MEDICAL SCHOOL INTERVIEW GUIDE — NHS and Medical Knowledge — NHS CURRENT TOPICS

Obesity Crisis

WRITTEN BY
MEDISTUDENTS TEAM
SEPTEMBER 20, 2021

As with some previous sections, key information in relation to obesity statistics and government policies to address these, is shown separately for each of the devolved nations within the UK:

England

The following are statistics provided by NHS England around obesity rates:

  • ‘Nearly two-thirds of adults in England are overweight or obese’
  • ‘A third of children leaving primary school are overweight or obese’
  • ‘In 2016/17, 617,000 admissions to NHS hospitals recorded obesity as a primary or secondary diagnosis’

NHS England’s ‘Statistics on Obesity, Physical Activity and Diet, England, 2020’ and the House of Commons Research Briefing, ‘Obesity Statistics’, also provide figures in relation to obesity in England. 

Key documentation:

Tackling obesity: government strategy

Published in July 2020, this outlines the ‘actions the government will take to tackle obesity and help adults and children to live healthier lives’. 

It addresses the issue of ‘COVID-19 and obesity’ and how they aim to address this.

It also links to Public Health England’s Excess Weight and COVID-19: Insights from new evidence

NHS Long Term Plan

Published in January 2019, and ‘drawn up by frontline staff, patients groups, and national experts to be ambitious but realistic’, the Long Term Plan sets the aims for the next 10 years in the NHS.

There is a section specifically on obesity, outlining what the concerns are and the plans to tackle these, including:

  • The government pledge to half childhood obesity and reduce the gaps between the most and least deprived by 2030
  • Targeted support and ‘access to weight management services in primary care for people with a diagnosis of type 2 diabetes or hypertension with a BMI of 30+’ 
  • ‘Doubling of the NHS Diabetes Prevention Programme’ over 5 years.

See also the ‘Implementation Framework’, which sets out how the ‘commitments in the Long Term Plan will be delivered’ and the ‘Interim NHS People Plan’, which sets out how people working in the NHS will be supported.

Health matters: obesity and the food environment

Government guidance published in 2017. It examines the ‘scale of the obesity problem [and] factors behind the rise in obesity levels’, as well as looking at how improvements can be made.

It outlines the following ‘national policies to tackle obesity’:

  • ‘A soft drinks industry levy’
  • ‘Sugar reduction’
  • Public Health England’s (PHE’s) ‘marketing campaigns’

Childhood obesity: a plan for action

Published in 2016 as a ‘plan for action to significantly reduce childhood obesity by supporting healthier choices’

It outlines a number of actions to achieve this, including:

  • The introduction of a soft drinks industry levy
  • ‘Taking out 20% of sugar in products’
  • Clearer food labelling
  • ‘Making healthy options available in the public sector [and making school food healthier’
  • ‘Helping all children to enjoy an hour of physical activity every day [and] improving the co-ordination of quality sport and physical activity programmes for schools’

Wales

The following are statistics provided in the government’s ‘Health Weight Healthy Wales: Youth and community version’ relating to obesity rates:

  • ‘60% of adults are overweight or obese’.
  • The number of overweight or obese adults is increasing by 10,000 each year.
  • ‘A quarter of all children (around 8,500) start school overweight or obese. 

Key documentation:

Healthy Weight Healthy Wales

The government’s ‘long term strategy to prevent and reduce obesity’ which was published in October 2019.

There are 4 key themes of the plan:

  • ‘Healthy Environments’ focusing on ‘food environments’ and ‘active environments’.
  • ‘Healthy Settings’ focusing on the ‘settings where we learn, work and live [...] providing healthier food choices and encouraging regular physical activity’.
  • ‘Leadership and Enabling Change’ to ‘develop a ‘wellness’ system’.
  • ‘Healthy People’ focusing on ‘people feeling more motivated, enabled and supported to make healthier choices throughout their lives’.

Healthy Weight Healthy Wales: Youth and community Version

Published alongside the ‘Healthy Weight Healthy Wales’. It details the same 4 key themes but outlines how they specifically relate to young people.  

Public Health Wales also outlines why obesity is a problem in Wales, how many people it affects and how this is being addressed, in their ‘Overweight and Obesity’ section.

Scotland

The following are statistics provided Public Health Scotland in relation to obesity rates:

  • ‘In 2016, 65% of adults were overweight including 29% obese’.
  • ‘In 2016, 29% of Scotland's children were at risk of becoming overweight (including obesity). 14% were at risk of becoming obese’.

This document also outlines ‘local and nations actions’, which you may find useful. 

The Scottish Health Survey confirms that the figures for adults have remained ‘stable since 2008’ and gives the following statistics for 2018:

  • ‘Two thirds (65%) of adults were overweight, including 28% who were obese’.
  • ‘Children at risk of obesity has remained relatively stable in 2018 at 16%’.
  • ‘70% of children (aged 2-15) were of healthy weight’.

Key documentation:

A healthier future: Scotland's diet and healthy weight delivery plan

Published in July 2018, this ‘strategy/plan’ sets out how the government will ‘work with partners in the public and private sector to help people make healthier choices about food’. 

It outlines the following ‘five key outcomes’ that they are working towards:

  • ‘Children have the best start in life – they eat well and have a healthy weight’.
  • ‘The food environment supports healthier choices’.
  • ‘People have access to effective weight management services’.
  • ‘Leaders across all sectors promote health weight and diet’.
  • ‘Diet-related health inequalities are reduced’.

Obesity and health inequalities in Scotland

Published in 2017 this ‘summary report’ focuses on the ‘inequalities in the distribution of obesity in Scotland among adults and children and how these have changed over time’.

Northern Ireland

The following are statistics provided Department for Health, from the ‘Health Survey (NI): First Result 2019/20’,  in relation to obesity rates:

  • ‘65% of adults were either overweight (38%) or obese (27%)’.
  • This is an increase from 2018/19 when the total was 62%.
  • ‘Around a quarter (25%) of children aged 2–15 were either overweight (20%) or obese (6%) – similar to 2018/19’.

Key documentation:

A Fitter Future for All

Produced by the Department of Health, Social Services and Public Safety, ‘A Fitter Future for All’ is the ‘framework for preventing and addressing overweight and obesity in Northern Ireland 2012-2022’.

It sets out the following overarching targets:

  • For adults: ‘to reduce the level of obesity by 4% and overweight and obesity by 3% by 2022’.
  • For children: ‘a 3% reduction of obesity and 2% reduction of overweight and obesity by 2022’.

It also outlines the following overarching objectives:

  • ‘To increase the percentage of people eating a healthy, nutritionally balanced diet’.
  • ‘To increase the percentage of the population meeting the CMO guidelines on physical activity’. 

You can find progress reports for the framework on the Department of Health website.

Ethical considerations & wider issues

Obesity is an important topic due to its impact on individuals’ overall health and quality of life. The NHS states that ‘obesity reduces life expectancy by an average of 3 to 10 years, depending on how severe it is [and] it’s estimated that obesity and being overweight contributes to at least 1 in every 13 deaths in Europe’. It also increases the risk of developing ‘many potentially serious health conditions’, including type 2 diabetes, several types of cancer, including bowel, breast and womb cancer, and liver and kidney disease. You can find the full range given by the NHS here.

Linked to this, is the cost of obesity to the NHS, which is also a wider issue associated with this topic. For examples of this, ‘Health matters: obesity and the food environment’, which outlines the cost to the NHS in England, and ‘The impact of overweight and obesity on hospital resource use (hospital episodes) in Scotland’ are useful starting points for further research.

Further research

Having an understanding of the following will support your to be able to discuss the topic of obesity, should it arise at your medical school interview:

  • The impact of obesity on an individual’s health and life expectancy
  • The impact of obesity on the NHS
  • Policies and strategies to tackle obesity across the UK
  • Public health campaigns aimed at reducing and preventing obesity

You may also find it useful to consider the impact that government policies and public health campaigns have on people’s actions, as well as what role doctors play in preventing and managing obesity. 

Some further areas which you may find interesting to explore are:

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