results?

The approval of the new food nutrition labelling standard with a "high in" front model. One of our victories was the approval of a front labelling template for high saturated fat, sodium and added sugar content, in black and white, to be included at the top of the label of products with added critical nutrients, which may not use other types of front labelling or claims about the same nutrients. Other achievements were setting nutritional information per 100g/mL, introducing mandatory information on total and added sugar, and standardizing the nutrition table design.

Some challenges remain, such as improving the nutritional profile, improving the front model based on current scientific evidence, and restricting claims about other nutrients and advertising for children. With this in mind, Idec published the web page "An eye on labels" and continues to monitor the process of implementing the standards.

كيف أثرت هذه النتائج على حياة الأشخاص الذين يعانون من السمنة؟

Although the new nutrition labelling standard was approved in October 2020, its implementation will only begin in October 2022, extending, in some cases, for another 3 years. Thus, we do not yet have concrete indicators of its results. However, according to impact and modelling studies of the implementation of standards in Latin American countries, and of the understanding, use and purchase intention of front labelling in Brazil, it is expected that the changes in the labelling standards - especially the front label - will generate better visualization and greater understanding of the information and, consequently, greater use and change in purchase intention. The improvement of nutritional labelling ensures the right to information for the consumer, who will be more aware of what they consume and make healthier food choices. In the long term, there should be an improvement in health conditions, such as a decrease in cases of obesity and NCDs.

By Laís Amaral Mais.

Find out more about the Brazilian Institute for Consumer Defense (Idec). 

In Brazil, obesity has increased over the last 25 years, from 13 % to 26%. Despite having a lot of information about obesity for health professionals, it is limited for patients with obesity.

To enhance people's knowledge of obesity, we created the NGO Obesidade Brasil, which addresses topics such as obesity being a disease, forms of treatment and diagnosis, prevention, and comorbidities.

Our goals are to provide scientifically-based information on obesity to patients by making people aware that obesity is a chronic disease and reducing prejudice against obese people.

Our project started in August 2019 while it was regulated and added to digital media in February 2020. Our NGO has a website, Facebook, Twitter, and Instagram, where people can ask questions, read articles and watch videos about this chronic disease.

In addition, once a month, we conduct webinars on a specific topic, for example, clinical, surgical, and psychological treatment of obesity.

There were three significant challenges identified by the Obesidade Brasil NGO relating to obesity: limited public access to obesity treatments, the rise of obesity prevalence in low demographic cities, and the understanding of obesity as a chronic disease.

Five months after the NGO was created, it had 6,500 followers combined in all social networks. The NGO reached in each publication an average of 3,000 unique viewers who were primarily female (76%) and young adults (35-44 years old) who live in the main capitals of the country (i.e., São Paulo, Rio de Janeiro, Belo Horizonte, and Brasília). We hope to contribute to people's awareness about obesity to improve adherence and demand for treatment while reducing the growth of this disease in our country.