Issue 141 Face to face

F2F

FACE TO FACE Ursula meets: DR PAUL SACHER Paediatric Dietitian Co-founder of MEND (Mind, Exercise, Nutrition . . .

Do it!): international child weight management programme Digital health and wellness expert

We met in a restaurant. It was a cold night and the little table candle was not doing much to help warm us. Our table was wobbly; it became a back and forth between us, tilting my way as I scribbled notes, or Paul’s way as he placed down his green tea.

Paul is originally from South Africa, has travelled extensively and has lived in the UK for 23 years. His first degree was at the University of Cape Town - a BSc in Human Physiology, with a view to becoming a doctor. A single lecture on nutrition was such an inspiration, that Paul signed up to a newly launched twoyear postgraduate degree in Clinical Nutrition and Dietetics.

To join various family members, he moved to Sydney in Australia. It took a while to get his South African dietetic qualification accredited, so he passed the time jobbing, including working as a hospital catering assistant, supervising the preparation of special diets.

Then, in 1995, upon the siren call of friends, he went to London. A locum agency offered him a newly-funded paediatric dietetic post at Chase Farm Hospital. The post was made permanent and Paul was asked to stay, but declined based on excessive travel time. He next did a four-day paediatric post at the Whittington Hospital, matched with a one-day research post at the Royal Free Hospital. After a few years, he moved to another paediatric

Ursula meets amazing people who influence nutrition policies and practices in the UK. and management post at Ealing Hospital, where he also developed a specialism in children (and adults) with HIV. “Great Ormond Street (GOSH) is the most challenging hospital for paediatics, so of course I could not resist applying for the post of Nutrition Support Specialist Dietitian when this was advertised in 2000,” said Paul. The post was half clinical and half research. Among the areas of research, Paul audited the efficiencies of the milk room, which is where hundreds of special prescribed milks are produced. He also researched the occurrence and types of treatments being provided to GOSH patients with obesity. Senior staff at the hospital showed great interest, but were not keen to take action: children attending GOSH usually suffered a plethora of other and more acute health issues.

So, Paul decided to develop a weight management programme for children in his spare time. He approached other health experts, including psychologist Dr Paul Chadwick, and ran a pilot project.

Children with obesity attended twice weekly group meetings with their parents or carers, focusing on changing behaviours around diet and physical activity. “We were very pleased when we found the programme resulted in wide ranging health and psychosocial benefits,” said Paul.

Ursula Arens Writer; Nutrition & Dietetics Ursula has a degree in dietetics, and currently works as a freelance nutrition writer. She has been a columnist on nutrition for more than 30 years.

www.NHDmag.com February 2019 - Issue 141

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F2F He shared that he had been a child with obesity. This was clearly the driver for his professional devotion. I asked why he had been overweight. “My mother had to cater to one son who was skinny and tennis-mad and another (me) who loved to play with action toys and watch videos. I just matched my brother for sports drinks and large food portions. I remember being taken to a dietitian and being told that I was fat, which made me feel even worse about myself,” said Paul.

Paul wanted to research obesity in childhood further and was very pleased to be awarded a fully-funded NIHR PhD scholarship. This led to the completion of a multi-site randomised controlled trial showing the success of the Mind, Exercise Nutrition…

Do it! (MEND) programme. In 2006, with the help of business-minded colleagues, it was time to leave healthcare research and employment and venture into the start-up world.

The growth of MEND was explosive, following millions of pounds secured from Big Lottery, Sainsbury’s and Weight Watcher’s. To date, no family has ever paid to attend a MEND programme. Over the years, MEND has been extensively evaluated in large international trials, resulting in the publication of more than 37 peer-reviewed publications. Over 7000 group leaders in seven countries have been trained to lead MEND programmes, and over 130,000 children and parents have participated, empowering them to make healthier lifestyle choices; and, as co-founder, Paul was busier than ever.

Then, ‘overnight,’ disaster hit the MEND organisation. After the NHS public health restructuring from Primary Care Trusts to Local Authorities, much of the funding for community based weight management programmes was slashed. “It is so short sighted to cut these programmes, because they are recommended by NICE as the firstline treatment and will certainly help to reduce future NHS costs. But, of course, when funding is tight, treatment is always prioritised over prevention. The truth is you need both,” said Paul.

Fortunately, MEND survived these cuts and continues to grow internationally.

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www.NHDmag.com February 2019 - Issue 141

Over 7000 group leaders in seven countries have been trained to lead MEND programmes

Recently, the YMCA of the USA chose MEND as their preferred child weight management programme, and it is currently being rolled out across their national USA network.

Paul looked amused at my suggestion that plums fell into his lap. To get plums, you have to climb trees. “Let me share something,” said Paul. “When I worked as a clinical dietitian, a very well-known recipe book author contacted the department for help, but none of the other dietitians were interested. I put a lot of work into helping the author, which led to another contacting me for help, which led to me being offered a contract to write my own book (From Kid to Superkid) to support parents to raise healthy kids. This book became one of my ladders.”

We talk about the fact that successful careers are usually zig-zag shaped in hindsight.

Opportunities often present themselves, but it takes bravery to jump into the cold and fastflowing currents that lead to professional achievement. Paul is now active in many exciting projects and particularly focused on the development of engaging and effective large-scale digital health services.

But a gap develops between us: I am a laggard when it comes to new technology and when he uses the term ‘sticky content’, I am of course thinking about toffee pudding. We may be at opposite ends in our excitement about the ability of big data to support health, but we are both surprised to find out how much we have in common. We both enjoyed our back and forth discussions. Perhaps it was the magic of the back and forth table?

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