The term obese describes a person who's very overweight, with a lot of body fat. It's a common problem in the UK that's estimated to affect around one in every four adults and around one in every five children aged 10 to 11.
There are many ways in which a person's health in relation to their weight can be classified, but the most widely used method is body mass index (BMI). BMI is a measure of whether you're a healthy weight for your height. For most adults, a BMI of:
• 18.5 to 24.9 a healthy weight
• 25 to 29.9 overweight
• 30 to 39.9 obese
• 40 or above severely obese
BMI isn't used to definitively diagnose obesity, because people who are very muscular sometimes have a high BMI without excess fat. But for most people, BMI is a useful indication of whether they're a healthy weight, overweight or obese.
A better measure of excess fat is waist circumference, which can be used as an additional measure in people who are overweight (with a BMI of 25 to 29.9) or moderately obese (with a BMI of 30 to 34.9). Generally, men with a waist circumference of 94cm (37in) or more and women with a waist circumference of 80cm (about 31.5in) or more are more likely to develop obesity-related health problems.
It's very important to take steps to tackle obesity because, as well as causing obvious physical changes, it can lead to a number of serious and potentially life-threatening conditions, such as:
• type 2 diabetes
• coronary heart disease
• some types of cancer, such as breast cancer and bowel cancer
Obesity can also affect your quality of life and lead to psychological problems, such as depression and low self-esteem.
Obesity is generally caused by consuming more calories – particularly those in fatty and sugary foods – than you burn off through physical activity. The excess energy is stored by the body as fat. Obesity is an increasingly common problem because for many people modern living involves eating excessive amounts of cheap, high-calorie food and spending a lot of time sitting down, at desks, on sofas or in cars.
There are also some underlying health conditions that can occasionally contribute to weight gain, such as an underactive thyroid gland (hypothyroidism), although these type of conditions don’t usually cause weight problems if they're effectively controlled with medication.
Proposed revisions to the eligibility criteria
MKCCG makes the following recommendation regarding Bariatric Surgery (Gastric Band, Gastric Bypass and Sleeve Gastrectomy) is categorised as Not Routinely Funded and all applications for surgery will be considered on a case by case basis, where the patient has exhausted all other routes to weight loss and where the patient’s obesity presents a significant risk of them developing more complex health conditions.
Further information and guidance
Whilst the funding will return with the service, the CCG feel that it should consult on not providing this service to the population and instead work with Public Health (http://www.whyweightmk.co.uk/) to promote healthier lifestyles and tackle obesity rather than managing the problem once it occurs. However, as stipulated in the latest NICE guidance (CG189; 2014), there will be a group of patients, especially people of different ethnicity, who may benefit from bariatric surgery as they are likely to develop more complex health conditions (especially Diabetes) if they are already significantly overweight.
This guideline offers evidence-based advice on the care and treatment of obesity.
It was previously called obesity: identification, assessment and management of overweight and obesity in children, young people and adults. This guideline updates and replaces section 1.2 of obesity prevention (CG43). New recommendations have been added about low-calorie and very-low-calorie diets, bariatric surgery and follow-up care.