We are delighted to announce that the Obesity Institute and Obesity UK have just been awarded an NIHR grant to work together with South Asian women and the LGBTQ+ community to codevelop much needed tailored support groups and more inclusive research.

Hi, my name's Ken Clare. I'm of 1-2 with the Bestie UK and I work as Patient and Public Involvement Lead in the Obesity Institute at Leeds Beckett University.

We've been supported by a grant from the European coalition for People Living with obesity to produce this podcast for World Obesity Day 2023.

We've got some great guests lined up to discuss the awesome joint work being done between the Eastern UK and the Institute at Leeds Beckett.

So just to set the scene, Obesity UK launched in 2019. It was the result of a merger between two charities, both of whom had a long history of supporting people living with obesity.

And for our first guest, I'm really pleased to introduce Jimmy Fallon, one of the members from Obesity UK

Hi, Jim.

Hi Ken. Thanks for bringing me in. My name is Jimmy Fallon. I have, I've suffered with obesity most of my adult life.

I've had a gastric rule and white gastric bypass performed on the NHS, 10 years ago, the 5th of April.

I went to my first meeting where I actually met Ken Clare two weeks after my surgery, and I was that passionate about what I learned because I went into this blind. I didn't know what I was doing.

I just thought that these smaller portions, but I'd still be able to eat everything.

I was wrong. I've become that passionate about it. I ended up.

Attending every meeting that we had. And ended up facilitating the face-to-face groups before lockdown.

00:02:10 Jimmy

And for me personally, it's kept me focused and it's great to be able to reach out and work with people who otherwise wouldn't have been able to get in touch with anyone because as we know, all the frontline services shut down all the surgeons and everyone went back to the normal duties, and it was if like people living with this long term illness, which is obesity, have been forgotten about.

It's really being helpful and it's great to be able to reach people who never would have been able to go and share on such a personal journey.

I'm passionate about getting peoples voices heard because we are a minority even though I've lost the weight. I still class myself as I need the support and that's a bit about me. Anything else, Ken?

Thanks to you and that's really good. And you give us a great insight both into your own personal story and into the work that you do. And I know that you really appreciate it and I know about the effort that you've put in and I know the community in Obesity UK do too.Thank you for that.

But I think that you and I, as we're working, and we've been going along over the years we've realised that there are.

Many groups that we don't really support very well and don't access our support groups and that serves really well as a link to the main body of this podcast. So, we've partnered with Leeds Beckett University to explore in more depth some of these issues.

So, to talk about this afternoon, we invited along 3 guests and I'm going to introduce them now. So firstly, Professor Louise Wells, who is a Co-director of the Obesity Institute at Leeds Beckett University.

Hi, Louisa.

Hi, Ken.

And councillor Hannah Bethel, a Co-investigator on the grant application and a champion for LGBTQ plus and BT within Leeds City Council, Ihana.

Hi there.

And last but not least, Doctor Halima Iqbal, who's a research lead for the South, Southeast Asian Muslim Ladies Group and lecturer in public health at the University of Bradford.

Hello, Halima.

Hiya, Ken.

So, Louisa, I'd like to start off with you for now we've heard from Jim about obesity UK.

And I'd like.

You if you could sort of paint the picture about the Obesity Institute and what?

The work is that goes on there.

I'd be delighted to, Kent. So, we launched the Obesity Institute actually on World Obesity Day last year and the idea of the Institute is to bring together academics from a range of different disciplines from across the university and further.

The field, but really importantly to work with policymakers, practitioners and super importantly to work with people with a lived experience of obesity to really understand what are the real-world problems and questions relating to obesity and also importantly, how can we actually work together to develop innovative person?

Centred and compassionate, inclusive solutions to these problems and questions. Really, to try and make a real and tangible difference to the lives of people living with obesity. This strong collaborative ethos has really facilitated.

A close working relationship with our a range of fantastic partners, one of which of course is obesity UK and it's been a quiet aspiration for a few years now for of Ken and I's to submit a research grant that was led by Obesity UK and truly driven by the voice of lived experience. And we were fortunate to.

Opportunity last year, in submitting the the grant that we're going to talk about today.

Thankfully that that was really super helpful. You've been along to the online support groups on ABC UK several times. Would you like to tell the audience about your experiences there?

I would can honestly, it was just the most amazing privilege and experience just to be able to go along and to be able to share our research findings.

I think as researchers, one of the things we're terrible at is actually communicating what we've found and to have the opportunity to be able to do that.

It was really, really fantastic, but really importantly to me was having that really vital opportunity to actively listen to the voice of lived experiences and these have proven so insightful and so incredibly important in underpinning. So much of the research we do.

In fact, I would say the impact has been quite profound in terms of the voices from the obesity UK.

Work group informing the development of one of our fastest growing research areas, which are a very big project around exploring the impact of emotional and disordered eating, and I don't think any of that would have been possible without the really valuable voice and insight from obesity UK members. So it was a fantastic opportunity I would encourage.

Anyone to come along if they're privileged enough to receive an invite, but also I would just like to say huge thank you to the obesity UK members for sharing, for sharing their fantastic experience.

Thanks, Louisa. So you can see from what Jimmy and Louise have said that we've achieved some great things, but we've got lots more work to do within certain groups in our community that we're not reaching currently as well as we could.

And the partnership working has pulled together this bid and members of communities were involved in the Co-production and Hannah and Halima are now going to talk more about those activities.

So I'm going to move over to other members of our panel now. So Hannah, your first up, could you tell us about the importance of peer support for the communities that you represent in Leeds City Council as need for LGBTQ plus and obesity, please?

Yeah. Thank you.

And it's so, so important to our community to have a peer support option available. GBTQ plus communities often don't feel safe with authority figures.

There's been a lot of persecution. We consistently have lower health outputs because the NHS and medical systems aren't made for.

And so actually having that peer support of people who are living through both the same chronic illness but also living through the same lifestyle and difficulties that we face in a heteronormative society is really, really important. And of course, because of the differences in health.

Outcomes LGBT plus people are often more likely to die younger and actually adding living with obesity to that on top is really, really important that we provide some sort of challenge.

There's specific needs within our community in terms of for myself as a Butch lesbian. I have previously being quite.

Pleased with living with obesity because it avoided the feminization of my body, and I know that obesity can mask a number.

Of issues around identity, but we similarly have major issues around living with obesity. So for trans members of our community, for example, they are less able to access healthcare and gender, reaffirming surgery if they're living with obesity because they're less able to access the surgeries themselves.

I think obesity more widely has a lack of clear direction.

In terms of the policy and obviously as a politician, I I embroil myself in policy as much as possible and actually.

It's rare that the wide range of factors really get a look in or a mention in the public health and NHS strategy, so even those who aren't living with a protected characteristic identity, actually, it's kind of an ad hoc.

System for them to manage to, to access rather weight management.

So actually those that have got protected characteristics quite regularly fall through the cracks or their needs aren't met consistency consistently.

And actually, how could we believe that they would be?

If the mainstream communities aren't so, I felt like it was really important to get involved with this, and I'm grateful for the opportunity.

Thanks. That's a great answer. And I'd like to ask, I know you work in lots of other areas within the Council and there's obviously your councillor in the boards as well.

There any other communities that you're aware of from your work that would benefit from tailored support?

Yeah, hugely, I mean.

Actually, I think obesity healthcare needs a revolution and we need more tailored support for people with food addiction and emotional eating binge eating.

People living in poverty. But of course, those living with obesity and an intersectional protected characteristic more widely than the LGBTQ plus.

Community are doubly left behind, my colleague Councillor Abigail Marshall Tatung, found similar gaps in an art, ethnically diverse communities here in Leeds, so I know that she's been looking into what we can, what we can achieve in a similar way to what I have with the LGBTQ plus community.

And now.

I'm going to pass on to Halima. I know that you undertook your PhD research within one of our least heard communities with Southeast Asian Muslim ladies.

Could you tell us how?

You know what were some of the key things that you learned about the need for culturally appropriate peer support during that process?

Yep, so research has shown that South Asian women have exceptionally high rates of obesity in comparison to the wider population and interventions to reduce obesity in this group are largely unsuccessful.

So from my own pH D research, I found that one of the reasons that women didn't access support on managing their work was because dietary advice isn't cultural.

Appropriate. So for instance, health professionals sometimes don't take into consideration cultural traditions, customs and beliefs around diet and physical activity.

So when women are offered advice and guidance, it's not really seen as relevant to the women. An example of this is when women participants in throughout my PhD, they mentioned that their dietician.

Discussed the eat well plate with them, but the proposed recipes there were not staple foods found in women's diets, so women disregarded those recipes.

As well as this, women lacked confidence in seeking advice from health professionals on how to live a healthy lifestyle because they felt that health professionals didn't know enough about their cultures and traditions so they couldn't advise them appropriately.

So that included things like not taking their advice to engage in physical activities such as going for walks in their local areas or joining gyms.

Or to go swimming when women didn't feel comfortable doing these due to religious reasons such as modesty and exercising when men were present.

So I feel that culturally appropriate peer support would rectify some of these issues because of shared understandings which will then enable trust and be more likely to produce positive results.

So women in my joint, the PhD, the participants also identified that a lot of South Asian women have poor mental well-being and that women don't leave the house much and are quite socially isolated.

So if there were culturally appropriate support groups where women could socialise, that would as well be quite beneficial to them.

Thank you, Halima, and your passion for the subject really came through in your answer there. Thank you. And I mentioned that earlier on in the in the podcast that this was about a bid and we bid for a Co produced funding application to the National Institute of Health Research.

Which is in brackets NIH and it it is a mouthful and it's a lot of jargon words, but it's a a research called Co develop and evaluate tailored peer support groups for these two populations that we've been talking about and we've got some voices on the podcast today, but it's important to point out.

That there's a really big tumour, researchers and people with lived experience of obesity from these communities have been involved in bringing this project together and working together.

And I think it's really unique in that we worked in a very closely, very close knit partnership approach and contributions are valued right across the group.

And I think.

We've brought words like Co production and Co creation, which are often used as jargon. We brought them to life.

So now I'm going to ask Louisa to tell us in a bit more detail about what the grant can mean for least her community groups and what you hope it will help us to achieve. Thanks, Louisa.

Thanks, Ken. And really honestly, I can't say what a privilege it was to work with such a fantastic team of members across obesity UK, but with our fantastic community groups who have really driven this application for us. So I guess in terms of what what we hope this grant will actually achieve.

I really hope it will plug a much needed gap in terms of peer support needs for some of our most diverse and most least heard communities.

I also hope it will provide a blueprint or a kind of guidance document that will actually help to inform the development of more tailored support groups across our broad and diverse country.

Our broad and diverse populations across the country, so not only will this be important in terms of ensuring we have.

Equity in support provision, which I know both myself and Ken from Obesity UK and also the Obesity Institute are Super, super passionate about, but it will also help these groups to.

To follow the same format as we undertake within the General Obesity UK groups by providing an opportunity to share relevant research findings and information and really importantly to be able to actively listen to the voices of diverse lived experiences in order to be able to start to Co-produce research together.

We really need to start to develop a rich research evidence base that reflects and importantly responds to the needs of everybody who is living with a beasting not just those who are most frequently heard.

And this work will really help us to develop more inclusive research going forward and as Hannah and Jimmy have both said, obesity is a really complex chronic disease.

There's never going to be a one-size-fits-all approach, so work like this going forward is going to be so critical.

Thanks, Louise. And you know I think we've all answered about how passionate we are about the work that we're.

Involved in and how?

That could go forward in the future.

And I know that we want to if we're successful, we're getting the funding and then we move forward into the next steps. So moving on today, I just want to ask both Hannah and Halima.

About lessons they've learned during the application Co production through the groups and what they think about the grant and the impact on their potential community groups. So, I'm going to ask Halima to go first this time please.

So during the application development, we may acknowledge the importance of the support groups as they recognised that weight was quite a pressing issue within the South Asian female popular.

Mission. So women felt that if the support groups were quite appropriately tailored to their needs, there would be higher attendance and that it proved beneficial to them in managing their weight.

It was quite interesting to me that almost immediately when I asked them without hesitation, they identified a wide range of reasons why they thought South Asian women did, did not or would not attend or be city support groups.

And many of these issues related to their religion and culture, as well as issues more general.

And they were immediately able to offer solutions as to many of the barriers that they identified, such as the need for it to be run and attended by South Asian Muslim women only to be held in places familiar and acceptable, such as mosques, community centres and schools, having facilitators or leaders who spoke Urdu and Gujaratis. So we could address the issue of language.

Barriers proposing times of the day, which would be best to hold the groups and to provide culturally appropriate education on how to manage the way.

I think the grant will be fantastic in providing that much needed tailored support for South Asian Muslim women. My own PhD research showed that a lot of Pakistani women have a desire to attend support for weight management, but it's never appropriate.

Also another finding for my PhD was that culturally appropriate education on diet and physical activity was desperately needed for this population. So I feel like this grant can really help fill that gap.

Thanks for limit. That's a fantastic answer. And now, Hannah, I'm going to put the same question to you. Just show me your impressions about the groups that you Co-facilitated. What came out of them and what you hope you get from the grant.

Thanks, Ken. It's a I could speak for hours. I'll, I'll try not to. But as politicians, we do have a tendency and there's so much so, so much that we learn.

And it was such a more complex picture than I was expecting, and I maybe even more complex than I was hoping for in that I was hopeful that it would be a relatively easy thing if we just put these particular factors in suddenly, we'd be able to make a difference and actually.

What I hadn't really paid attention to was just how nonhomogeneous the LGBT plus women and nonbinary people is as a group.

There's the intersectionality playing the intersectionality of identity that plays out is huge. I mean, for example, we've talked just now about South Asian Muslim women as a group.

But it could be that there will be South Asian Muslim women in the LGBT plus group as just a small fraction of the wider diverse population that's within there.

So I think one of the things that really came up for us was that there will be some difficulty in creating that safe space with those intersectional identities and how we manage that really effectively.

There's a lot of I would go as far as to say fear, actually around diet, culture and that kind of protruding into what we do.

There's a lot of stigmatisations of LGBT plus people's bodies and how we use them, what we wear, there's.

Danger when we go into the toilets like there's a huge range of things around our bodies that already creates a huge amount of stigma.

So adding into that the sort of diet, culture, mentality and stigma into a weight management programme there was a real.

Real, almost visceral response to anything that was that was based around that, and I think.

That made us reconsider the weight management side to be more around Wellness. And actually, we had to develop an acceptance that actually managing living with obesity doesn't need to necessarily mean actively dieting the weight management or the losing weight element can come as part of a much wider holistic approach to Wellness. And I think that will probably be the.

The route that we that we take.

We also had some kick wrap back around media advice and the wide variety of TikTok based well-being and obesity-based advice that you can get and how we kind of.

Pushed back against false information that's being given out in our community by some really, really influential celebs and really influential people.

And so there's just so much more for us to learn and so much more discovery for us to do in this community around how we're going to most effectively be able to support and I guess that's what I want from if we get the grant is to be able to move forward and provide this support.

For our community around their Wellness and I'm really, really excited to be able to be almost at the cutting edge and lead the way in helping to, as Louisa said, kind of put together a blueprint for how it can be useful across the country, because this isn't just a problem here in Leeds. It's a problem all over the country and it's wonderful, genuinely wonderful to be able to be involved.

Thank you, Hannah, and I've learned so much from being part of this team and I've learned things from being on this podcast today.

If funding is obtained, we hope to start this project in April 2023. You can find out more about the project and about obesity UK on www.obesityuk.org.uk and about the Obesity Institute on leedsbeckett.ac.uk/ObesityInstitute all one word

And so to round up, I'd really like to thank our fantastic panel for coming along and being the voices of this project.

So I'd like to say big thank you to Jimmy Fallon from the Obesity UK Councilor, Hannah Bithell, Doctor Halima Iqbal and Professor Louise Ells. I'd also like to thank all the members of the team and the Co-production groups that made this work possible.

And I think finally I've got to say a huge thank you to the European Coalition for People living with obesity and the grant that made this World Obesity Day Europe podcast post.

And I'm really excited to announce to you some late breaking news that we've been successful in getting the bid granted to us and we'll be starting the work on the 1st of April 2023. And I'm really looking forward to seeing the fruit of all the work that's already been put in and taking this forward in the coming year.

Thank you all for listening.