Hot Topic - Obesity

Obesity definition

Obesity is defined as a Body Mass Index over 30

Obesity rate statistic

Around 64% of adults in England are overweight or living with obesity, and roughly 26.5% are obese

Overweight definiton

A BMI between 25.0 and 29.9

Cause of obesity

interaction of social, environmental and genetic factors

Effects of obesity

Obesity reduces life expectancy by up to 10 years through inflammatory and destructive processes

BMI - calculation

BMI is calculated by dividing the patient’s weight in kg by the patient’s height (in metres) squared

How much does obesity cost the NHS?

• Obesity and excess weight are estimated to cost the NHS in the region of £11 to £12 billion a year in treating related conditions such as type 2 diabetes, heart disease and several cancers

How much does obesity and excess weight cost the whole economy?

total annual cost of obesity and overweight to society at around £126 billion, including roughly £31 billion in lost productivity

Note

In my GP clinics, very little of that cost is the headline drug bill. It is the slow accumulation of appointments, medications and complications across a patient's life. obesity is not one disease but a driver of many

Age -related obesity

¾ of 45 - 74-year-olds are overweight or obese

Is obesity increasing

Yes - for both adults and children

Causes of obesity

• Behavioural

• Biological

• Environmental

Behavioural

• Increasing culture of fast, processed food intake

• Decreasing culture of fruit, fibre and vegetable intake

• Increase in sedentary lifestyles - desk jobs, longer working hours

• Increase in non-active hobbies - gaming, watching TV etc.

Biological

• Genetics

• Increasing incidence of hereditary conditions with a high risk of obesity e.g. Prader Willi Syndrome

• The cascading effect of obesity - 80% chance of the children of obese parents also becoming obese

• Increasing incidence of endocrine disorders which contribute to obesity e.g. PCOS

Environmental

• Increased access to motorised transports

• Increased availability of ultra-processed, high-calorie foods

• Increased labour-saving technology, reducing activity levels

Effects of obesity

• Inflammation and oxidative stress - this causes cellular damage and increases the risk of developing long-term health conditions like diabetes and Alzheimer’s.

• Insulin resistance - Obesity causes impaired glucose uptake in tissues, leading to the development of insulin resistance and type 2 diabetes.

• Hypertension - inflammation, hormonal dysfunction, compressed blood vessels, and dyslipidaemia interact to raise blood pressure in obese patients.

• Osteoarthritis - excess weight in obesity subjects joints and bones to increased mechanical stress which increases the risk of developing osteoarthritis.

UK Timeline of tackling obesity

Apr 2018 - Sugar tax on soft drinks

Apr 2022 - Calorie labels on large menus

Jun 2025 - GPs begin offering Mounjaro

Nov 2025 - Budget toughens the sugar tax

Jan 2026 - Junk food ban takes effect

The Sugar Tax

• applies to UK-produced or imported sugary drinks above a sugar threshold

• government announced it would strengthen the levy from 1 January 2028 by lowering the threshold from 5g to 4.5g of sugar per 100ml and, for the first time, bringing milk-based drinks into scope

Impact

• Evidence shows that the sugar tax has been successful, with fewer childhood tooth extractions and lower than expected obesity levels in 10-11 year-old girls since its introduction.

• Notably, this benefit was strongest in girls from deprived households, highlighting the tax's potential to combat health inequalities.

• However, no significant impact was seen on boys or younger children; overall sugar consumption across the UK rose slightly in 2023.

NHS Better Health Campaign

• free NHS Weight Loss Plan app

• The campaign has contracts organised with nutritional and weight management companies to provide free or discounted resources and software to help patients lose weight.

high in fat, salt and sugar (HFSS) advertising restrictions

a 9pm television watershed for less healthy food and drink, plus a total ban on paid-for HFSS advertising online, which became legally enforceable on 5 January 2026

Calorie labelling benefits

• Help customers make informed choices

• Customers have a right to know nutritional information that will impact their health

• Restaurants must be transparent

Calorie Labelling negatives

• Could exacerbate eating disorders for those with anorexia or bulimia nervosa

• It places the burden entirely on consumers without requiring restaurants themselves to offer sufficient healthy option

Empathetic considerations

• Calorie labelling = people with eating disorders

• Sugar - free tex = unfairly burden lower-income groups

• People from deprived socio-economic backgrounds may not be able to access physical activity

• May stigmatise obese people

• Positive messages are important = accessibility, promoting a healthy lifestyle, nutrition-focused menu items