A quarter of adults in England are obese, public health survey finds

A quarter (26%) of adults in England were obese in 2021, with rates higher among men, older people, and those in more deprived areas, a report from the Health Survey for England has shown.

The survey of 5,880 adults was conducted via telephone interviews, due to the Covid-19 pandemic,  for most of 2021 about a variety of topics including cigarette smoking, e-cigarette use and alcohol consumption.

The Health Survey for England report, published today by NHS Digital, showed that obesity rates increased with age, with just 8% of adults aged 16-24 being classed as obese, compared to 32% of those aged 65-74.

The prevalence of obesity was highest among adults living in the most deprived areas, at 34%, compared to 20% in the least deprived areas, and a higher proportion of men were either overweight or obese (69%) compared to 59% of women.

Among adults who were obese, 11% reported that they had received a diagnosis of diabetes from a doctor, compared to 5% of adults who were classed as overweight and 3% of those who were neither overweight or obese.

Mark Burdon, pharmacist and owner of Whickham Pharmacy in Newcastle-upon-Tyne, told The Pharmacist that the figures relating to age, sex and deprivation were consistent with the demographics he saw in his pharmacy for the weight management clinic.

However, he described NHS provision as a ‘postcode lottery’, saying that his area did not provide a tier three service. While private services were popular, he said that these programmes could cost patients over £200 per month.

‘It doesn’t help with health inequalities in that respect. If it was a locally commissioned service, that would be fantastic’, he said, adding that effective weight loss programmes could help reduce NHS costs in other areas, such as spending on diabetes drugs and pain management.

‘At the minute, most of the patients I’m seeing are primarily men. We’ve had some fabulous results with some of the men, fantastic lifestyle changes. The products and the medicines that we can offer them are just one part of it, the vast majority of it is how they change their lifestyle. And the medicines just give them that that kind of kickstart that help to get themselves into a healthy routine,’ he said.

‘One guy brought me some Christmas presents in the other day because he was so grateful that we’d done it, he was absolutely over the moon!’

Pharmacist and IP Ali Hashemian, director of Bath and District Pharmacy Limited, told The Pharmacist that his weight loss clinic, delivered under a PGD to patients with a BMI of 30 or more, helped patients see ‘a trend of weight loss every couple of weeks’ using the medication Saxenda, ‘which helps motivate them to eat better and exercise more as well’.

Community pharmacist Gareth Evans, from Wansford Pharmacy in Peterborough, said that his pharmacy provides a range of services to help patients lose weight, such as meal replacement programmes.

He said that solutions had to be tailored to the patient’s individual need and expressed concerns that NHS solutions looked at the issue within ‘a finite time scale’.

‘People get help for three months. And if you've got someone that's 10 stone overweight, three months is not really going to cut it,’ he said.

He also described the focus of NHS programmes on low calorie dieting as ‘restrictive’, ‘rather than realistic in terms of what’s needed’.

‘From my experience unless people have lost all their excess weight, there’s a propensity to quickly put that back on because they've not reached their absolute target,’ he said.

Pharmacists had an opportunity to offer people help before they reached the ‘obese’ category, he added.

‘With weight management it’s just as much about prevention. There's a lot of concentration on the obese category, but you've got to be overweight before you get obese.’

‘Two thirds of the population are either overweight or obese and I think that's the figure we should be concentrating on more’, he added.

Earlier this week, the Pharmaceutical Services Negotiating Committee announced that all contractors must participate in a mandatory weight management campaign this January,

As part of the Health living support domain of the 2022/23 Pharmacy Quality Scheme, pharmacy teams are also required to proactively discuss weight management with at least 25 patients and refer at least 4 who meet the criteria for referral to either a Local Authority funded tier 2 weight management service or the NHS Digital Weight Management Programme.

The Health Survey for England report also found that 12% of adults in England smoked, with more men (13%) than women (10%) reporting that they currently smoked.

Of these current smokers, 16% also currently used e-cigarettes as did 13% of ex-regular smokers.

Two-thirds of adults (66%) had never regularly smoked, and only 1% of those who had never smoked cigarettes currently used e-cigarettes.

The survey also asked participants about their alcohol consumption – 79% of participants reported that they had drunk alcohol in the last 12 months, while 49% reported that they drank alcohol at least once a week.

The report also found that men were more likely than women to drink at increasing or higher risk levels, with 28% of men compared to 15% of women saying that they usually drank more than 14 units of alcohol a week.