Tackling Obesity in England - National Audit Office

More documents

Recommendations

Info

TACKLING OBESITY IN ENGLANDAppendix 5 Thehuman costs of obesity1 Obese people are more likely to suffer from a number ofserious chronic diseases, many of which are lifelimiting.Besides the physical effects, the psychologicaland social burdens of obesity can also be debilitating.Diseases associated with obesityCoronary heart disease2 The most common cause of premature mortality amongobese people is coronary heart disease. Our work onthe costs of obesity in 1998 (the latest year for whichdata were available) suggests that approximately28,000 people in England suffered a heart attackin that year that was directly attributable to obesity(Appendix 6).3 In women, obesity is the third most powerful predictorof cardiovascular disease (after age and blood pressure).This is in part because it is strongly associated with otherimportant risk factors for heart disease such as highblood pressure and high cholesterol. The risk of heartattack for an obese woman is approximately three timesthat of a lean woman of the same age 44 .Osteoarthritis6 Osteoarthritis, or degenerative disease of the weightbearingjoints such as the knee, is a very commoncomplication of obesity, which causes a great deal ofdisability 47 . Pain in the lower back is also frequentlysuffered by obese people, and may be one of the majorcontributors to obesity-related absences from work. It islikely that the excess weight alone, rather than anymetabolic affect, is the cause of these problems.Respiratory disease7 Many respiratory disorders are related to obesity, themost serious of which is obstructive sleep apnoea.Sufferers experience the intermittent cessation ofbreathing during sleep, which causes broken sleeppatterns and may contribute to high blood pressure andheart disease 48 .Reproductive disorders8 Obese people of both sexes are more likely to sufferreproductive disorders, and for obese women there is anincreased risk of complications during pregnancy. 49Type 2 diabetes4 Of all serious diseases, Type 2 diabetes has the strongestassociation with obesity 10 . The metabolic problemswhich give rise to this type of diabetes most commonlyoccur as a result of excess weight. Indeed, the risk ofdeveloping Type 2 diabetes rises with increasing bodymass index well below the threshold of clinical obesity.Women who are obese are 12 times more likely todevelop non-insulin dependent diabetes than women ofa healthy weight. Diabetes itself predisposes people tohigh blood pressure and heart disease 45 .Cancer5 The link between obesity and cancer is less welldefined.Research suggests that the risk of a number ofcancers is increased by obesity, including: breast cancerand cancer of the endometrium, uterus, cervix, ovaryand gall-bladder in women; and cancer of the rectumand prostate in men 46 . The clearest association is withcancer of the colon, for which obesity increases the riskby nearly three times in both men and women.Social and psychological penaltiesStigmatisation9 In studies that have examined the reactions ofschoolchildren to various forms of physical disabilityand obesity, obese children were consistently rated theleast attractive by their peers. In one study of obeseschoolgirls, obesity was rated a social stigma by78 per cent of girls in the healthy weight range, and62 per cent of overweight girls 50 . Obese girls wereperceived by their peers to be less active, less attractive,less healthy, weak-willed and having inferior physicalabilities and poor self-control regarding dietary habits.10 Another study noted that in affluent societies, obesepeople are subject to intense prejudice anddiscrimination, and that children as young as sixdescribe obese children as "lazy, dirty, stupid, ugly,cheats and liars" 51 . Thus, the stigma of overweightappears to have two aspects: stigmatisation of theappearance of the body and stigmatisation of thecharacter of the person for the perceived moral failure ofnot controlling one's weight.appendix five55
TACKLING OBESITY IN ENGLANDImpact on mental health11 Obese people, and the severely obese in particular, aremore likely to suffer from a number of psychologicalproblems, including binge-eating, low self-image andconfidence, and a sense of isolation and humiliationarising from practical problems 10 .12 In a study that examined the psychological wellbeing ofextremely obese patients awaiting surgery to induceweight loss, many more patients listed social rather thanmedical considerations as their main reason for seekingsurgery. Of these patients, 40 per cent said they "always"or "usually" had experienced acts of discrimination atwork, within the family or in a public place; 77 per centfelt depressed and in low spirits daily or almost daily;and all patients considered themselves unattractive.13 It is difficult to separate cause from effect in therelationship between obesity and psychologicaldisorders. Whilst mental wellbeing may suffer as a resultof the pressures associated with being obese,psychological problems may equally contribute to thetype of behaviours, such as emotional and binge-eating,that can result in the onset of obesity.appendix five56
Page 1 and 2:
Tackling Obesity in EnglandREPORT B
Page 3 and 4:
Tackling Obesity in EnglandREPORT B
Page 5 and 6:
TACKLING OBESITY IN ENGLANDPart 3:
Page 7 and 8: TACKLING OBESITY IN ENGLAND5 The Go
Page 9 and 10: TACKLING OBESITY IN ENGLANDnnnthe D
Page 11 and 12: TACKLING OBESITY IN ENGLANDnnnna jo
Page 13 and 14: TACKLING OBESITY IN ENGLAND2The way
Page 15 and 16: TACKLING OBESITY IN ENGLANDStudy me
Page 17 and 18: TACKLING OBESITY IN ENGLANDThe prev
Page 19 and 20: TACKLING OBESITY IN ENGLANDnnnless
Page 21 and 22: TACKLING OBESITY IN ENGLAND2.21 As
Page 23 and 24: TACKLING OBESITY IN ENGLANDPart 3Ma
Page 25 and 26: TACKLING OBESITY IN ENGLAND10Exampl
Page 27 and 28: TACKLING OBESITY IN ENGLAND3.28 Vie
Page 29 and 30: TACKLING OBESITY IN ENGLANDCase Stu
Page 31 and 32: TACKLING OBESITY IN ENGLAND13 Refer
Page 33 and 34: TACKLING OBESITY IN ENGLAND16Topics
Page 35 and 36: TACKLING OBESITY IN ENGLANDPart 4In
Page 37 and 38: TACKLING OBESITY IN ENGLANDInitiati
Page 39 and 40: TACKLING OBESITY IN ENGLANDCase Stu
Page 41 and 42: TACKLING OBESITY IN ENGLANDaccounta
Page 45 and 46: TACKLING OBESITY IN ENGLANDoffer fi
Page 47 and 48: TACKLING OBESITY IN ENGLAND4.51 To
Page 49 and 50: TACKLING OBESITY IN ENGLAND25Inters
Page 51 and 52: TACKLING OBESITY IN ENGLANDappendix
Page 53 and 54: TACKLING OBESITY IN ENGLANDAppendix
Page 55 and 56: TACKLING OBESITY IN ENGLANDAppendix
Page 57: TACKLING OBESITY IN ENGLAND31 Preva
Page 61 and 62: TACKLING OBESITY IN ENGLANDthe data
Page 63 and 64: TACKLING OBESITY IN ENGLAND25 Third
Page 65 and 66: TACKLING OBESITY IN ENGLANDStudies
show all

Tackling Obesity in England - National Audit Office

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?