In 2022 the National Institute for Health and Care Research (NIHR) published a comprehensive review of research on what local authorities can do to reduce obesity.The Obesity Policy Action (OPA) framework divides measure into upstream policies, midstream policies, and downstream policies. Upstream policies have to do with changing society, while midstream policies try to alter behaviors believed to contribute to obesity at the individual level, while downstream policies treat currently obese people. Management
The main treatment for obesity consists of weight loss via lifestyle interventions, including prescribed diets and physical exercise. Although it is unclear what diets might support long-term weight loss, and although the effectiveness of low-calorie diets is debated, lifestyle changes that reduce calorie consumption or increase physical exercise over the long term also tend to produce some sustained weight loss, despite slow weight regain over time. Although 87% of participants in the National Weight Control Registry were able to maintain 10% body weight loss for 10 years, the most appropriate dietary approach for long term weight loss maintenance is still unknown. In the US, intensive behavioral interventions combining both dietary changes and exercise are recommended. Intermittent fasting has no additional benefit of weight loss compared to continuous energy restriction. Adherence is a more important factor in weight loss success than whatever kind of diet an individual undertakes.Several hypo-caloric diets are effective. In the short-term low carbohydrate diets appear better than low fat diets for weight loss. In the long term, however, all types of low-carbohydrate and low-fat diets appear equally beneficial.
In Lutheran Sweden, the Protestant clergy played a pioneering role in voluntary smallpox vaccination as early as 1800. The first vaccination was carried out in Liechtenstein in 1801, and from 1812 it was mandatory to vaccinate.The question of who first tried cowpox inoculation/vaccination cannot be answered with certainty. Most, but still limited, information is available for Benjamin Jesty, Peter Plett and John Fewster. In 1774 Jesty, a farmer of Yetminster in Dorset, observing that the two milkmaids living with his family were immune to smallpox, inoculated his family with cowpox to protect them from smallpox. He attracted a certain amount of local criticism and ridicule at the time then interest waned. Attention was later drawn to Jesty, and he was brought to London in 1802 by critics jealous of Jenners prominence at a time when he was applying to Parliament for financial reward. During 1790–92 Peter Plett, a teacher from Holstein, reported limited results of cowpox inoculation to the Medical Faculty of the University of Kiel. However, the Faculty favoured variolation and took no action. John Fewster, a surgeon friend of Jenners from nearby Thornbury, discussed the possibility of cowpox inoculation at meetings as early as 1765. He may have done some cowpox inoculations in 1796 at about the same time that Jenner vaccinated Phipps. However, Fewster, who had a flourishing variolation practice, may have considered this option but used smallpox instead.