In response to your call for examples of policies and programmes that have been successful, I would like to draw your attention to MEND - Mind, Exercise, Nutrition .....Do it! I will also mention other new approaches to changing lifestyles that have been inspired by the MEND experience.
MEND describes itself as "the largest and most extensively evaluated child weight management programme in the world". Over 85,000 children have completed MEND classes in 6 countries. The largest operations are in UK, USA, Canada and Australia/New Zealand.
MEND was conceptualised 16 years ago by specialists at Great Ormond Street Hospital and University College London Institute of Child Health, both in UK. It was piloted amongst 7 to 13 year-old children from 2002 and then promoted and managed by Mend Central, a social enterprise, from 2004. The aim is to bring about lasting changes in the lifestyles of children who are overweight or obese, so that they become fitter, healthier and happier as they reach or maintain a healthier weight. Courses are usually offered to groups after school once a week for 12 weeks, with both parents or guardians and their children participating. The courses were originally designed and are constantly being enhanced by dieticians, nutritionists, physical activity experts and behaviour change specialists o the basis of evaluations. Training sessions, however, are conducted by non-specialists who have undergone specific purpose-built training and who are supervised and evaluated by MEND management: the use of non-specialists as trainers allows for rapid scaling up of the programme.. Teaching is based on experiential learning methods with a strong emphasis on the fun of learning by doing.
Once participants understand why they are putting on weight and the problems that this implies, they become interested in possible solutions.
Most MEND courses are run in low-income communities, especially those with a high proportion of ethnic minorities, in which the incidence of childhood obesity is highest. Courses are provided free, with funding coming from national health services, local authorities or foundations. Children are enrolled either by parents or are referred to MEND by schools and family doctors.
MEND has been subject to a great deal of research and evaluation. This has looked at the extent to which "graduates" maintain increased physical activity levels, attain greater cardio-vascular fitness, reduce time spent in sedentary behaviour, stick to improved diets and attain higher levels of self-esteem.. Results are generally encouraging ( for links to research findings, see http://healthyweightpartnership.org/pdf/MEND-References.pdf).The same principles are being applied to the design of programmes to address the needs of overweight and obese people in different age groups, including babies, teen-agers and mums (http://www.mytimeactive.co.uk/mend) as well as adults (http://www.discovermomenta.com). Very recently, with funding from the English National Health Service, programmes have been launched in the UK that have been specifically designed to help people make the lifestyle changes required to prevent or cope with Type 2 Diabetes (http://reedmomenta.co.uk/).
What is abundantly clear is that the impact of programmes such as MEND can be greatly enhanced if they operate within a supportive policy environment. This implies, for instance, a need for restrictions on advertising of "unhealthy" foods aimed at children; taxing sugar and high fat foods; promoting lower portion sizes in ready-made meals and in fast-food restaurants; national guidelines for preparing healthy school meals and so on.
Andrew MacMillan