Obesity-related health inequality could overwhelm NHS, new reports says

A ‘deep and widening gap’ in the rates of obesity between the richest and poorest parts of the country could overwhelm the NHS, according to a new briefing published by The King’s Fund.

The report found that the majority of adults in England are now overweight or obese. In 2019, 64% of adults in England were overweight, with 28% being obese and 3% morbidly obese.

It also highlighted a significant increase in obesity in the most deprived communities in England in recent years. The gap in obesity rates between women from the most and least deprived areas is 17 percentage points, up from 11 percentage points in 2014, while for men the deprivation gap is 8 points, an increase from just 2 points in 2014.

People in the most deprived areas are also more than twice as likely to be admitted to hospital for obesity-related health problems. Last year there were more than 1 million hospital admissions linked to obesity in England, an increase of 17% compared to 2018/19. Rates of obesity related hospital admissions in the most deprived parts of the country are 2.4 times higher than in the least deprived areas.

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.

The key findings are drawn from a range of sources including data published by NHS Digital, Public Health England and the Organisation for Economic Co-operation and Development (OECD).

Tackling the obesity crisis must be at the top of the agenda

Richard Murray, Chief Executive of The King’s Fund, said: “Our analysis lays bare a deep and widening gap in the rates of obesity between the richest and poorest parts of the country, with women in our most deprived communities faring particularly poorly. Given the serious health risks that come with obesity and the significant cost to the NHS, this is exacerbating shocking inequalities in health and will only add extra pressure on the NHS.

“People in deprived areas can face significant barriers to accessing affordable, healthy food and taking regular exercise and there is much more the NHS can do to support people to make healthier choices and target services where they are needed most. If levelling up is to mean anything, the new Secretary of State must put tackling the obesity crisis and reducing health inequalities at the top of his agenda.”

The briefing concludes that recent governments have taken a fragmented approach to tackling obesity and while some individual policies have been successful, they have fallen short of the cross-cutting approach needed. Much more needs to be done to improve the availability of affordable, healthy food for people in deprived areas and support them to eat well and take regular exercise.

It also argues that the NHS must do more to tackle obesity and support people to make healthier choices. This includes using local insights to target services at communities with the greatest need, training the workforce to offer advice about diet and nutrition, and incentivising referrals to specialist diet programmes and more intensive clinical interventions like weight-loss surgery.