Lifestyle: obesity

Note:
On 1 April 2019:
West Suffolk Council replaced Forest Heath District Council and St Edmundsbury Borough Council
East Suffolk Council replaced Suffolk Coastal District Council and Waveney District Council
This State of Suffolk report was created before these changes, so gives information for the pre-2019 council areas.

 

1 Five key points

  1. In 2017/18, 1 in 5 children aged 4-5 years old and nearly 1 in 3 children aged 10-11 years old were overweight or obese in Suffolk. Considering obesity alone, nearly 1 in 10 children aged 4-5 years old and more than 1 in 6 children aged 10-11 years old were obese.  (3.3 Prevalence of overweight/obesity among children)
     
  2. In 2016/17, more than 6 in 10 adults were overweight or obese in Suffolk. The highest rates in the County were found in Waveney, where 7 in 10 adults were overweight or obese. (3.2 Prevalence of overweight/obesity among adults
     
  3. The health complications associated with obesity are wide ranging. Obese people are 5 times more likely to develop type 2 diabetes and 2.5 times more likely to develop high blood pressure, which is a risk factor for stroke and heart disease. Obese people are also at increased risk of certain cancers and are 3 times more likely to develop colon cancer. (2 Why is obesity important in Suffolk?
     
  4. Across England, overweight and obesity levels increase with age and are highest among people aged 45+, among whom the prevalence of overweight and obesity is almost 3 in 4. Given Suffolk’s ageing population and high proportion of older people, overweight and obesity are likely to be an increasingly common problem in future years. (2 Why is obesity important in Suffolk?)   
     
  5. The number of people admitted to hospital for reasons linked to obesity have nearly doubled over the last four years, from 734 to 1,352 per 100,000 Suffolk residents. In 2016/17, this equated to more than 10,000 Suffolk residents. (3.4 Hospital admissions associated with obesity)

2 Why is obesity important in Suffolk?

It is estimated that obesity is responsible for more than 30,000 deaths each year. On average, obesity deprives an individual of an extra 9 years of life, preventing many individuals from reaching retirement age. In the future, obesity could overtake tobacco smoking as the biggest cause of preventable death.[1]

Being overweight or obese is defined as having abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in metres). A person with a BMI between 25 - 30 is considered overweight, and a BMI above 30 indicates obesity.[2]

Obesity is most commonly caused by eating too much food high in fat and sugar and moving too little. When people consume high amounts of energy, particularly fat and sugars, but don't burn off the energy through exercise and physical activity, much of the surplus energy is stored by the body as fat. Some underlying medical conditions and medication can also contribute to weight gain, as can some rare genetic conditions.[3] But in most cases obesity has more to do with environmental or societal factors, such as unhealthy eating habits.

The health complications associated with obesity are wide ranging (Figure 1). Obese people are 5 times more likely to develop type 2 diabetes and 2.5 times more likely to develop high blood pressure, which is a risk factor for stroke and heart disease.[1] Obese people are also at increased risk of certain cancers and are 3 times more likely to develop colon cancer. Obese children are more likely to suffer from bullying and may be affected by weight stigma, which can lead to low self-esteem, body image issues, anxiety and depression.[4]

Despite the compelling evidence base for eating a healthy diet, many people still find it difficult to eat healthily. This is primarily because we live in environments where less healthy choices are the default, thereby encouraging excess weight gain and obesity. As a society, we are not burning off enough of the calories that we consume. People in the UK are around 20% less active now than in the 1960s. If current trends continue, we will be 35% less active by 2030.[1] Societal changes have designed physical activity out of our lives. Fewer people work in manual jobs and technology dominates at home and at work, the two places where we spend most of our time. It is estimated that adults spend around six hours a day in sedentary pursuits (watching TV, other screen time, reading and other low energy activities).[5]

It is estimated that the NHS spent £6.1 billion on overweight and obesity-related ill-health in the year 2014-15. In addition to direct health costs, a person who is severely obese is three times more likely to need social care than someone who is a healthy weight.[6] More broadly, obesity has a serious impact on economic development. The overall cost of obesity to wider society is estimated at £27 billion. The UK-wide NHS costs attributable to overweight and obesity are projected to reach £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year.[1]

Figure 1: Health complications associated with obesity[7]

Figure 1: Health complications associated with obesity

 

Source: Public Health England. Adult Obesity: Applying all our Health. (2018).

Across England, overweight and obesity levels increase with age and are highest among people aged 45+, among whom the prevalence of overweight and obesity ranges between 71-74% (Figure 2).[5] Given Suffolk’s ageing population and high proportion of older people, overweight and obesity are likely to be an increasingly common problem in future years. 

Figure 2: Obesity levels by age group, England, 2016 [5]

Figure 2: Obesity levels by age group, England, 2016

 Source: House of Commons. Briefing paper: Obesity Statistics. (2018)

3 What is the local picture for Suffolk?

3.1 Obesity as a risk factor

Years Lived with Disability (YLDs) are a measurement of the burden of disease. In 2017, having a high BMI was the number one risk factor for YLDs in Suffolk, accounting for more than 7,780 years lived by Suffolk residents with a disability.[8] Having a high BMI was the fourth highest risk factor for death, contributing to nearly 750 deaths among Suffolk residents in 2017. Two other metabolic risks closely associated with obesity, high blood pressure and high fasting plasma glucose, contributed to even more deaths in 2017 than having a high BMI.

3.2 Prevalence of overweight/obesity among adults

In 2016/17, more than 6 in 10 adults (61.5%) were overweight or obese in Suffolk, which is comparable to the England average (61.3%).[9] The prevalence of overweight and obesity was statistically comparable to England and Suffolk in all districts/boroughs except Waveney, where it was significantly higher (70.6%) (Figure 3).

Figure 3: Prevalence of overweight and obesity among adults, 2016/17, districts/boroughs, Suffolk, England[9]

Figure 3: Prevalence of overweight and obesity among adults, 2016/17, districts/boroughs, Suffolk, England

Source: Public Health England. Public Health Profiles. (2018).

3.3 Prevalence of overweight/obesity among children

The National Childhood Measurement Programme (NCMP) measures the height and weight of children aged 4-5 (reception year) and 10-11 (Year 6) each year in primary schools in Suffolk.

Results from the 2017/18 academic year indicate that prevalence of overweight and obesity in reception age children is lower in Suffolk (20.5%) than England (22.4%) and similar to the East of England (20.6%).[9] Similarly, the prevalence of overweight and obesity in Year 6 children is lower in Suffolk (31.5%) than England (34.3%) and similar to the East of England (31.7%). Despite performing better than England it is important to note that nearly 1 in 3 Year 6 students in Suffolk are above the recommended healthy weight (Figure 4).

Variation is seen in the prevalence of overweight and obesity between the districts/boroughs in Suffolk, with lower prevalence in the less deprived areas and higher prevalence in the more deprived areas (including Ipswich and Waveney).

Figure 4:  Prevalence of overweight/obese among reception and Year 6 age children, Suffolk, districts/boroughs, England, 2017/18[9]

Figure 4:  Prevalence of overweight/obese among reception and Year 6 age children, Suffolk, districts/boroughs, England, 2017/18

Source: Public Health England. Public Health Profiles. (2018).

You can explore the data for local authority, BMI classification and academic year in the NHS Digital tool for the National Child Measurement Programme.

3.4 Hospital admissions associated with obesity

Only a handful of people are admitted to hospital for reasons directly related to being obese; most are admitted for conditions that are caused by or exacerbated by being overweight. In 2016/17, 10,009 people in Suffolk were admitted to hospital because of their obesity. This corresponds to a rate of 1,352 per 100,000 Suffolk residents, which is higher than the England average (1,159 per 100,000 population). The number of hospital admissions where obesity is a factor have nearly doubled over the last four years, from 734 to 1,352 per 100,000 Suffolk residents.[10]

You can explore the data about hospital admissions in the NHS Digital obesity related hospital admissions tool 

4 How do policies tackle obesity?

The UK Government published Childhood obesity: a plan for action in 2016. This laid out the government’s plan to reduce England’s rate of childhood obesity within the next 10 years by encouraging:[11]

  • industry to cut the amount of sugar in food and drinks
  • primary school children to eat more healthily and stay active

In 2018 this was followed by Childhood obesity: a plan for action, chapter 2.[12] This publication outlined the actions the government will take towards its ambitious goal of halving childhood obesity and reducing the gap in obesity between children from the most and least deprived areas by 2030.

Based on the principles described in these national documents, organisations in Suffolk are currently creating a strategy to tackle childhood obesity in the County. Tackling childhood obesity effectively will require the development of a sustained ‘whole systems approach’, which seeks to link together many of the influencing factors on obesity and requires co-ordinated action and integration across multiple sectors. Joined up working between health, education, social care, planning, housing, transport and business can bring about major change to combat childhood obesity, making better use of resources and improving health and wellbeing. This strategy will be published in 2019.

The most recent national policy aimed at tackling obesity in the whole population, rather than children alone, was Healthy Lives, Healthy People: A Call to Action on Obesity in England[13], which was published in 2011. This report outlined national ambitions to see a sustained downward trend in the level of excess weight among both children and adults by 2020. With the benefit of hindsight, we can see that these ambitions were not realised.

5 Further information

NICE produce a range of products relating to obesity, including pathways, guidance and quality standards: www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal--nutritional-and-metabolic-conditions/obesity#panel-pathways

The Public Health England guidance document Adult obesity: applying All Our Health[7] gives further reading, resources and good practice. www.gov.uk/government/publications/adult-obesity-applying-all-our-health/adult-obesity-applying-all-our-health

OneLife Suffolk is a local resource, which offers support and advice on a wide variety of different health improvement programmes. OneLife Suffolk provides free weight management programmes for adults and children, including Slimming World on referral. The weight management services are designed to create long lasting shifts in behaviour and give support and tools throughout the programme. onelifesuffolk.co.uk/

6 References

[1]         Public Health England, “Health matters: obesity and the food environment,” 2017. [Online]. Available: https://www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment--2

[2]         World Health Organisation, “Obesity.” [Online]. Available: https://www.who.int/topics/obesity/en/

[3]         NHS, “Causes of obesity,” 2016. [Online]. Available: https://www.nhs.uk/conditions/obesity/causes/

[4]         J. Rankin et al., “Psychological consequences of childhood obesity: psychiatric comorbidity and prevention,” Adolesc. Health. Med. Ther., vol. 7, pp. 125–146, Nov. 2016.[1] J. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5115694/

[5]         House of Commons, “Obesity Statistics,” London, No.3336. Available at: https://researchbriefings.parliament.uk/ResearchBriefing/Summary/SN03336#fullreport

[6]         Public Health England, “Public health matters: Weight management services - why are they important?” [Online]. Available: https://publichealthmatters.blog.gov.uk/2017/07/10/weight-management-services-why-are-they-important/

[7]         Public Health England, “Adult Obesity: Applying all our Health,” 2018. [Online]. Available: https://www.gov.uk/government/publications/adult-obesity-applying-all-our-health/adult-obesity-applying-all-our-health

[8]         Institute of Health Metrics and Evaluation, “Global Burden of Disease 2017 Compare tool,” 2018. [Online]. Available: https://vizhub.healthdata.org/gbd-compare/

[9]         Public Health England, “Public Health Profiles,” 2018. [Online]. Available: https://fingertips.phe.org.uk

[10]      NHS Digital, “Statistics on Obesity, Physical Activity and Diet - England, 2018 [PAS],” 2018. [Online]. Available: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2018

[11]      HM Government, “Childhood obesity: a plan for action,” 2016. [Online]. Available: https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action

[12]    HM Government, “Childhood obesity: a plan for action, chapter 2.” [Online]. Available: https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action-chapter-2.

[13]      Department of Health, Healthy lives, healthy people : our strategy for public health in England. London, 2010. Available: https://www.gov.uk/government/publications/healthy-lives-healthy-people-our-strategy-for-public-health-in-england