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Sir John Bourn, head of the National Audit Office, told Parliament today that the prevalence of obesity in England had tripled over the last 20 years and continues to rise. Most adults in England are now overweight, and one in five is obese.

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Producing the first authoritative estimates of the costs and consequences of obesity in England, Sir John estimated that obesity accounted for 18 million days of sickness absence and 30,000 premature deaths in 1998. On average, each person whose death could be attributed to obesity lost nine years of life. Treating obesity costs the NHS at least £½ billion a year. The wider costs to the economy in lower productivity and lost output could be a further £2 billion each year.

Sir John recommends that greater effort is placed on establishing an evidence based approach to the problem to enable the NHS to adopt a more consistent approach to the management of obesity. Continued and more extensive joint working across government is also needed, both nationally and locally, to promote long term changes in lifestyles.

NAO research identified wide variation in the way general practices manage overweight and obese patients, and uncertainty about which treatment and referral options are the most effective. Sir John recommends that the Department of Health leads work to clarify the responsibilities of primary care teams for identifying people at risk from excess weight, and to develop and disseminate guidelines on effective treatment programmes.

Sir John identifies substantial and valuable cross-Governmental work to tackle obesity through encouraging physical activity and better diet in schools and the population generally. But the departments involved need to build on their successful joint working to date and involve other national and local partners to develop and implement cohesive approaches aimed at preventing more people from becoming obese. Key recommendations are that:

  • a high priority must be given to implementing the nutrition initiatives included in the NHS Plan to improve the balance of the diet;
  • the Department of Health should lead the development of a cross-government strategy, including the Department for Culture, Media and Sport, to promote the health benefits of physical activity (in particular sport and active forms of travel, such as walking and cycling);
  • the Department for Education and Employment should continue to reinforce the importance of physical activity and encourage more physical activity in schools; and
  • there should be strengthened guidance to schools to help them weigh up the advantages and disadvantages of participating in commercial sponsorship schemes that might promote behaviours contrary to key messages on healthy eating.

Sir John commented:

“Nearly two thirds of men and over half of women in England are now overweight or obese. And the problem here is increasing faster than in most other European countries. If prevalence continues to rise at the current rate, more than one in four adults will be obese by 2010. This would significantly increase the incidence of associated diseases, such as coronary heart disease, and would cost the economy over £3.5 billion a year by that date.

“There are no easy solutions to the problem but progress is possible. There is scope to do more to promote healthier lifestyles and improve NHS services for the increasing number of people whose health is at risk from excess weight.”


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