Obesity module 1: management in primary care

Ethnicity

There is considerable variation in obesity prevalence between different ethnicities in England (see figure 4).^6–11

The point at which the level of body fat becomes risky to health varies between ethnic groups, and the validity of using current definitions of obesity for non-white minority ethnic groups is debatable. Different ethnic groups are associated with a range of different body shapes, and different physiological responses to fat storage.¹²

Evidence suggests that people from black, Asian and other minority ethnic groups are at an equivalent risk of diabetes and other health conditions at a lower BMI than white populations (see later section).

Costs

The cost to society and the economy of people being overweight or obese was estimated at almost £16 billion in 2007 (more than 1% of gross domestic product). Spending on obesity in 2007 accounted for 6% of NHS costs. As obesity levels continue to increase, it is estimated that the combined costs of treating obesity-related diseases increase by £1.9–2 billion per year in the UK.^13,14

Recognising comorbidities

Obesity leads to both chronic and severe medical conditions. It is estimated that life expectancy is reduced by an average of two to four years for those with a BMI of 30 to 35 kg/m², and eight to 10 years for those with a BMI of 40 to 50 kg/m².¹⁵

Doctors of all specialties will increasingly be confronted with patients in whom obesity has modified the presentation and treatment needs of the diseases it causes (see figure 5).¹

Increasing body fatness is associated with serious medical complications, including:²

More recently, associations have been recognised between obesity and several cancers, Alzheimer’s disease and renal failure.¹⁹