Obesity and the Importance of Weight Management

Sharon BartramSharon BartramHealth Trainer Manager

Community Services

Alongside the tradition of curing theAlongside the tradition of curing the sick and injured grew a new strand

Preventing people from getting sick in the first placegetting sick in the first place

Public HealthPublic Health• Immunisation and vaccination• Screening

A id t ti• Accident prevention• Emergency planningg y p g• Health protection (TB, measles, influenza)

H l h lif l• Healthy lifestyles

Effects of Obesity and Alcoholects o Obes ty a d co oHeart and circulatory disease

StrokeStrokeType 2 DiabetesSome cancersSome cancers

Mobility problemsMental health problemsMental health problems

Liver problemsDigestive disordersDigestive disorders

Suicide and accidental death

Very worryingly…..y y g y

The potential of the first generation EVER who will begeneration EVER who will be

outlived by their parentsoutlived by their parents

Prevalence of obesity among adults aged 16+ yearsHealth Survey for England 1993‐2010 (3‐year average)

22.6%23.1% 23.0%

23.5% 23.9% 24.3% 24.5% 24.4%24.9%

23 8% 24.1%Women

17 1%17.7%

18.5%

19.8%20.7%

21.2%22.0%

6%

19.0%

20.2%

21.4% 21.8%22.3% 22.3%

22.8% 23.1%23.8%

23.3%Men

17.1%

14.1%

15.2%

16.2%16.9%

17.7%

94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09

© NOO 2012 Adult (aged 16+) obesity: BMI ≥ 30kg/m2

19 19 19 19 19 19 20 20 20 20 20 20 20 20 20 20

Adult prevalence by BMI statusHealth Survey for England (2008‐2010 average)

Healthy weight

Obese

24.9%Healthy weight

31.8%

Obese

24.1%

40.8%WomenMen

Overweight

32.2%

Underweight

1.7%Overweight

42 4%

Adult (aged 16+) BMI thresholdsUnderweight: <18.5kg/m2

Healthy weight 18 5 to <25kg/m2

Underweight

2.1%

42.4%

Healthy weight: 18.5 to  <25kg/m2

Overweight: 25 to <30kg/m2

Obese: ≥30kg/m2

© NOO 

Prevalence of morbid obesity among adults aged 16+ yearsHealth Survey for England 1993‐2010

4.0%

4.5%Men Women

3.0%

3.5%

d ob

esity

1 5%

2.0%

2.5%

nce of morbid

0.5%

1.0%

1.5%

Prevalen

0.0%1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Year of measurement

© NOO 2012

The chart shows 95% confidence limits

Adult (aged 16+) morbid obesity: BMI ≥ 40kg/m2

Trend in raised waist circumference among adultsHealth Survey for England, 1993 ‐ 2010

40%

50%Women

Men

30%

20%

0%

10%

The chart shows 95% confidence limitsAdults aged 16+ years

© NOO 2012

Adults aged 16+ yearsRaised waist circumference defined as >102cm (40”) for men and >88cm (35”) for women

Adult obesity prevalence modelled estimatesNational Centre for Social Research,  2006‐2008

13.1 to 22.3%

Obesity prevalence (%)by Local Authority

13.1 to 22.3%22.4 to 23.6%23.7 to 25.0%25.1 to 26.8%26.9 to 32.9%

London inset:

26.9 to 32.9%

© NOO 2012 Adult (aged 16+) obesity: BMI ≥ 30kg/m2

© Crown Copyright. All rights reserved. DH 100020290 2011

Financial Costs of ObesityFinancial Costs of Obesity• Current annual NHS cost £4.2 billion in 2007

• Foresight Report 2007 - Estimated to rise to 90% b 2050 if t t d ti90% by 2050 if current trends continue

• Will cost us the tax payer £50 billion pounds per year to pay for the costs associated with it

• National Obesity Observatory

• BBC 27 September 2010 Rise in number of Scots hospitals buying 'obesity beds‘

• BBC 23 January 2012 Ambulance service buys vehicles for obese patients (£8m)buys vehicles for obese patients (£8m)

BBC 19 M h 2010 M t it i f• BBC 19 March 2010 Maternity services for obese women 'not good enough'

Beds Stillbirth diabetes pre eclampsia more likely to need a caesareanBeds, Stillbirth, diabetes, pre-eclampsia, more likely to need a caesarean

Personal Costs of Obesity and Related Conditions

E ti l di t d i t• Emotional distress and anxiety• Disability and immobilityy y• Life time of drugs

S i l ti l di t i l ti• Social stigma leading to isolation• Reliance on care from family, friends and y,

care providers

Why? Where has obesity come from?y y• Increase in real incomes and lower comparative food

pricesp• More car ownership and less active transport• Less active employment / changing shift patterns• Changes in food manufacture and retail• Greater reliance on convenience and takeaway food• Large retailers and fewer local fresh supplies of food• Changes in socialising and culture• Sedentary pastimes, TV video games• More households in which both partners work

What can we do about it?Support and education for individuals

Health Trainer Service– Health Trainer Service– Leisure centres and Local Authority provision– Private sector commercial slimming providers andPrivate sector, commercial slimming providers and

physical activity providers– Voluntary groups and sports clubs

One licensed drug - Orlistat

Bariatric surgery

Is that going to be enough?g g gNo!!

It needs to be tackled across the board by fgovernment, food producers, retailers, planning

authorities, parks and green space providers, i f h l llcommunity safety teams, schools, colleges,

hospitals, ….

The list is endless

What have we learnt?• Very few people want to be fat• Its easy to make the small changes but the longer, more enduring

challenges are difficult when you are faced with them everywhere, everyday and food has to be thought about

• People’s mind set needs to change before their eating and exercise p g gpatterns do

• Society around people has to change (eg smoking)• Unhealthy behaviours have to stop being the default option andUnhealthy behaviours have to stop being the default option and

healthier options have to be the easiest choice

A t d l tAnswers on a postcard please to……..

Thank you for listeningy g

Sharon BartramSharon BartramHealth Trainer Service

Helmsley HouseNorth Tees HospitalNorth Tees Hospital

01642 383834Sharon.Bartram@nhs.net