Exercise Referral Schemes for may not be the answer to the obesity crisis

Despite being widespread in the UK as a popular way of promoting physical activity in primary care, it is questionable whether Exercise Referral Schemes actually work.

Their effectiveness and cost effectiveness have been called into question in systematic reviews (Campbell et al., 2015Pavey et al., 2011). These uncertainties have been acknowledged by NICE in their most recent guidance on Exercise Referral Schemes (2014), which makes their choice to continue to recommend these schemes puzzling, to say the least.

And they are costing around £100 million a year – money that could be far better allocated and achieve significant results, improving the health of our nation.

Recent research from Northumbria University (Kelly et al., 2016) is particularly damning. Of the 6894 people who were referred to the South Tyneside Exercise Referral Scheme between 2009 and 2014, 37.8% dropped out in the first 6 weeks. Less than half were left at the end of the 12-week scheme. And those who need it most, those with the highest risk of developing preventable diseases, are among those most likely to dropout.

Although the research only looked at one area, South Tyneside, we’d hazard to guess that the results would be similar everywhere in the UK.

It’s crucial to understand that these sport-based schemes are unlikely to engage the disengaged – clearly evidenced by the high dropout rate and highlighted as one of two main issues Oliver and colleagues (2016) in their recent critique of Exercise Referral Schemes.

Without doubt, physical activity is critical in the battle against obesity and other preventable diseases. But the current focus on prescription and compulsion has to change if we’re going to succeed. We have to empower people to take personal responsibility for their health and their lives by giving them the motivation and understanding to make authentic, self-endorsed lifestyle change.

This issue reaches far beyond Exercise Referral Schemes. Most countries advocate a minimum amount of physical activity, usually along the lines of doing at least 150-minutes of moderate to vigorous intensity exercise per week. And it this sole focus on exercise that needs to change.

There are many other kinds of physical activity that are demonstrably important to our health and wellbeing, including the amount of time we spend sedentary and the total number of calories we burn every day. So, in fact, there are a multitude of physical activity options to choose from. We can all choose activities that fit into our life and that we enjoy – after all, we are all more likely to stick with something we like!

KiActiv® is a clinically proven behavioural medicine platform that uses personalised physical activity in a free-living environment for the prevention and treatment of chronic disease. It is focused on promoting free-living physical activity, which is accessible to everyone. Significantly,  it appeals to those disengaged by exercise and sport, who tend to be most at risk of disease. It creates a flexible service that moves physical activity beyond its traditional settings and makes it part of your every day life.