Tackling Obesity & Managing Weight during a Pandemic

As the UK Government continues to launch measures to address the issue of obesity, in light of the increased risk it places on patients who contract the covid-19 virus, we at HSH have been reviewing how this health crisis applies to the prison estate and what measures we can introduce to support the prison population.

“Obesity is one of the biggest health crises that the UK faces. Almost two-thirds (63%) of adults in England are overweight or living with obesity with obesity-related illnesses in adults and children costing the NHS £6 billion a year.

The urgency of tackling the obesity time bomb has been brought to the fore by evidence of the link to an increased risk from COVID-19.

Living with excess weight puts people at greater risk of serious illness or death from COVID-19, with risk growing substantially as body mass index (BMI) increases. Nearly 8% of critically ill patients with COVID-19 in intensive care units have been morbidly obese, compared with 2.9% of the general population.”

A review into patient experience has highlighted that the majority of patients deem the prison setting to be restrictive when it comes to a healthy diet, with many patients advising that they would not eat a lot of the things they eat in prison if they were living in the community. In comparison, gym/exercise facilities and access are considered to be as good as, if not better, than facilities and access within the community.

Patients that we have spoken to have generally agreed that the option to select healthier foods at meal times is limited, though we understand from our prison colleagues that healthy options are available. As well as scheduled meal times, patients also have the ability to purchase additional foods using their allocated allowances; however, most patients stated that, given the option, they would likely opt to purchase a chocolate bar over a piece of fruit.

Based on these findings, HSH has identified that it is extremely important for patients to have greater awareness and understanding of the things they do have control over when it comes to food: portion size, balanced diet and the positive impact that healthier choice can have on their health and well-being.

To support the above and in line with the NHS drive on better health, we are encouraging conversation between our clinicians and patients within the prisons about all aspects of a health lifestyle, with a particular focus on weight and diet. We are also working to ensure that our patients have access to a range of information about healthy lifestyles and what they can do within the confines of the prison to make healthier choices.

We often find that patients come into a consultation, see a set of scales and ask if they can weigh themselves. This is an ideal opportunity to open a discussion about diet and exercise and how patients can make changes in these areas. Many patients are unaware of portion size and ways in which they can make small, achievable changes, such as reducing carbohydrate intake.

“Move more and eat better.”

We offer regular ‘weigh-ins’ to support patients trying to lose weight and patients on certain medications where weight may be affected. There is also remedial gym available to help patients increase their activity.

We run a range of clinics that help to identify, advise and support patients with weight issues, such as NHS health checks, long term condition reviews and cholesterol clinics. We are also looking at launching men’s health groups and weight loss groups within our prisons: these services will aim to provide diet and lifestyle advice that will support patients to improve their overall health and well-being and educate them on the benefits of making small changes.

Author: Tierney Harris, Advanced Clinical Practitioner