What should we be doing next?

1. There needs to be serious consideration of the resources needed to invest in preventive services, and in all other tiers of the obesity pathway.

2. The Nice Obesity guideline (CG 43, 2006) highlights the lack of research and evidence to support interventions to manage or prevent obesity, therefore any investment would need to be phased, with each phase subject to a cost-effectiveness evaluation before moving to the next phase.

3. There needs to be continued development of partnership working in order to address the wider causes of increasing rates of overweight and obesity, for example through planning and transport policies within the city, and encouraging a greater uptake of physical activity.