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Physiotherapists given NICE backing to run supervised physical activity sessions for people who are overweight or obese

Jan 17, 2025

News | Sports & Exercise | Sports physiotherapy

Ian McMillan

Physiotherapists or practitioners who are members of the Chartered Institute for the Management of Sport and Physical Activity (CIMSPA) can lead supervised physical activity sessions for people who are overweight or obese.

That is one of the key recommendations given in amended guidance from the National Institute for Care and Health Excellence that was published earlier this week (14 January).

The recommendation appears in a section on physical activity and diet in the ‘Overweight and obesity management’ guideline – coded NG246 – which updates what NICE stated last year.

Those holding supervised physical activity sessions are advised to: ‘Ensure staff leading supervised physical activity sessions are qualified and insured, for example, a physiotherapist or a practitioner member of the CIMSPA.’

CPR qualifications are required

Organisers should also make sure that people running children’s sessions have a paediatric cardiopulmonary resuscitation qualification, according to the updated guideline.

‘People who have lived with obesity and have lost weight should be advised that they may need to do from 60 to 90 minutes of activity a day to avoid regaining weight’

Elsewhere in the section dealing with physical activity sessions, the guideline notes that adults should be encouraged to increase their physical activity – even if they do not lose weight as a result, because of the other health benefits it can bring.

They should also be encouraged to meet the recommendations set out in the UK Chief Medical Officers’ physical activity guidelines for weekly activity. See NHS advice on treating obesity.

In order to prevent obesity, most people may need to do 45 to 60 minutes of moderate-intensity physical activity a day, particularly if they do not reduce their energy intake. People who have lived with obesity and have lost weight should be advised that they may need to do from 60 to 90 minutes of activity a day to avoid regaining weight. (See NHS advice on treating obesity.) 

The guideline states that adults need to build up to the recommended activity levels for weight maintenance, using a managed approach with agreed goals.

Recommendations include

  • activities as part of everyday life, such as brisk walking, gardening or cycling (see NICE’s guideline on walking and cycling)
  • supervised exercise programmes
  • other activities, such as swimming, aiming to walk a certain number of steps each day, or stair climbing.

Practitioners should take account of the person’s current physical fitness and ability for all activities, and encourage people to cut the time they spend being inactive (such as leisure-based screen time), the guideline states.

Physical activity approaches for children and young people

Practitioners should encourage children and young people to increase their level of physical activity – even if they do not lose weight as a result – because of the other health benefits physical activity can bring. ‘Encourage them to meet the recommendations in the UK Chief Medical Officers’ physical activity guidelines for daily activity, NHS physical activity guidelines for children and young people and the Department of Health and Social Care’s physical activity guidelines for disabled children and disabled young people,’ the guideline notes. 

NICE reiterates a point made in previous versions: ‘Be aware that children who are already living with overweight or obesity may need to do more than the standard recommended amount of activity.’ 

However, in an updated recommendation NICE adds: ‘Give children the opportunity and support to both include more physical activity in their daily lives (for example, walking, cycling, using the stairs and active play; see also NICE’s guideline on walking and cycling) and to do more regular, structured physical activity (for example football, swimming or dancing).

‘Agree the choice of activity with the child, and ensure it is appropriate to the child’s interests, ability and confidence and is affordable for the family (see the UK Chief Medical Officers’ physical activity guidelines for ideas of free activities).’

The guideline includes new and updated recommendations on

To access the latest version of ‘Overweight and obesity management’, see: https://www.nice.org.uk/guidance/ng246

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