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An update on adult obesity levels in the UK and the cost to the NHS

July 18, 2016
Toni Steer

Obesity levels in UK adults

Obesity is defined as a body mass index (BMI) greater than 30kg/m2. The most recent (2014) data shows that around 1 in 4 adults (aged 16 and upwards) are obese (Health and Social Care Information Centre, 2015). Data from comparable surveys in Scotland, Wales and Northern Ireland show a similar picture (Public Health England, 2016a).

A simple statistic of 1 in 4 obese adults hides a more complex picture across the UK. The prevalence of obesity varies by:

  • Sex – women have a slightly higher prevalence than men (25.2% compared with 24.9%).
  • Age – for both men and women obesity is lowest in the youngest adults (16-24 years). Levels gradually increase with age until reaching the peak for men in the 55-64 year age range (35%) and then decrease. For women this it’s a little different, with peaking in the 65–74 year age group (34.9%) and remaining above 30% until old age (over 85 years).
  • Income, education, social class, deprivation – obesity is higher amongst individuals with the lowest incomes, educational attainment, social class and living in the areas with highest deprivation.
  • Region - there are also variations by region, for example, obesity levels in men in the North East are 32.9% compared with 17.6% in London.
  • Ethnicity – the highest levels of obesity are seen in women who are Pakistani, black Afri-can and black Caribbean. This pattern is not seen so clearly in men of different ethnici-ties. Public Health England (2016b)

Reliable data on obesity in the UK is now available for the past 20 years and Table 1 shows the notable increase in levels over this time.

 

Table 1: Adult obesity trends in the UK 1993 - 2014 

Adult obesity trends 1993-2014

The health risks from adult obesity

Carrying excess weight increases blood pressure, blood glucose and lipid levels and puts additional strain on joints. These and other hormonal changes greatly increase the risk of ill health.

 

Table 2. Health risks of obesity 

Cardiovascular diseases

Coronary heart disease, stroke, deep vein thrombosis
pulmonary embolism

Type 2 Diabetes

 

Cancer

Endometrial, breast, colon

Musculoskeletal

Osteoarthritis, back pain

Respiratory

Sleep apnoea, asthma

Reproductive

Menstrual abnormalities, infertility, polycystic ovarian
syndrome, complications during pregnancy and birth

Gastrointestinal

Gastro-oesophageal reflux, gall stones

Psychological

Low self-esteem, stress, depression


The increased risk of ill-health is striking. For example, compared with a non-obese women, an obese woman is 13 times more likely to develop type 2 diabetes, and 3 times more likely to have a heart attack. An obese man is 5 times more likely to develop type 2 diabetes and 3 times more likely to develop colon cancer compared with non-obese counterparts (Department of Health, 2011).

The cost of obesity to the NHS

The increase in levels of obesity and the associated risk of ill health has inevitably created a burden on health care.

Costs have been estimated by the National Audit Office (NAO, 2001), the House of Commons Health Committee (HCHC, 2004) and the Foresight Programme (Foresight, 2007).

The NAO estimated costs of treating obesity at £479 million, HCHC at £1 billion and Foresight at £2.3 billion. This data indicates that costs are rising but it’s important to note that there has been no consistency in the definition of health costs. Each report and study has used a different method to model estimates, so care should be taken when trying to draw out trends. The National Obesity Observatory (NOO, 2010) has produced a useful summary paper providing further details on how the costs were derived in these reports.

More recently direct costs to the NHS have been estimated at £5.1 billion, annually (Scarborough et al 2011). But this has now been uprated to £6.1 billion to take into account inflation over the past decade ((Public Health England 2016c). And looking further forward, by 2030 costs are likely to increase by a further £2 billion (Wang et al, 2011).

And the real costs are likely to be even higher as it’s believed that the estimates have not included investment in areas such as staff training and specialist equipment e.g. beds, chairs, hoists and operating tables designed to support obese individuals. These types of costs are not limited to the NHS, they have an impact on other organisations for example, local authorities providing social care for those who are obese.

The wider costs to society

Indirect costs, such as loss of earnings, due to ill-health, or premature mortality had been estimated as reaching £27 billion by 2015 (Foresight, 2007). But the wider costs are not just monetary, they also include impacts on the individual in terms of their quality of life.

What can be done?

Prevention is the key to reducing obesity related costs on the NHS and society in the future. Public health initiatives such as funding an individual on a commercial weight loss programme can save the NHS £230 over their lifetime (Brown & McPherson, 2009). Now more than ever is not the time to look for costs savings or stop investing in public health.

References

Brown M, McPherson K (2009) Modelled estimates of a 12 week commercial weight loss programme showed potential savings of £230 health care costs per participant over a lifetime. Computer modelling of the health and economic outcomes of the Weight Watchers GP referral scheme. The European Journal of Obesity: 2 (suppl 2):115.

Department of Health (2011) Healthy Live, Healthy People: A Call to Action on Obesity in England. Available here. [Accessed 08 July 2016].

Foresight: Butland B, Jebb S, Kopelman P (2007) Tackling obesities: future choices – project report (2nd Ed). London: Foresight Programme of the Government Office for Science. Available at here. [Accessed 08 July 2016].

House of Commons Health Committee (2004). Obesity: Third Report of Session 2003/4. London: The Stationery Office.

Health and Social Care Information Centre (2015) Health Survey for England, 2014: Trend Tables. Available here. [Accessed 07 July 2016].

National Obesity Observatory (NOO) (2010). The economic burden of obesity. Available here. [Accessed 08 July 2016].

National Audit Office (2001) Tackling Obesity in England. London: The Stationery Office. Public Health England (2016a) UK and Ireland Prevalence and Trends. Available here. [Accessed 07 July 2016].

Public Health England (2016b) Slide Sets. Available here. [Accessed 07 July 2016].

Public Health England (2016c) Economics of Obesity. Available here.  [Accessed 08 July 2016].

Scarborough P, Bhatnagar P, Wickramasinghe K, Allender S, Foster S, Rayner M (2011). The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006–07 NHS costs. Journal of Public Health, [online] Volume 33 (4), 527-535. Available here.  [Accessed 08 July 2016].

Wang Y, McPherson K, Marsh T, Gortmaker S, Brown M (2011). Health and economic burden of the projected obesity trends in the USA and the UK. The Lancet [online] Volume 378 (9793), 815-825. Available here. [Accessed 08 July 2016].

ObesityBMIprevalenceNHSdirect costindirect costpublic healthill-health

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