‘GPs should routinely weigh patients whose condition may be linked to obesity’

Patients whose ill-health may be linked to being overweight should be routinely weighed at appointments to help stave off obesity and spiralling care costs, councils say.

Concern around offending overweight patients is believed to be contributing to a significant rise in adult social care costs, costly housing adaptations and reliance on expensive specialist equipment.

Some health practitioners are not recording information on weight or BMI (body mass index) when they see severely obese patients presenting with linked conditions due to a “fear of offence and a lack of referral services”, the Local Government Association (LGA) said.

And others “often” compensate for the loss of mobility in obese patients by recommending expensive, specialised equipment that can compound the problem, it added.

One housing occupational therapist consulted as part of the LGA’s report said: “There is a taboo/stigma around the issue of obesity.

“It’s never raised either by the professional or by the person themselves.”

A service provider added that “if you ignore the underlying condition (i.e. obesity) and concentrate on the secondary conditions … this can compound the issues and make the person’s situation worse”.

Unless this is tackled, obesity’s major health implications could “bankrupt” social care and the NHS, the LGA warns.

Obesity is one of the biggest public health challenges, with up to a third of adults predicted to be obese by 2024.

It is linked to a wide range of diseases including type 2 diabetes, some cancers, heart and liver disease, and stroke.

More recently it has been thrown into the spotlight by the coronavirus pandemic, with research suggesting obese people are more likely to be admitted to hospital with Covid-19 or die from the virus.

With Public Health England due to be scrapped, questions will now be raised about which body will lead the country’s obesity strategy.

The LGA is urging GPs, nurses and nutritionists to have honest conversations with patients where they suspect their weight is the underlying cause of another condition.

They also want the weight of these patients to be routinely recorded at appointments.

And health professionals should be given training in how to raise weight-related issues “sensitively and in a non-judgemental way”.

Ian Hudspeth, chairman of the LGA’s Community Wellbeing Board, said: “Unless we tackle the stigma and serious challenge of obesity, the costly and debilitating major health conditions it causes could bankrupt adult social care and NHS services.

“Health professionals need to start having frank conversations about their people’s weight if it could be an underlying cause of their condition and routinely record it; individuals need to take responsibility for their own decisions and government needs to support them to do so.

“Obesity needs to be tackled head-on, otherwise people’s health will continue to suffer, health inequalities associated with obesity will remain, and the economic and social costs will increase to unsustainable levels.”

The annual cost met by councils funding community-based social care for a severely obese person is nearly double that for a person with a healthy BMI, equating to an extra £423,000 a year overall for a typical council.

And analysis of the English Longitudinal Study of Ageing estimated that obese people over the age of 65 are 25% more likely to be using long-term care in two years’ time than those in the healthy range.

Despite this research, the LGA noted there is no systematic collection of national and local level data on the links between obesity and social care need.

It said rising obesity levels have also sparked increased demand for expensive bariatric equipment, with one council recording a 47% rise in spending on this over a three-year period.

It is also calling for the public health grant to councils to be increased to at least £3.9 billion a year by 2024/25 so it matches the growth in overall NHS funding.

Andrew Radford, chief executive of the eating disorder charity Beat, said obesity reduction at population level should be done in a “non-stigmatising way, without any extra risk to those affected by eating disorders”.

He continued: “To achieve this, we are asking that campaigns to reduce obesity be developed in consultation with eating disorder professionals alongside weight management experts. They should also avoid language which shames or blames people living with obesity.”

A Department of Health and Social Care spokeswoman said: “We are taking bold action in our new obesity strategy – banning unhealthy food adverts before 9pm, ending deals like ‘buy one get one free’ on unhealthy food, and introducing calorie counts on menus – to help people make healthy choices.

“We know losing weight is hard, and we are working on plans to make more weight-loss support available through doctors. We’ll set out further detail on this in due course.”