Excess weight blamed for eighth of hospital admissions for women over 50
The figures come from the biggest health research project in the UK, which found that obesity-related diseases and ill-health in women were responsible for 2m days in hospital a year, The Guardian informs. While the researchers the Million Women Study run from University of Oxford have not put a figure on the overall cost, the bill to the taxpayer would amount to an annual sum of well over £500m based on the cost of more than £250 a day for an NHS bed.
This is preventable disease, said Gillian Reeves, lead author of the study published in the journal BMC Medicine. "A lot of the work I do is related to cancer. A lot of the risk factors for breast cancer, in particular, you can't change."
But weight, one of the breast cancer risk factors, can be altered. "In some sense, it is quiet nice to think this is a modifiable risk factor - there is a lot to be gained by not putting on excess weight," she said. The Million Women Study is able to look at changes in the health of a whole population over time because of its size - between 1996 and 2001 it enrolled a quarter of all women in the UK between 50 and 64 by inviting them to join when they first went for breast cancer screening. The group consists of 1.3 million women.
Most studies on the impact of being overweight have focused on one or more diseases that are commonly associated with it, such as type 2 diabetes and heart disease. The Oxford researchers, however, were able to look at all the diseases in women with a BMI (body mass index) of 25 or more, which is the usual classification of overweight. They had full information on height and weight for 1.2 million of the participants. Most were either overweight (36%) or obese (18%), giving a total of 54% - slightly lower than the official figure for women in England, which is almost 58%. Those who were overweight in the study were less likely to take strenuous exercise, but also less likely to smoke, take hormone replacement therapy or drink alcohol.
The most common reason overweight women were admitted to hospital was for cataract surgery (more than 45,000 admissions), followed by gallbladder disease (more than 35,000). After these two, which are not immediately thought of as weight-related, came breast cancer (34,307 admissions) and heart disease (32,483).
"All but three of the 25 categories of admission considered showed clear associations with BMI, although the magnitudes, and sometimes the shape, of the associations varied considerably," says the paper.
Among those overweight (BMI 25+), 74% of diabetes admissions, 66% of knee replacements, 38% of gallbladder disease and one in five heart attacks were attributable to weight. In the obese group (BMI 30+), their weight was the cause of 59% of diabetes admissions, 51% of knee replacements, one in five hip replacements and 10% of strokes. Weight also caused more minor conditions, such as carpal tunnel syndrome (31% in the overweight and 23% in the obese), which are a big cost to the NHS because they are so common. By looking only at diseases like stroke and breast cancer, said Reeves, "previous reports may have under-estimated the effect of BMI".
The more excess weight women put on, the more time they were likely to spend in hospital, the study found. "The increased risk is quiet steady," said Reeves. Even moderately overweight women were more likely to be admitted to hospital than those of normal weight. The team have not looked at the cost of the admissions to the NHS, but intend to do further work on that. Some conditions will be much more costly for the NHS to treat than others.
Hospital admissions for men will not exactly match those for women, because some diseases affect one sex more than the other. But there is no reason to think men's excess weight is less of a health problem or costs the NHS less. More men carry excess weight than women - 67% in England - but although 42% of men are overweight compared with 32% of women, the numbers that are obese are much the same, at around 25%.
Overweight and obesity are a concern for Public Health England (PHE), which advises the local authorities who have now been given control of the public health budget so that they can develop initiatives specific to local issues. But Prof Kevin Fenton, national director of health and wellbeing at PHE, said more needs to be done at every level about obesity, which is "entirely preventable".
He said: "Obesity is a complex issue that requires action at national, local, family and individual level. Everyone has a role to play in improving the health and wellbeing of the public, and children in particular
"More than five out of 10 women are overweight or obese, that is 57.8% of the [female] population. The prevalence of obesity increases with age; 20.9% of women are obese in the 25-34 age group and 33.7% of women in the 65-74 age group.
"PHE are committed to helping to tackle obesity through a range of approaches that support action on the local environment to make eating less and being more physically active, easier."
