Much of the NHS does not take obesity seriously enough, despite it being an unfolding health disaster that costs the UK £98bn a year, says a report.
Only five of England’s 42 integrated care boards (ICBs) – regional groupings of NHS trusts which coordinate care over wide areas – have made tackling obesity or sticking to a healthy weight one of their top priorities, according to the Future Health thinktank.
Its analysis found that the other 37 ICBs did not identify obesity as a key issue in their forward plans, which set out what they see as the most pressing issues over the next five years.
“Too many parts of the NHS are giving obesity too little priority,” said Richard Sloggett, the report’s author, a former special adviser at the Department of Health and Social Care.
“Given what a huge and worsening problem obesity is – for individuals, the NHS, society at large and also its impact on the economy – I was concerned to see that so few NHS bodies regarded tackling it as one of their key priorities,” he added.
Two ICBs did not reference obesity at all in their detailed forward plans and three only once, adding to the impression that they did not see it as a main concern.
Almost two-thirds of adults in Britain are overweight or obese as a result of changes in food, eating habits and activity levels. Obesity is one of the top five causes of early death in England, alongside smoking, poor diet, high blood pressure and use of alcohol and drugs.
Sloggett, Future Health’s founder, said a postcode lottery in access to NHS care for those with excess weight means that “millions are missing out on treatment and obesity remains an issue largely passed over when setting NHS priorities”.
Prof Frank Joseph, a consultant in diabetes, endocrinology and internal medicine at the Countess of Chester hospital, called the findings alarming, saying: “The lack of priority is sadly inexplicable.”
But the variation in patients’ ability to get psychological help, weight management advice and bariatric surgery is the result of “chronic underfunding” that has left the NHS able to offer only “fragmented care” rather than a good service to everyone seeking it, he added.
The findings come two weeks after the BMJ disclosed that some NHS weight management services have had to stop accepting referrals because they cannot 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 people a year undergo obesity surgery, even though specialists say many more would benefit.
Many people who could benefit from weight loss drugs such as Wegovy and Mounjaro may miss out because of the lack of importance the NHS appears to give obesity and the wide gap between the demand for obesity care and health service’s ability to provide it, warned Joseph, who has set up a firm to provide private care people cannot get on the NHS.
For example, the National Institute for Health and Care Excellence’s guidelines are “relatively dead in the water” because care can only be prescribed by often-overwhelmed 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 efforts of local authorities who lead on obesity prevention,” a spokesperson said.
“While the NHS can and does play its part, any serious analysis would be clear that as a country we cannot treat our way out of the obesity crisis, and far wider action is needed to stem it at source.”
