Vision: The North East will curtail its increase in average body mass index and increase the proportion of people whose weight is within safe limits, eradicating the differential between social groups.

The North East population will be the most physically active in the country, both in its activities of daily living and in its recreational choices. The support available for individuals to alter their activity levels will be clearly and fairly defined and will be provided according to individual need.

Note: With regard to action on diet and physical activity modification we will distinguish two major categories of our population:

• Current risk: those who have signs, symptoms, established risk factors or manifest disease which may be altered by activity-based changes
• Future risk: those who do not have those characteristics
• We will establish a Regional Advisory Group for Obesity, Diet and Physical Activity in conjunction with regional specialists and agencies, voluntary and community sector organisations and key businesses in food supply. This group will look both at the service needs of current risk individuals and will liaise closely with the RAG for Economy, Culture and Environment on environmental design and other policies. * We will establish comprehensive, integrated, community-based obesity treatment and support services. These will be supported by a regionally agreed specification of best practice.
• An infrastructure across the region will be established to support family interventions for seriously obese children and families, together with a clear specification of best practice in delivering these.
• Access to bariatric surgery, orlistat and sibutramine will be greater than the national rates of uptake of those treatments, exceeding the proportional excess of obesity and overweight within our region. * For current risk individuals we will establish a formal referral system for individuals from the NHS to registered, licensed, performance-monitored deliverers of evidence-based and costeffective lifestyle alteration packages of care across the public, private and voluntary and community sectors, setting in place an appropriate, accompanying per-patient payment by the NHS to those providers.
• We will broaden rehabilitation services to establish an entitlement to access across a range of conditions including psychiatric illness, chronic angina, post-cardiac surgery, diabetes and glucose intolerance, peripheral vascular disease, chronic obstructive airways disease, asthma, stroke and hypertension. Entitlement will be determined on the basis of our strategic principles
• For the general population of future risk individuals we will sustain across the public, private, voluntary and community sectors a formal network of health trainers to assist individuals and groups in improving their health related behaviours. At present Health Trainers are predominantly employed by the NHS, but it is rational both that the future base of these workers should be much more diverse, and that NHS funding should be concentrated on current risk individuals. Future recruitment of health trainers will focus on local authorities and other sectors, with training and network support provided by the NHS to assure an appropriate level of health competence.
• We will work with all public sector bodies to develop personnel and estate plans for increasing physical activity, to include promotion of walking, cycling and public transport as the normal mode of travel, with advice, support and financial incentives to discourage car usage, and targeted behavioural change support.
• In conjunction with the proposed social marketing campaign relating to smoking and pregnancy, we will conduct similar work to influence pre-conceptual diet and diet during pregnancy.
• We will undertake specific and funded lobbying of MPs, MEPs, ministers, commissioners and the Food Standards Agency regarding: alterations to food content, limitation of portion sizes, consistent labelling, and promotion of food to children.
• Our principal way of influencing the lifestyles of the future risk group will be through a programme of interagency work to design physical activity into the environment.
• We will monitor and report upon entitlement and access to rehabilitation support.

Potential areas of action for RAG consideration: Malnutrition -Folate supplementation - Potential workplace-based interventions - Value of cooking skills training -Action on transfats - The role of access to food in different communities - Quality of nutrition in care environments - Appropriate actions on diet in pregnancy - What determines long-term changes in physical activity - How to engage disenfranchised groups and individuals

The Obesity, Diet and Physical Activity group have established a Bariatric Prescribing and Surgery sub-committee. Sub committee members can access this area by clicking here