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22K5. Body mass index 30+ - obesity
22K7. Body mass index 40+ - severely obese
22K.. Body Mass Index (with an associated BMI value of 30 or over)
22KB. Baseline body mass index (with an associated BMI value of 30 or over)
22KC. Obese class I (body mass index 30.0 - 34.9) (v29)
22KD. Obese class II (body mass index 35.0 - 39.9) (v29)
22KE. Obese class III (BMI equal to or greater than 40.0) (v29)
The prevalence of obesity is a major public health challenge for the United Kingdom. In England, for example, 23 per cent of adults are obese. In Scotland in 2010, 27.4 per cent of the adult population aged 16 or over and under the age of 65 were obese (BMI >30).
There is a substantive evidence base on the epidemiology of obesity and its association with poor clinical outcomes. In addition to the obvious associated disease burden such as inactivity, degenerative joint disease, lower employment and mood disorders, obesity is also a major contributory factor for some of the commonest causes of death and disability in developed economies, most notably greater rates of diabetes mellitus and accelerated onset of cardiovascular disease. Obesity has therefore become a major health issue for the United Kingdom. The Foresight UK Tackling Obesities report 2007 estimated the cost to the UK of obesity to be £50 billion in 2050 at today’s prices. http://www.bis.gov.uk/foresight/ourwork/projects/current-projects/tackling-obesities/reports-and-publications
Tackling obesity is a high priority for the four UK health departments.
For England, the Government published "A call to action on obesity in England" in October 2011. This sets out new national ambitions for tacking excess weight in children and adults and calls on a range of partners to play their part.
In Northern Ireland this is happening though the draft Obesity Prevention Framework for NI 2011-2021 – A fitter Future for All
In Scotland this will be achieved through the Scottish Government and COSLA long term obesity strategy, published in February 2010, ‘Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight’
To assist individuals, the Scottish Government supports NHS weight management programmes including "Counterweight" which is an evidence-based approach to managing weight in primary care that helps obese patients achieve a healthier lifestyle and lose weight. The route map however recognises that obesity cannot be viewed simply as a health issue, nor will it be solved exclusively by reliance on individual behaviour change. A successful approach will requireactions by individuals concerned, as well as cross-portfolio and cross-sector collaboration and investment to make deep, sustainable changes to our living environment in order to shift it from one that promotes weight gain to one that supports healthy choices and healthy weight for all.
In Wales this is happening through the All Wales Obesity Pathway, published in June 2010. This is intended for use as a tool for Local Health Boards to map provision for the prevention and treatment of obesity, to identify gaps and to implement and manage activity across the full range of determinants which cause obesity and overweight patients in Wales. http://Wales.gov.uk/topics/health/improvement/index/pathway/?lang=en
NICE public health guidance 2 (2006). Four commonly used methods to increase physical activity: brief interventions in primary care, exercise referral schemes, pedometers and community-based exercise programmes for walking and cycling.
http://guidance.nice.org.uk/PH2 and http://guidance.nice.org.uk/PH41 and http://guidance.nice.org.uk/PH44
NICE public health guidance 6 (2007). Behaviour change at population, community and individual levels. http://guidance.nice.org.uk/PH6/Guidance/pdf/English
NICE clinical guideline CG43. Prevention, identification, assessment and management of overweight and obesity in adults and children 2008.
Health Survey for England 2009 http://www.ic.nhs.uk/pubs/hse09report
Sullivan et al. Diabetes Care 2005; 28 (7): 1599-603
Gregg et al. JAMA 2005; 20; 293 (15): 1868-74
Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight. http://www.scotland.gov.uk/Topics/Health/health/healthyweight
The contractor establishes and maintains a register of patients aged 16 or over with a BMI >=30 in the preceding 12 months
The register includes all patients whose BMI has been recorded in the practice as part of routine care. It is expected that this data will inform PH measures.
See indicator wording for requirement criteria.
Prepared By Jean Keenan