NHS’s approach to obesity is “failing patients”

A case study entitled Confronting Obesity in the UK: The need for greater coherence has been published today by the Economist Intelligence Unit (EIU), with experts calling for a coherent strategy to tackle obesity1. The study explores the UK’s approach to obesity management and interviews experts, highlighting that commitment to a multi-stranded programme and cultural change is needed to enable obesity services in the UK to live up to their potential. 

According to Dr Matthew Capehorn, clinical manager of the Rotherham Institute for Obesity (RIO) in South Yorkshire, who was interviewed for the case study, £5bn is spent on prevention strategies, leaving just £300m for treatment. The case study reveals that the continued structural reform of the UK healthcare system has led to confusion over accountability, creating huge differences in access to treatment. According to Capehorn, only 60% of obesity services across the UK have access to higher levels of treatment, but the level of access varies significantly.

“The UK has excellent evidence based guidelines from National Institute of Health and Care Excellence detailing strategies for the prevention and management of obesity in children and adults. We now need to ensure that these are implemented” said Professor Rachel Batterham, Head of the UCLH Bariatric Centre for Weight Management and Metabolic Surgery and the UCL Centre for Obesity Research. “We know that for some patients, especially those with type 2 diabetes, that bariatric surgery leads to unrivalled health benefits and cost-saving for the NHS. Unfortunately, less than 1% of the patients who could benefit from this surgery currently receive surgery. This represents a major missed opportunity in terms of improving health and economic savings”*.

Obesity is a rising concern in the UK with 62% of the population now overweight or obese2. Yet, according to the case study, the shortage of obesity services is negatively impacting patients; as people with severe obesity are forced to wait longer to be assessed, have their associated medical problems treated and receive weight-loss advice. 

Obesity is a major public health concern across Europe and the UK is no exception.  Due to its association with serious chronic diseases such as type 2 diabetes, cardiovascular disease and some cancers3, obesity places a huge burden on both the UK’s health and economy. The study highlights that the one quarter of the population that is obese cost the NHS £6bn–8bn alone in 20154. By 2025 the NHS cost of all weight related disease is predicted to reach £21.5 billion per year4,over 20% of the current NHS budget.

The study, which was commissioned by the Johnson and Johnson subsidiary, Ethicon, follows the release of an EIU report entitled, Confronting Obesity in Europe: Taking action to change the default setting. The report highlights the need for European policymakers to address the impending health crisis and stresses that national approaches to obesity need to take into account two distinct populations: those of a healthy weight and those who are already severely obese5.

“The study suggests that a more holistic and cost effective strategy is needed to tackle obesity, and we believe that bariatric surgery could play an important role here” said Silvia De Dominicis, Vice President of Ethicon EMEA. “At Ethicon, we pride ourselves on value-based healthcare and we’re committed to supporting patients in the UK. We hope that this case study helps to open up an urgently needed discussion with policymakers and shape the future of the obesity strategies. It’s time to act.”

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