NHS Digital has published a report - ‘Statistics on Obesity, Physical Activity and Diet, England, 2020’ – has revealed that in 2018/19 there were 11,117 hospital admissions with a primary diagnosis of obesity, an increase of 4% on 2017/18 (10,660 admissions). Approximately 74% were female. There has been an upward trend since 2014/15, with an increase of 22% over that period.
In 2018/19 there were 876,000 thousand hospital admissions where obesity was recorded as the primary or a secondary diagnosis, an increase of 23% on 2017/18 (Approximately 65% were female), when there were 711,000 admissions. Some (though not all) of this increase may be due to hospitals being more likely to record obesity as a secondary diagnosis than they were previously, the report noted. For admissions directly attributable to obesity, the number increases to middle age, peaking at 45 and 54, before declining in older age groups. Seventy percent of patients were aged between 35 and 64.
Of those admissions where obesity was a factor, but it was not the primary diagnosis (main reason for the admission), the most common diagnoses related to maternity issues and knee joint issues (arthrosis of the knee). Others in the top ten diagnosis types were the formation of gallstones (Cholelithiasis), hip issues (arthrosis of the hip), and heart disease.
While there were a large number of different primary diagnoses recorded for admissions where obesity was a factor, and collectively the top ten diagnosis types accounted for less than a quarter of all these admissions (181,000).
Rates for both admissions directly attributable to obesity, and for admissions where obesity was a factor increase with the level of deprivation. Admissions directly attributable to obesity were around four times more likely in the most deprived areas (33 per 100,000 population), compared to the least deprived areas (8 per 100,000 population). Admissions where obesity was a factor were around two and a half times more likely in the most deprived areas (2,443 per 100,000 population), compared to the least deprived areas (1,000 per 100,000 population).
Admission rates ranged from 413 to 3,804 per 100,000 population, with the highest admission rate over nine times greater than the lowest rate. Wigan, Wirral, York, Stoke-on-Trent and Nottingham all recorded admission rates of over 3,000 per 100,000 population, whereas Wokingham and West Berkshire both recorded admission rates below 500 per 100,000 population. The national rate was 1,615 per 100,000 population.
In 2018/19 there were 7,011 hospital admissions with a primary diagnosis of obesity and a main or secondary procedure of bariatric surgery. This is an increase of 6% on 2017/18 (6,627). Over three quarters (79%) of admissions were for females and over three quarters of patients (78%) were aged between 35 and 64.
Figure 1: Age profile of bariatric surgery admissions
Admissions for obesity related bariatric surgery were over times times more likely in the most deprived areas (20 per 100,000 population), compared to the least deprived areas (6 per 100,000 population). Admission rates ranged from 0 to 47 per 100,000 population. The national rate was 13 per 100,000 population. Southwark (47 per 100,000 population), and Telford and Wrekin (45) recorded the highest admission rates.
Since 2010, Orlistat (Xenical) is the only drug available in the UK that is recommended specifically for the management of obesity and 355,000 (Orlistat) were prescribed for the treatment of obesity in primary care in 2019. That is 4% fewer than in 2018 when there were 371,000 items, and continues a long-term downward trend.
The majority of adults in England in 2018 were had overweight or obesity (63%), the proportion of adults who had obesity was 28%. Morbid obesity has also increased, from fewer than 1% in 1993, to 3% in 2018. Overall, 67% of men and 60% of women were classed as having overweight or obesity.
The proportion of adults who had overweight or obesity according to their BMI varied by region. The lowest levels were in London, and the highest levels in North East and the West Midlands. There was no statistically significant variation for obesity. The proportion of adults who had overweight or obesity increased with age among both men and women. It was highest among men aged between 55 and 64 (82%), and women aged between 65 and 74 (70%). The proportion of adults who had obesity also increased with age and was highest among men aged between 45 and 54 (36%), and among women aged between 55 and 64 (37%).
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