NHS limiting access to essential obesity services across England, British Medical Journal reveals
The National Health Service (NHS) is restricting access to crucial obesity services across England, leaving individuals in nearly half of the country without the ability to seek appointments with specialist teams for necessary support and treatments, including weight-loss injections.
This concerning situation was uncovered through an investigation by the British Medical Journal (BMJ), which mirrors the findings of a recent report by the Future Health research agency. The agency’s report highlighted that many of England’s Integrated Care Boards (ICBs) have failed to establish detailed strategies to address obesity and provide treatment, despite the condition costing the United Kingdom an estimated £98 billion annually in healthcare expenses, lost productivity, and other associated costs.
Richard Sloggett, the report’s author and a former special adviser in the Department of Health and Social Care, described these new revelations as evidence of the NHS “rationing” obesity treatment. He emphasised, “These findings back up our Future Health research showing that many ICBs do not currently see obesity as a priority. In certain parts of the country, there is no access to tier 3 and tier 4 services at all. This rationing is leading to a postcode lottery of care. Given the scale of the obesity challenge facing the country and the wider health and economic costs and impacts associated with it, there is an urgent need for the government and the NHS to commit new action. This should start with a clear timeline for reviewing NHS obesity services and ensuring there is a minimum service specification agreed and in place in each ICB.”
A spokesperson for NHS England responded to the BMJ’s investigation by stating that the NHS was “working with the Department of Health to support improvements in the obesity pathway.” However, experts argue that more decisive action is needed.
The BMJ’s investigation also revealed that budget cuts have disproportionately impacted local services focused on obesity care. Individuals living with obesity are often viewed as less deserving of care compared to those with other health conditions, exacerbating the situation. This reality has led to what one expert describes as a “postcode lottery of care,” where access to obesity services varies significantly depending on geographical location.
Data collected through freedom of information requests sent to all 42 of England’s ICBs showed that patients in one in six local healthcare areas were unable to access bariatric surgery, a treatment considered one of the most clinically effective interventions for obesity.
Dr Nicola Heslehurst, a professor of maternal and child nutrition at Newcastle University and chair of the UK Association for the Study of Obesity, voiced her concerns about the current state of weight management services. She told the BMJ, “Current weight management services do not in any way meet the need,” and warned that “radical” action was necessary to combat the rising prevalence of obesity, the associated care costs, and health inequalities. She also stressed the impact on future generations, cautioning that without intervention, children may be “set up for a life course of poor health.”
Obesity imposes a significant financial burden on the NHS in England, costing an estimated £6.5 billion each year. It is also recognised as the second leading cause of cancer after smoking, highlighting the urgency for a comprehensive and effective response.
ICBs receive funding from NHS England to deliver healthcare services for their local communities. However, recent budget cuts have placed immense financial pressure on these boards. In many cases, when resources are limited, services perceived as lower priority are denied funding, with obesity care frequently being the first to face budget reductions.
The BMJ’s investigation found that just over half (24) of England’s 42 ICBs commissioned the full spectrum of adult weight loss services and were open to new referrals. These services range from localised diet and lifestyle classes to more advanced interventions, such as semaglutide weight-loss injections (marketed as Wegovy) and gastric bypass surgery.
However, over a third of ICBs reported imposing restrictions on tier three obesity services, which involve multidisciplinary teams capable of prescribing weight-loss medications. Among these ICBs, six had closed their services to new patients, seven provided services only to certain parts of their catchment area, and four lacked any tier three services altogether.
Tier four services, which include more intensive weight-management interventions like gastric bypass surgery, are also severely restricted. The investigation found that seven ICBs do not offer any bariatric surgery, further highlighting the disparities in access to care across different regions of England.
John Wilding, a professor of medicine at the University of Liverpool, criticised the lack of prioritisation for obesity services, stating, “Obesity services are not deemed a priority.” He also pointed out a prevailing bias within the healthcare system, noting, “I think there is an unconscious bias which says: ‘This is mostly their fault, so they should just get on with it, go on a diet and lose weight.’ But we know from genetics and other factors that it’s much more complicated than that.”
These findings underscore an urgent need for a comprehensive review of NHS obesity services and the establishment of a uniform standard of care across all ICBs. The current restrictions on access to essential obesity treatment services not only create health inequalities but also contribute to escalating healthcare costs and long-term negative health outcomes. Without significant changes in policy and practice, the NHS faces an ongoing struggle to address the obesity crisis effectively.
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Emphasise lifelong health gains over weight loss in obesity treatment, study suggests
The focus of obesity treatment should shift from mere weight loss to a broader perspective of lifelong health improvements, according to new research published in The Lancet this week.
Professor Carel le Roux, a spokesperson for the Irish Society for Clinical Nutrition and Metabolism (IrSPEN), emphasised that the true measure of success in treating obesity should not be confined to the number of kilograms lost, but rather the enhancements in overall health and quality of life. “The success of treating obesity should not be measured in kilograms, but improvements in health and quality of life,” he stated.
While the prevailing recommendation is to aim for a 15% reduction in body weight as an initial target to address most obesity-related complications effectively, Professor le Roux highlighted the inherent challenges in establishing a universal weight goal suitable for all patients. The diverse range of complications associated with obesity makes it “difficult to identify a single realistic weight goal suitable for all patients,” he noted.
In an interview on RTÉ’s Morning Ireland, Professor le Roux, who is also a co-author of the study, underscored that obesity should not be seen as a curable condition, but rather one that can be managed through continuous treatment. “Researchers now understand that obesity cannot be cured but can be controlled if treatments are continued lifelong,” he explained.
He warned that discontinuing treatment after achieving weight loss can lead to a relapse in obesity, negating all the health benefits that had been gained. “If obesity treatment is stopped once weight loss is achieved, the disease of obesity relapses and all of the benefits are lost,” he said.
“We want people to live longer, but also to live better, if we control the disease lifelong,” he continued, emphasising that the ultimate goal is not just about shedding pounds, but about combining weight loss with significant health gains, including a reduction in heart attacks. He added, “We’re not saying that it’s not about weight loss on its own, but it’s about the combination of health gain and actually living longer because of reduction of heart attacks.”
Professor le Roux stressed the importance of a sustainable approach to treatment, tailored to the individual’s needs and circumstances. “It doesn’t matter what the treatment is, provided it works for you and you can maintain it in the long term. Please don’t start a treatment if you’re not prepared to take it for the rest of your life,” he advised.
Addressing the societal stigma surrounding obesity, Professor le Roux, an obesity specialist at St Vincent’s University Hospital, pointed out that many individuals who have obesity have been unfairly blamed for their condition from a young age. “Most people who have obesity have been blamed for it since a young age,” he said, highlighting the need to shift the narrative from blame to responsibility. “While it is not their fault, it is their responsibility to treat the disease.”
He drew parallels with other chronic conditions to underscore this point. “The same way it would be your responsibility to treat the disease of asthma or epilepsy,” he added, illustrating that once people recognise obesity as a disease, they can access the appropriate treatment. “It becomes plain sailing and it’s incredible how it transforms peoples’ lives because they feel healthier, they feel more functional, they can do more things, and their quality of life improves dramatically,” he said.
Professor Helen Heneghan, a Bariatric Surgeon, echoed the sentiments of Professor le Roux, noting that medications for obesity are only effective as long as they are taken, necessitating long-term use to maintain the associated health benefits. “Obesity medications only work while patients take them and that long-term use is required to maintain the health benefits,” she remarked.
However, Professor Heneghan also identified several challenges affecting long-term adherence to obesity treatments, including high costs, supply chain issues for newer medications, and patient dissatisfaction with side effects. “A current issue with obesity treatment is that long-term adherence is low, which is affected by many factors such as high costs to patients, supply chain shortages for the newer medications, and patients’ dissatisfaction with side effects,” she explained.
For patients who do not achieve their treatment goals with medications, Professor Heneghan suggested that bariatric surgery should be considered. She further noted that patients who do not respond optimally to bariatric surgery or experience a recurrence of obesity-related conditions might benefit from transitioning to obesity medication. “If obesity treatment goals are not reached with medications, bariatric surgery should be considered,” she advised, adding, “People with a suboptimal response to bariatric surgery, or a recurrence of obesity-related diseases, may then benefit from moving to an obesity medication.”
Dr Mick Crotty, the Obesity Lead at the Irish College of General Practitioners, highlighted a significant barrier to effective obesity treatment: the widespread misconception that obesity is a self-inflicted condition that can be resolved simply by eating less and exercising more. “Many problems partly result from the common misconception that obesity is a self-imposed condition that can be treated by asking people to eat less and move more,” he said.
This misconception, Dr Crotty argued, contributes to the disparity in care provided to individuals with obesity compared to those with other chronic diseases, both at the individual and systemic levels. He called for the Health Service Executive (HSE) to ensure that the level of access to effective obesity treatments matches that of other chronic diseases. “The HSE should plan to maintain the same level of access or coverage for effective treatments for obesity as for other chronic diseases,” he concluded.
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Researchers apply innovative mathematical technique to help combat obesity
Researchers from Katz School and UMass Dartmouth have unveiled a groundbreaking method that employs an advanced mathematical technique to deepen understanding of the factors influencing weight loss. Detailed in their white paper, “A Choquet-Integral Based Approach to Identify Weight Loss Component Subsets,” their research was showcased at the IEEE/ACM International Conference on Connected Health: Applications, Systems, and Engineering Technologies (CHASE) in June.
Traditionally used in theoretical mathematics and economics, the Choquet Integral is now making strides in the biomedical field. This technique provides a sophisticated method for targeting and optimising various metrics and factors affecting weight loss, showing promise in the practical application to health data.
The innovative use of the Choquet Integral has enabled the researchers to identify key health factors critical for weight loss, improving the precision and efficiency of their study methods over traditional approaches. This method not only minimises errors but also enhances the extraction of useful information by concentrating on the most pertinent data. The Choquet Integral utilises a fuzzy measure, which unlike traditional metrics that provide definite values such as size or length, can manage uncertainty and overlaps. This allows for a more adaptable evaluation of complex, interrelated data sets.
Matthew Fried, the leading author of the paper and a Ph.D. student at Katz School under the mentorship of Dr. Honggang Wang, explained, “We believe this methodology could pave the way for more efficient and accurate health data analysis, ultimately contributing to better health outcomes and advancing the fight against obesity.”
The methodology was rigorously tested across four distinct datasets, including random numbers, fabricated data, standard heart data from the UC Irvine Libraries, and National Institutes of Health (NIH) health data. The technique proved effective in differentiating between actual data and noise, underscoring its suitability in modelling interactive features and measuring variables like insulin and glucose levels, LDL (bad cholesterol), HDL (good cholesterol), height, and more.
Dr. Honggang Wang, co-author and chair of the Graduate Department of Computer Science and Engineering at Katz School, stated, “We studied how different health factors affect each other, whether positively or negatively, using this special mathematical approach. This method helped us understand more clearly which biological factors are most important for weight loss.”
This cross-disciplinary application of the Choquet Integral to health data analysis not only enhances the efficiency of machine learning models by selecting reduced versions of power sets but also has the potential to transform weight loss studies and other areas in the biomedical field.
Hua Fang, another co-author and professor of computer & information science at the University of Massachusetts Dartmouth and UMass Chan Medical School, noted, “The benefits of this technique extend beyond weight loss studies. It has broad potential applications in various biomedical fields where analysing complex inter-variable relationships is crucial.” This marks a significant step forward in the use of mathematical models to enhance biomedical research and health care outcomes.
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Beyond BMI: A new framework for diagnosing obesity with a focus on overall health
The traditional method of diagnosing and managing obesity, which heavily relies on body mass index (BMI), is increasingly seen as inadequate. Acknowledging this, the European Association for the Study of Obesity (EASO) has introduced a comprehensive new framework for diagnosing, staging, and managing adult obesity. Detailed in a recent publication in Nature Medicine, this framework aims to incorporate the latest scientific insights and advancements, including novel obesity medications, to ensure more effective and inclusive treatment strategies.
Obesity is widely recognised as a multifactorial, chronic, relapsing, non-communicable disease characterised by an abnormal and/or excessive accumulation of body fat. Traditionally, the diagnosis has been predominantly based on BMI cut-off values. This method fails to consider critical factors such as the distribution and functional roles of adipose tissue in the disease’s severity.
The EASO Steering Group, comprising current and former association presidents among other experts, has crafted a series of statements that update the obesity management approach to reflect the latest scientific knowledge. A key update in this new framework is the revised approach to the anthropometric component of obesity diagnosis. The authors explain, “An important novelty of our framework regards the anthropometric component of the diagnosis. The basis for this change is the recognition that BMI alone is insufficient as a diagnostic criterion, and that body fat distribution has a substantial effect on health.” They specifically highlight the health risks associated with the accumulation of abdominal fat, noting its association with an increased risk of cardiometabolic complications and its significance as a determinant of disease, even in individuals with a BMI below traditional obesity thresholds.
The new framework underscores the importance of considering abdominal (visceral) fat accumulation as a critical health risk factor, even in individuals with lower BMI (≥25–30 kg/m^2) who exhibit significant abdominal fat but may lack overt clinical symptoms. This broader definition aims to reduce the risk of undertreating these individuals compared to the current BMI-based criteria.
Treatment recommendations within the framework align with existing guidelines but emphasise behavioural changes such as dietary adjustments, increased physical activity, stress management, and improved sleep quality. Psychological therapy, obesity medications, and metabolic or bariatric procedures are also considered crucial, depending on individual needs.
The steering committee has pointed out that the traditional reliance on BMI cut-offs in clinical trials and guidelines often excludes individuals who, despite having a lower BMI, carry a significant obesity-related health burden. The committee suggests a shift towards including patients with a BMI of at least 25 kg/m^2 and a waist-to-height ratio above 0.5, who also exhibit medical, functional, or psychological impairments, in obesity medication and treatment programmes.
The authors make a call to action to pharmaceutical companies and regulatory bodies: “This statement may also be seen as a call to pharmacological companies and regulatory authorities to use inclusion criteria that are more adherent to the clinical staging of obesity and less to traditional BMI cut-offs when designing future clinical trials with obesity medications.”
In conclusion, the authors advocate for a paradigm shift in obesity management, likening it to the management of other chronic non-communicable diseases. They emphasise the importance of defining long-term, personalised therapeutic goals from the outset of treatment, considering the disease’s stage and severity, therapeutic options, side effects, patient preferences, and individual challenges. They stress the necessity for a comprehensive, life-long treatment plan over mere short-term weight reduction, stating, “Emphasis on the need for a long-term or life-long comprehensive treatment plan rather than short-term body weight reduction is warranted.”
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China initiates comprehensive three-year strategy to combat obesity epidemic
China has launched a three-year public initiative aimed at improving weight management to address the escalating issue of obesity within its populace. This initiative involves a collaborative effort among the National Health Commission (NHC), the Ministry of Education, the Ministry of Civil Affairs, and 13 additional governmental departments. These bodies have collectively issued a detailed strategy that is set to commence this year.
The primary objectives of this initiative include heightening public awareness regarding effective weight management strategies and fostering an environment conducive to healthy living nationwide.
According to the newly released strategy, there is a targeted focus on enhancing the weight status of various demographic groups, including pregnant women, young adults, children, the elderly, and workers in certain occupational sectors.
Guo Yanhong, who heads the NHC’s Health Emergency Response Office, highlighted the urgent need for this campaign given the rising rates of obesity. The comprehensive plan suggests that employers should enhance facilities to encourage physical activities at workplaces.
Furthermore, the initiative seeks to boost physical activity among students by promoting the establishment of health-conscious dining facilities within schools and ensuring students engage in at least one hour of physical exercise during and after school each day. There is also a push to decrease the availability of high-salt, high-sugar, and high-fat foods on school premises.
The strategy supports incorporating traditional Chinese medicinal practices into weight management regimes and advocates for a shift towards “healthy consumption” habits. This includes modifying food processing methods to bolster nutritional content while reducing the levels of oil, salt, and sugar in processed foods.
Recognising the link between body weight and overall health, the NHC points out that obesity often predisposes individuals to chronic diseases such as metabolic syndromes, cardiovascular diseases, and certain cancers. A pivotal goal of this campaign is to preemptively address these health issues by focusing on holistic wellness rather than merely treating diseases. The campaign also aims to include support for underweight individuals and those suffering from malnutrition.
In addition to dietary and exercise recommendations, the action plan calls for the adoption of advanced technology. It recommends the development and use of intelligent wearable devices that can monitor weight and other health metrics effectively. The integration of big data and artificial intelligence is also encouraged to tailor personal health management plans.
This announcement was made shortly after China’s approval of the widely acclaimed weight loss drug Wegovy, manufactured by Novo Nordisk. Following the endorsement by China’s National Medical Products Administration, Novo Nordisk is set to market its injectable weight-loss medication within China, where approximately 16.4% of the population is currently considered overweight.
This approval has sparked a surge in the demand for weight loss pharmaceuticals in China, prompting several companies to develop medications akin to Novo Nordisk’s Ozempic and Wegovy.
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Poor muscle health in Individuals with obesity increases risk of early death, study finds
A pivotal study presented at the European Congress on Obesity (ECO) in Venice, Italy, from 12-15 May, 2024, has unveiled a stark correlation between suboptimal muscle health and an increased risk of premature death among individuals with obesity.
The research, carried out by a Swedish team on a UK cohort, established that individuals with compromised muscle composition were three times more likely to die during the study period compared to those with healthier muscle conditions. Dr. Jennifer Linge of AMRA Medical in Linköping, Sweden, spearheaded the research and shared compelling insights. “By examining muscle composition, we can predict which individuals with obesity are most at risk of early death in the forthcoming years,” Dr. Linge explained, highlighting the potential of muscle analysis as a predictive tool for mortality.
In recent years, weight loss has become a central strategy in managing chronic conditions such as type 2 diabetes and cardiovascular diseases. With pharmaceutical advancements, patients are now achieving significant weight reductions, previously possible only through surgical interventions. However, this brings to light concerns about possible detrimental effects on muscle health, including severe muscle mass loss and reduced mobility.
Dr. Linge elaborated on the complexities of muscle health in individuals with obesity, “Although individuals with obesity typically have more muscle mass, their muscles tend to be comparatively weaker. They also exhibit lower muscle quality, as well as reduced mobility and function.” She emphasised the importance of thorough muscle composition assessments, which consider both muscle quantity and quality, in evaluating the safety of rapid weight loss treatments, particularly for more vulnerable patients, such as those with sarcopenic obesity or advanced age.
The study also highlighted a critical gap in research concerning muscle health among populations with obesity, despite existing evidence from MRI studies that link poor muscle health with reduced functional performance, increased illness, and higher mortality rates in individuals with non-alcoholic fatty liver disease (NAFLD) and the general populace.
To address this, Dr. Linge and her colleagues utilised the AMRA Researcher software to analyse MRI scans from 56,109 participants in the UK Biobank study. They measured muscle volume and muscle fat, establishing a personalised muscle volume z-score to benchmark each individual’s muscle volume against the norm for their sex and body size.
From the extensive dataset, 9,840 participants—half of whom were men, with an average age of 64.4 years and a mean BMI of 33.5 kg/m²—were identified as having obesity and had comprehensive data on muscle composition. Of these, 2,001 (20.3%) exhibited adverse muscle composition. Over an average follow-up of 3.9 years, 174 participants died, predominantly from ischemic and hypertensive diseases.
The study findings indicated that neither low muscle volume z-score nor high muscle fat alone significantly influenced mortality risk. However, adverse muscle composition—characterised by both low muscle volume and high muscle fat—was strongly associated with a tripled risk of death during the follow-up period. This association persisted even when adjustments were made for factors like strength (hand grip), other diseases (cancer, type 2 diabetes, and coronary heart disease), and lifestyle factors (smoking, alcohol consumption, and physical activity), revealing a 70% increased risk of early death.
Sex, age, type 2 diabetes, and smoking were also noted as factors increasing the risk of premature death.
Dr. Linge concluded, “These results underscore the paramount importance of maintaining muscle health in people with obesity. It is crucial to determine whether drugs that achieve significant or rapid weight loss are inadvertently causing excessive muscle loss or worsening muscle quality, to ensure safer treatment approaches for obesity, particularly for those at greater risk.” This call to action not only emphasises the significance of maintaining muscle health but also the necessity of careful evaluation of treatment strategies for obesity.
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Workers with obesity are twice as likely to take long-term sick leave
In a comprehensive study recently presented at the European Congress on Obesity in Venice, it was discovered that employees with obesity are significantly more likely to require sick leave compared to their healthier counterparts, highlighting a growing concern over obesity’s impact on workforce productivity and economic output. This pioneering research offers a detailed analysis of how obesity levels are influencing work attendance, revealing that the issue is contributing to a culture of increased sickness absence, which is straining the economy.
The study, which scrutinised the behaviour of 123,000 workers across Europe, including the UK, indicates that Britain’s performance is notably poor, with six out of ten adults classified as having either overweight or obesity. This finding places the UK among the worst of 28 countries examined. The timing of this revelation is critical as the UK is currently experiencing unprecedented levels of long-term sickness.
Researchers reported that workers in the highest obesity bracket were 2.5 times more likely to have been absent from work due to illness for a week or more over the past year, compared to those maintaining a healthy weight. Additionally, even individuals with mild overweight were found 22% more likely to have taken at least seven sick days annually.
This alarming data coincides with UK Prime Minister Rishi Sunak’s appeal last month to curb the “sick note culture” by not overly medicalising normal life stresses, a statement made in light of proposed welfare reforms. This appeal comes as the Office for National Statistics highlights that long-term sick leave figures have surged from 2.1 million to 2.8 million people since before the pandemic, with an estimated £50 billion allocated annually towards sickness benefits for working-age individuals.
Critics argue that the government’s efforts to address sick leave will be futile without serious measures against obesity, a major public health threat linked to numerous long-term illnesses. They emphasise the grave consequences facing the UK, branding it the “sick man of Europe” due to its inability to address significant health issues, with obesity being the foremost.
Presented at the European Congress on Obesity in Venice, the study’s findings further establish that higher body weight correlates with increased absenteeism. Separate studies corroborate these findings, showing the UK as having the third highest obesity rates among Organisation for Economic Co-operation and Development (OECD) countries. This extensive research is the first to detail how obesity impairs productivity by keeping individuals out of work, thereby exacerbating societal exclusion.
In the UK, long-term sickness has now become the leading cause of women exiting the workforce, with an additional 500,000 women becoming economically inactive due to this issue in the past five years. This surge is largely attributed to conditions like back pain, often exacerbated by excessive weight.
The study’s lead, Dr Thomas Czypionka from the Health Economics and Health Policy Research Group at the Institute for Advanced Studies in Vienna, emphasised the broad spectrum of health complications arising from obesity, including hypertension, diabetes, arthritis, and sleep apnoea. He highlighted the urgent need for stringent measures to tackle obesity, particularly through the reduction of ultra-processed food consumption.
Policy makers and health experts agree that addressing obesity is critical for improving public health and economic productivity. The government has initiated steps such as imposing sugar reduction targets in soft drinks and mandating calorie counts on menus to mitigate obesity levels. Further, a £2.5 billion plan aims to assist over a million people, including those with obesity-related health conditions, to overcome barriers to employment.
This comprehensive study not only underscores the profound individual and societal impacts of obesity but also stresses the imperative for coherent public health strategies to curb this escalating issue.
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Close to half of all cancer diagnoses linked to obesity, research finds
A pivotal study has revealed a significant correlation between obesity and an increased risk of various cancers, intensifying concerns over a looming public health crisis. Conducted at Lund University in Malmo, Sweden, this extensive research tracked over four million adults over four decades, uncovering that excess weight could be a contributing factor in more than 30 different types of cancer.
This landmark research, set to be unveiled at the European Congress on Obesity in Venice, has been described as “groundbreaking” by experts, highlighting a potential health crisis in the making. The urgency of these findings has prompted health charities to call for immediate governmental action in response to this alarming revelation. They emphasise the economic burden of obesity, which is estimated to cost the UK nearly £100 billion annually, with NHS expenses alone reaching £19 billion.
The Health Secretary, Victoria Atkins, asserted the government’s commitment to addressing this issue robustly, with plans to leverage apps and technology to transform public health approaches expected to roll out this summer. Atkins stressed the government’s goal for citizens to enjoy longer, healthier lives.
Detailed findings from the study indicated that, of the 332,500 cancer cases recorded during the research period, 40% could be linked to obesity. Annually, the UK sees around 390,000 new cancer diagnoses, suggesting approximately 150,000 cases could be obesity-related. Previously, global studies had identified 13 cancers linked to excess weight, including cancers of the bowel, breast, womb, and kidney. This latest study has extended that list, identifying a total of 32 cancer types associated with obesity. Notably, a five-point increase in Body Mass Index (BMI) was found to enhance cancer risks significantly—by 24% in men and 12% in women for previously established obesity-related cancers. Additionally, this increase was connected to a 17% higher risk for men and 13% for women in 19 other newly associated cancers, including malignant melanoma and various rare cancers like those of the pituitary glands and small intestine.
The comprehensive nature of the study, examining 122 types and subtypes of cancer over 100 million years of follow-up, underlines the severe public health implications. Researchers highlighted that keeping a normal weight could potentially prevent a substantial proportion of cancer cases, with established obesity-related cancers accounting for 25% of all cases and this proportion rising to 40% when including potential obesity-related cancers.
Obesity rates in the UK have nearly doubled since the 1990s, with a current 26% of adults in England categorised as having obesity and another 38% as having overweight. Obesity now surpasses smoking as the primary cause of four major cancers, though smoking remains a significant risk factor.
Forecasts by Cancer Research UK suggest that reducing obesity could prevent approximately 8,000 cancer cases in England by 2040. Prof Jason Halford, president of the European Association for the Study of Obesity, emphasised the strength of the analysis and the need for further research to confirm these associations and explore the underlying mechanisms.
The NHS is exploring innovative approaches, including the use of weight loss medications like Wegovy, to tackle obesity effectively. Government plans to promote healthier lifestyles through technology and legislative measures are also underway, aiming to make healthy choices more accessible to the populace.
Katharine Jenner, director of the Obesity Health Alliance, a coalition of 50 health charities, stressed the clear results of the study and the need for urgent, effective public health policies to prevent obesity and associated diet-related cancers. This includes implementing restrictions on junk food marketing and introducing levies on unhealthy foods to facilitate healthier choices for all.
Lead researcher Dr Ming Sun highlighted that the impact of obesity on cancer might be more extensive than previously understood, suggesting it as a risk factor for more cancer types, particularly rarer ones that have seldom been studied in this context. The study’s findings underscore the necessity of public health measures to tackle the obesity epidemic and its detrimental effects on health outcomes comprehensively. Dr Jennifer L Baker, co-chairman of EASO’s childhood obesity working group, further elucidated potential biological mechanisms such as chronic inflammation and hormonal changes that might explain the increased cancer risk associated with obesity.
In conclusion, this study serves as a critical indicator of the link between obesity and an increased risk of various cancers, urging immediate and robust action to mitigate this public health threat.
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Research indicates higher likelihood of midlife obesity in individuals whose parents had obesity
In the midst of growing concerns regarding global health, a pivotal study poised for presentation at the esteemed European Congress on Obesity (ECO) in Venice, from 12th to 15th May 2024, sheds light on the intergenerational transmission of obesity, revealing profound insights into how parental obesity significantly influences the likelihood of obesity in their offspring during middle age.
This groundbreaking research, led by Mari Mikkelsen from the Department of Community Medicine at UiT Arctic University of Norway in Tromsø, embarks on a novel investigation into the persistence of obesity from one generation to the next, particularly extending beyond adolescence and well into adulthood—a period often overlooked in previous studies. Mikkelsen’s team delved into the intricate relationship between the Body Mass Index (BMI) of parents and their adult children, employing data meticulously gathered from the Tromsø Study, a comprehensive, ongoing population-based health study.
The analysis encompassed 2,068 parent-offspring trios, focusing on individuals aged 40-59 years who participated in the seventh wave (2015-2016) of the Tromsø Study, with their parents’ data drawn from the fourth wave (1994-1995). The findings illuminate a compelling correlation between the BMI of parents in their middle years and that of their children at a similar stage in life, underscoring a pronounced genetic and environmental legacy of obesity.
Specifically, the study reveals that when both parents had a BMI indicating obesity (BMI ≥ 30 kg/m²) during their forties and fifties, their offspring were six times more likely to experience obesity at the same age compared to those whose parents were within a normal weight range (BMI 18.5-24.9 kg/m²). Moreover, the presence of obesity in just one parent still significantly elevated the likelihood of the offspring living with obesity, with the odds being over three times higher.
An intriguing aspect of the research was the quantification of the BMI transmission effect: an offspring’s BMI increased by 0.8 units for each 4-unit rise in the mother’s BMI and by 0.74 units for every 3.1-unit increase in the father’s BMI. These findings persisted even after adjustments for several variables, including the sex, age, education, and physical activity levels of both parents and offspring.
Mikkelsen’s team provides a nuanced understanding of the multifaceted factors contributing to this familial trend in obesity. Genetic predispositions play a crucial role by influencing susceptibility to weight gain and shaping reactions to an increasingly obesogenic environment. Additionally, shared family behaviours concerning diet and exercise, established during childhood and adolescence, may further perpetuate similar BMI statuses within families.
This profound research not only reinforces the enduring impact of familial obesity patterns but also emphasises the critical need for effective obesity prevention and treatment strategies. By highlighting the long-lasting consequences of parental obesity on their children into middle age, the study paves the way for future research aimed at identifying and mitigating the factors responsible for the intergenerational transmission of obesity. In doing so, it offers hope for breaking the cycle of obesity and fostering a healthier future for subsequent generations.
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Study indicates significant benefits from obesity care, though few receive it
Obesity represents a significant global health challenge, marked by its complex aetiology and the substantial health risks it poses. Effective management of obesity can dramatically improve health outcomes, yet access to comprehensive obesity care remains limited for many. A recent study conducted by a team from Michigan Medicine at the University of Michigan has shed light on the effectiveness of various obesity treatment strategies and highlighted the disparity in access to these interventions.
The study, engaging tens of thousands of individuals diagnosed with obesity, meticulously evaluated the outcomes of diverse weight management interventions, including nutrition counselling, medically supervised meal replacements, anti-obesity medications, and bariatric surgery. The findings revealed that the likelihood of achieving a weight loss of 5% or more within a year varied significantly across the different treatment modalities, ranging from nearly one in four to almost certain success, depending on the specific intervention utilised.
Notably, the research emphasised that a modest weight loss of just 5% can have profound health benefits, underscoring the importance of accessible and effective weight management strategies. However, a critical observation from the study was the underutilisation of available treatments, with a mere fraction of the study population receiving any form of medically endorsed weight management care from their primary healthcare providers.
The investigation revealed a troubling gap in the provision of obesity-related healthcare, with the majority of individuals suffering from obesity not receiving adequate treatment through their regular healthcare channels. This gap is not due to a lack of effective treatments but rather to a systemic failure to integrate these options into standard care practices. The study’s authors advocate for a more proactive approach by primary care clinics, health systems, and insurers to facilitate access to and engagement with effective obesity treatments.
In response to these findings, the University of Michigan has embarked on an innovative programme aimed at transforming obesity care. The Weight Navigation Program, spearheaded by Dina Hafez Griauzde, M.D., M.Sc., and Andrew Kraftson, M.D., seeks to offer personalised treatment paths for patients, leveraging the expertise of board-certified obesity medicine physicians and ongoing support mechanisms, including digital communication tools, to ensure long-term engagement and success.
This initiative not only provides immediate care options for individuals struggling with obesity but also serves as a model for integrating evidence-based weight management strategies into primary care, potentially reshaping the landscape of obesity treatment.
The study conducted by Michigan Medicine highlights the critical need for improved access to and utilisation of weight management treatments in the fight against obesity. By demonstrating the efficacy of various treatment options and pioneering new approaches to care delivery, the research team has laid a foundation for a more inclusive and effective obesity care framework. As healthcare systems and insurers begin to recognise and address the barriers to obesity treatment, there is hope for a future where comprehensive, personalised obesity care is accessible to all who need it.
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Over a billion people now affected by obesity worldwide, comprehensive analysis shows
A groundbreaking analysis published in The Lancet has highlighted a concerning milestone in global health: the number of children, adolescents, and adults living with obesity worldwide has exceeded one billion. This significant finding marks a shift in the nutritional challenges faced globally, with obesity now surpassing undernutrition as the predominant form of malnutrition in the majority of countries.
This detailed examination of global data reveals a stark increase in obesity rates among the world’s youth in 2022, which are now four times higher than they were in 1990. For adults, the increase is equally alarming, with obesity rates more than doubling for women and nearly tripling for men. Specifically, the analysis found that 159 million children and adolescents, along with 879 million adults, were living with obesity in 2022.
Simultaneously, the study reports a decline in the prevalence of underweight individuals since 1990, indicating progress in one area of malnutrition but highlighting the growing concern of obesity. Professor Majid Ezzati of Imperial College London, a leading figure in the study, expressed grave concerns about the obesity epidemic’s expansion into younger demographics and stressed the importance of improving access to healthy, nutritious foods to combat both obesity and undernutrition.
The study, a collaborative effort between the NCD Risk Factor Collaboration (NCD-RisC) and the World Health Organization (WHO), analysed weight and height measurements from over 220 million people aged five years and older across more than 190 countries. This extensive data collection aimed to trace the evolution of obesity and underweight from 1990 to 2022, using Body Mass Index (BMI) as a key measure.
The findings reveal a dramatic rise in obesity rates globally, with significant increases observed in nearly all countries examined. In parallel, there has been a notable decline in underweight rates, shifting the focus of nutritional health challenges.
Regionally, the study provides detailed insights into the prevalence of obesity and underweight. For instance, in Polynesia and Micronesia, as well as in the Caribbean and the Middle East and North Africa, obesity rates have surged, surpassing those in many high-income industrialised countries, particularly in Europe. Specifically, Tonga and American Samoa reported the highest prevalence of obesity among women, while American Samoa and Nauru topped the list for men.
In contrast, the United Kingdom saw its obesity rates climb from 13.8% to 28.3% for women and from 10.7% to 26.9% for men between 1990 and 2022. Similarly, the United States experienced a significant increase in obesity rates, with women’s rates jumping from 21.2% to 43.8% and men’s from 16.9% to 41.6% over the same period.
China and India also witnessed notable increases in obesity rates, albeit from lower baselines. China’s obesity rates rose from 2.0% to 7.8% for women and from 0.8% to 8.9% for men, while India saw increases from 1.2% to 9.8% for women and from 0.5% to 5.4% for men.
Despite these increases, the study also highlighted countries where underweight remains a significant concern, with Eritrea and Timor-Leste for women, and Eritrea and Ethiopia for men, recording the highest prevalence of underweight in 2022.
The study underscores the complex global challenge of addressing both obesity and undernutrition, emphasising the need for comprehensive policy measures and international cooperation to tackle these issues effectively. Despite limitations, such as the imperfect nature of BMI as a measure and variable data availability, the analysis provides a crucial overview of global nutritional trends, highlighting the urgent need for action to create a healthier global population.
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Study confirms light exercise effectively counters childhood obesity
Childhood obesity, a growing concern worldwide, might have a surprisingly straightforward solution: light exercise. Recent research led by an international team of scientists from the Universities of Exeter, Eastern Finland, Bristol, and Colorado, underscores the profound impact of light physical activity in combating the rise of obesity in children.
Drawing from the University of Bristol’s Children of the 90s study, the research tracked 6,059 children (53% female) from age 11 to 24. Amid global reports revealing a worrying trend of inactivity among adolescents — with over 80% failing to meet the World Health Organization’s guidelines for daily physical activity — the study presents an urgent narrative. The lack of exercise is anticipated to contribute to 500 million new cases of noncommunicable diseases by 2030, costing an estimated $23 million annually.
What’s striking about the study is the revelation that light physical activity, rather than moderate-to-vigorous exertion, plays a crucial role in reducing fat mass gain in youth. Dr. Andrew Agbaje of the University of Exeter, a key contributor to the study, emphasises the overlooked benefits of light physical activities like walking, household chores, and leisurely swimming. He suggests shifting public health messages from an emphasis on 60 minutes of moderate-to-vigorous activity to encouraging at least three hours of light activity daily.
Participants were observed over 13 years, with physical activity levels and health markers meticulously monitored using waist-worn accelerometers and dual-energy X-ray absorptiometry. The results were startling: each additional minute of sedentary behaviour correlated with a 1.3-gram increase in total body fat mass. In contrast, each minute of light physical activity corresponded to a 3.6-gram decrease in total body fat mass, amounting to a significant reduction of 950 grams to 1.5 kilograms over the study period.
In comparison, moderate-to-vigorous physical activity showed a minimal effect, reducing total body fat mass by only about 0.7 to 1.7 percent. This finding challenges the prevailing public health guidelines, which predominantly advocate for higher-intensity exercise.
The study, published in Nature Communications, calls for a reevaluation of health guidelines and policy statements, urging public health experts, policymakers, and parents alike to promote light physical activity as a key strategy in preventing childhood obesity. As Dr. Agbaje concludes, sustaining light physical activity can be the much-needed antidote to the detrimental effects of a sedentary lifestyle in young populations.