There's nothing especially different about levels of child obesity in Leeds, or about the concern expressed in professional circles.
Just like in any other area, all the research shows there are more overweight children than 20 years ago.
But Leeds has taken action to make schemes devised to tackle the issues more effective. The city's childhood obesity project is trying to change families' behaviours, and find out how different interventions can work closely together.
"For years, we've had various health and anti-obesity initiatives run by different agencies," says Janice Burberry, co-ordinator of the project and children's lead at the primary care trust. "There are long-standing projects, some more recent ones, some a bit hidden away and off the radar – just bringing it all together so we all knew what existed was the first major achievement."
The process began four years ago, when an official report claimed that Leeds "lacked a systematic approach" to tackling what everyone agreed was an obvious and increasing problem.
"Some programmes weren't evaluated in any way, and others were poorly targeted, or lacked effective leadership," says Burberry. So the strategy started with a close look at what appeared to work and what didn't, and continued with a careful survey of the gaps, and the missed opportunities to work together.
"We've found there are benefits in encouraging workers from different projects to do joint training," she says
"Just recently, our dance coaches from DAZL – Dance Action Zone Leeds – got together with Watch It, a community-based initiative backed by Leeds University for eight to 15-year-olds and their families.
"Now, dance teachers are rake-thin, as we know – so the Watch It workers got them to don fat suits, to feel what it's like to exercise if you're overweight, how tired, thirsty and breathless you get. It really helped them have more understanding of their client group."
DAZL, a registered charity supported by the PCT and the city council, has as part of its core programme a three-year plan to get overweight children moving.
A dance troupe can offer the same fun, pizzazz and performance element other youngsters get from team sports, without the competitive element that leaves chubbier children on the sidelines.
DAZL's facilitator, Ian Rodley, talks enthusiastically of the current plans. "Girls aren't so hard to bring in, yet it's really difficult to reach inactive boys. But we've had some great success with teaching them hip-hop and street dance – they bring their own music, and we devise routines with them."
Targeting is a key element of the strategy. A city-wide survey called Trends asked school nurses to track the height and weight of all year 6 school pupils in the city, some time before a national programme doing the same thing got underway. This is done sensitively.
"We're aware that even at this age – 10 to 11 – some children are very shy about their body size and shape," says school nurse co-ordinator Anne Marie Connor. "So we visit each class before the assessment day, and let them know it will be done privately, they don't have to take their clothes off and the results are confidential."
Results have shown some unexpected 'pockets' of obesity. "Yes, as expected, the levels are higher in areas of social and economic deprivation," says Burberry. "But there is another 'hot spot' of mainly middle-class families, where poverty is not an issue. We think they are the group called 'treaters' in the survey into obesity done by the National Social Marketing Centre.
"They're families where high-fat, high-sugar snacks are freely available and where the parents value giving children what they want – maybe because they suffered some deprivation themselves when they were young. They're not active, and the children tend to spend a lot of time indoors, playing with the latest games console."
Working out the best way to engage the 'treaters' is a challenge for the strategy – different groups need different messages and support. The plan is seek out ways to show the 'treaters' that doing good things for their children can mean more than giving them 'stuff' - a regular physical activity, done as a family, brings long-lasting benefits.
"We've learnt it's more effective not to use direct health-based messages, but instead to find ways of promoting physical activity and healthy eating, in a form that families at high risk want to share," says Burberry.
"When DAZL puts on a performance it's an opportunity for families to be proud of their children. Tapping into a parent's desire for their child to have a good time and create a positive family memory will be much more effective in achieving behaviour change than telling people to be active for an
hour a day."
