Much of the NHS is not taking obesity seriously enough, despite it being an unfolding health disaster that is costing huge amounts of money. the United Kingdom £98 billion per yeara new report claims.
Only five of England’s 42 integrated care boards (ICBs) – regional groupings of NHS trusts that coordinate care across large areas – have made tackling obesity or maintaining a healthy weight one of their top priorities, the Future health thinktank.
The analysis showed that the remaining 37 ICBs had not identified obesity as a major issue in their future plans. The plans outlined the most pressing issues for the next five years.
“Too many parts of the NHS are not giving obesity enough priority,” said Richard Sloggett, the report’s author and a former special adviser at the Department of Health and Social Care.
“Given the huge and worsening problem of obesity – for individuals, the NHS, society as a whole and also its impact on the economy – I was concerned that so few NHS bodies considered tackling it as one of their key priorities,” he added.
Two ICBs did not refer to obesity at all in their detailed future plans and three only once. This reinforces the impression that they do not consider it a major concern.
Almost two-thirds of adults in the UK are overweight or obese as a result of changes in diet, eating habits and activity levels. Obesity is one of the top five causes of premature death in England, alongside smoking, poor diet, high blood pressure and alcohol and drug use.
Sloggett, founder of Future Health, said a postcode lottery in access to NHS care for overweight people means “millions of people are missing out on treatment and obesity remains a problem that is largely overlooked in NHS priority setting.”
Prof Frank Joseph, a specialist in diabetes, endocrinology and internal medicine at the Countess of Chester Hospital, found the findings alarming, saying: “The lack of priority is sadly inexplicable.”
But the variation in patients’ ability to get psychological help, advice on weight management and bariatric surgery is the result of “chronic underfunding” that leaves the NHS only able to provide “fragmented care” rather than a good service to everyone who asks for it, he added.
The findings come two weeks after the BMJ revealed that some NHS weight management services have had to stop accepting referrals because they could not cope with demand. At least seven ICB areas have seen a specialist service close their lists, including in Manchester, Bristol, Suffolk and Essex.
And only about 4,000 More people undergo obesity surgery every year, while specialists say many more people would benefit from it.
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Many people who could benefit from weight-loss drugs such as Wegovy and Mounjaro are at risk of missing out because the NHS appears to be devaluing obesity and there is a large gap between demand for obesity care and the health service’s ability to deliver it, warned Joseph, who has set up a company to provide private care to people who cannot access the NHS.
For example, the National Institute for Health and Care Excellence guidelines are “relatively dead in the water” because care can only be prescribed by often overstretched weight management services, he added.
NHS England declined to comment directly on Future Health’s findings, which were commissioned by Johnson & Johnson, a maker of equipment used in obesity surgery. The NHS stressed that preventing obesity in the first place, rather than treating it, should be the top priority.
“The NHS provides a wide range of support to help people lose weight and live healthier lives, complementing the efforts of local authorities who are leading the way in preventing obesity,” a spokesperson said.
“While the NHS can and does play its part, any serious analysis would make it clear that as a country we cannot solve the obesity crisis through treatment. Much wider measures are needed to tackle the crisis at its source.”