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Rates of obesity in England are high and rising, with a strong systemic relationship between obesity and deprivation. Rates are also higher in women than in men, and in some ethnic minority groups compared to the white British group.
Recent governments have taken a fragmented approach to tackling obesity, and while some individual policies have been successful, this approach has fallen short of the cross-cutting population health approach that is needed. This briefing explores the role of the NHS in tackling obesity, focusing on how the NHS can work with local partners and engage with communities to deliver targeted interventions to treat and prevent obesity.
Key messages
In 2019, 64 per cent of adults in England were overweight, with 28 per cent being obese and 3 per cent morbidly obese. Obesity is a significant health risk and is associated with increased risk of diseases including diabetes, heart disease and some cancers.
There has been a significant increase in obesity in the most deprived communities in England in recent years, leading to a widening gap between the most and least deprived areas. The obesity prevalence gap between women from the most and least deprived areas is currently 17 percentage points and for men it is 8 percentage points, up from 11 percentage points for women and 2 percentage points for men in 2014.
Childhood obesity has followed a similar pattern. For children in year six there was a 13-percentage-point gap in obesity rates between the most and least deprived children in 2019, up by 5 percentage points since 2006.
The causes of obesity are many and varied. The most important risk factor is an unhealthy diet, while physical inactivity also plays a role. People in deprived areas often face significant barriers to accessing affordable, healthy food and to taking regular exercise.
In 2019/20 there were more than 1 million hospital admissions linked to obesity in England, an increase of 17 per cent on the previous year. Rising rates of obesity translate to increasing costs for the NHS. In 2014/15 the NHS spent £6.1 billion on treating obesity-related ill health, this is forecast to rise to £9.7 billion per year by 2050.
Differences in obesity rates translate to worse health outcomes for people in more deprived areas and contribute to health inequalities. Rates of obesity-related hospital admissions in the most deprived areas of England are 2.4 times greater than in the least deprived areas.
There is more that the NHS can and should be doing to tackle obesity. This includes using local insights to target services at communities with the greatest need, training its workforce to offer advice about diet and nutrition, and incentivising referrals to specialist diet programmes and more intensive clinical interventions like weight-loss surgery.
These levers, while effective, are best used as part of a whole-system approach to tackling obesity. There is an important, yet under-developed, role for integrated care systems and local place-based partnerships in co-ordinating action and helping partners to take a coherent approach.