kids in playgroundKath Sharman, founder of a well-established obesity intervention programme, has said that recent evaluations have shown that encouraging positive social interaction is one of the key steps to devising a successful obesity programme.

She pointed to evidence gleaned from the data of 435 young people attending the SHINE programme between September 2011 and March 2016. The data has been used to establish the mean change in antropometic measures, as well as the importance of the psychosocial aspect of the programme.

A film shown early on in her talk at Primary Care (2016) emphasised the huge psychological effect being obese has on children - low self-esteem is common and they are more at risk of social isolation and bullying. She believes progammes which purely focus on weight loss and don’t consider the psychological effects on children simply won’t work.

The impact of her words were illustrated in a film which demonstrated the thoughts and feelings of children and young people attending the SHINE programme, run by Sharman. All kids in the SHINE programme are aged 10 to 17 and severely obese (in the 99.6th percentile). “Walk in my shoes for a day then tell me what you think…”, implored one obese YP.

The 12-week SHINE programme uses a step care approach composed of three phases, starting with a low intervention strategy and then moving up (specialist services may be required). Most children start at Phase 2, which invests equal time between traditional weight management and the psychosocial factors. Phase 3 is the additional support given to ‘maintain’ the weight loss. Positive peer interaction amongst the young people attending the programmes helps to retain them.

The study results showed that among the children attending the programme during the evaluation period, self-esteem increased by 38%, depression went down by 46% and levels of anxiety halved. Sharman said the drop-off rate for 12-week programmes is usually high, but the fact that 95% of young people who continue into Phase 3 still attend is an excellent testimony to the success of the SHINE programme. By the end of the programme most of the children attending had reduced their weight from being severely obese to obese.

The data also demonstrated what was keeping young people engaged, highlighting a clear need to focus on the wider determinants of psychosocial health. Establishing clear expectations from the start, with staff providing a supportive and positive nurturing environment, allows young people to be respected and feel they have their own voice. Sharman also attributed the success of SHINE to the enjoyable interactive content of the programme, alongside the encouragement of social interaction. The fact that young people were encouraged to make friends with their peers as well as lose weight was a key factor in its success.