Tackling Obesity in England - National Audit Office

TACKLING OBESITY IN ENGLANDPart 1IntroductionWhat is obesity?1.1 Obesity is a condition in which weight gain has reachedthe point of seriously endangering health. While somepeople are more genetically susceptible than others, thedirect cause of obesity in any individual is always anexcess of energy intake over energy expenditure.Virtually all obese people develop some associatedphysical symptoms by the age of 40, and the majoritywill require medical intervention for diseases thatdevelop as a result of their obesity before they are 60 2 .Why we studied obesity1.2 Obesity has a substantial human cost by contributing tothe onset of disease and premature mortality. It also hasserious financial consequences for the NHS and theeconomy. These costs are increasing as around20 per cent of the population is now classified as obese,and the upward trend over the last 20 years iscontinuing 1 . We carried out this study:The administrative context1.3 Although obesity is intricately bound up withindividuals' lifestyles, a number of public sectoragencies play a potentially significant role in shapingthe policy response. Figure 2 gives an overview of therole of the various bodies described below.The Department of Health1.4 The management of public health risks such as obesityfalls within the Department of Health's strategicobjective "to reduce avoidable illness, disease andinjury in the population". Within this overall goal, thereare four relevant policy objectives:nnto work across Government and with local agenciesand groups on a range of measures designed toimprove the health of the public;to provide accurate and accessible information onhow to reduce the risk of illness, disease and injury;nnto identify and measure the human costs of obesity,and to estimate the financial costs to the NHS andthe wider English economy (Part 2);to assess how the NHS, and in particular the primarycare sector, is responding to the problem (Part 3);nnto encourage people to live healthily; andto raise standards and set targets to galvanise andencourage widespread improvements in publichealth, and a narrowing of current inequalities inhealth status.nnto examine how effectively different Governmentdepartments are working together to create anenvironment conducive to limiting the prevalence ofobesity (Part 4); andto make recommendations that might help to createa climate in which individuals are aware of theconsequences of obesity, and can make informeddecisions about their lifestyle. In this we draw aparallel with another serious lifestyle issue - smoking- where such an approach has been successful inreducing prevalence within the population as awhole, if not in all sections of it.1.5 In 1992, the Department of Health launched the cross-Governmental 'Health of the Nation' strategy 3 . Thisincluded 27 targets related to the achievement of betterhealth in England. Two of the Department's targetsrelated to the fat content of the diet, and two others tothe future prevalence of obesity for men and women.We reviewed progress towards these targets in 1996 4 .part one7