Patterns and trends in adult obesity
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These PowerPoint slides present key data and information on adult obesity in clear, easy to understand charts and graphics. They have been produced by the Obesity Risk Factors Intelligence team in the Health Improvement Directorate and can be used freely with acknowledgement to ‘Public Health England’. These slides should be useful to practitioners and policy makers working to tackle adult obesity at local, regional and national level. For example they are regularly used to make the case for tackling obesity in presentations to health and wellbeing boards, other committees and to elected members as well as in regional and national conference and workshop presentations.
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Patterns and trends in adult obesity
- 1. Patterns and trends in adult obesity A presentation of data on adult obesity July 2017
- 2. Overweight and obesity among adults Health Survey for England 2013 to 2015 (three-year average) 2 Patterns and trends in adult obesity Adult (aged 16+) overweight and obesity: BMI ≥ 25kg/m2 Almost 7 out of 10 men are overweight or obese (66.8%) Almost 6 out of 10 women are overweight or obese (57.8%)
- 3. Obesity among adults Health Survey for England 2013 to 2015 (three-year average) 3 Patterns and trends in adult obesity Adult (aged 16+) obesity: BMI ≥ 30kg/m2 One out of four men is obese (25.7%) One out of four women is obese (25.8%)
- 4. 4 Patterns and trends in adult obesity Adult (aged 16+) BMI thresholds: Underweight: <18.5kg/m2 Healthy weight: 18.5 to <25kg/m2 Overweight: 25 to <30kg/m2 Obese: ≥30kg/m2 Adult BMI status by sex Health Survey for England 2013 to 2015 (three-year average)
- 5. 5 Patterns and trends in adult obesity Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Trend in obesity prevalence among adults Health Survey for England 1993 to 2015 (three-year average)
- 6. 6 Patterns and trends in adult obesity Adult (aged 16+) overweight including obese: BMI ≥ 25kg/m2 Trend in excess weight among adults Health Survey for England 1993 to 2015 (three-year average)
- 7. Trend in severe obesity among adults Health Survey for England 1993 to 2015 (three-year average) 7 Patterns and trends in adult obesity Adult (aged 16+) severe obesity: BMI ≥ 40kg/m2
- 8. Prevalence of overweight and obesity by age: men Health Survey for England 2015 8 Patterns and trends in adult obesity Adult (aged 16+) BMI thresholds: overweight: 25 to <30kg/m2; Obese: ≥30kg/m2
- 9. Prevalence of overweight and obesity by age: women Health Survey for England 2015 9 Patterns and trends in adult obesity Adult (aged 16+) BMI thresholds: overweight: 25 to <30kg/m2; Obese: ≥30kg/m2
- 10. Prevalence of adult obesity by region Health Survey for England 2015 10 Patterns and trends in adult obesity Adult (aged 16+) obesity: BMI ≥ 30kg/m2
- 11. Adult obesity prevalence by income Health Survey for England 2015 11 Patterns and trends in adult obesity Adult (aged 16+) obesity: BMI ≥ 30kg/m2
- 12. Adult obesity prevalence by education Health Survey for England 2009 to 2013 (five-year average) 12 Patterns and trends in adult obesity The chart shows 95% confidence intervals Adult (aged 16+) obesity: BMI ≥ 30kg/m2Education measure is highest qualification attained
- 13. Adult obesity prevalence by deprivation Health Survey for England 2014 13 Patterns and trends in adult obesity Adult (aged 16+) obesity: BMI ≥ 30kg/m2 21.6% 22.1% 28.8% 25.2% 24.4% 21.7% 22.5% 26.4% 30.9% 32.7% 0% 5% 10% 15% 20% 25% 30% 35% Least Deprived 2nd 3rd 4th Most Deprived Obesityprevalence Index of Multiple Deprivation 2010 quintile Men Women
- 14. Trend in adult obesity prevalence by social class Health Survey for England 1994 to 2013 (five-year average*) 14 Patterns and trends in adult obesity Adult (aged 16+) obesity: BMI ≥ 30kg/m2 0% 5% 10% 15% 20% 25% 30% 35% 40% 94-98 95-99 96-00 97-01 98-02 99-03 00-04 01-05 02-06 03-07 04- Obesityprevalence I- Professional II - Managerial technical IIIM - Skilled manual IIIN - Skilled non-manual IV - Semi-skilled manual V - Unskilled manual 0% 5% 10% 15% 20% 25% 30% 94-98 95-99 96-00 97-01 98-02 99-03 00-04 01-05 02-06 03-07 04-08 05-09 I- Professional II - Managerial technical IIIM - Skilled manual IIIN - Skilled non-manual IV - Semi-skilled manual V - Unskilled manual Men Women *No data on social class was collected in 2010 and 2011. Therefore data presented as 06-10 are based on a four year average. Data presented for 07-11, 08-12, and 09-13 are based on a three year average.
- 15. 15 Patterns and trends in adult obesity The chart shows 95% confidence intervals Adult (aged 16+) obesity: BMI ≥ 30kg/m2Obesity prevalence is age standardised 18.8% 17.4% 13.2% 12.2% 11.5% 16.0% 20.9% 18.7% 13.9% 13.1% 26.2% 15.1% 31.6% 25.5% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% White Irish Indian Pakistani Bangladeshi Black African Black Caribbean Obesityprevalence Men Women Adult obesity prevalence by ethnic group Health Survey for England 2006 to 2010 (five-year average)
- 16. Adult mean waist circumference Health Survey for England 16 Patterns and trends in adult obesity Adults aged 16+
- 17. Adult very high waist circumference Health Survey for England 17 Patterns and trends in adult obesity Adults aged 16+ Very high waist circumference is taken to be greater than 102cm in men and greater than 88cm in women
- 18. Adult very high waist circumference by age Health Survey for England 2013 to 2015 (three-year average) 18 Patterns and trends in adult obesity Adults aged 16+ * Very high waist circumference is taken to be greater than 102cm in men and greater than 88cm in women
- 19. Trend in very high waist circumference among adults Health Survey for England 1993 to 2015 19 Patterns and trends in adult obesity Adults aged 16+, the chart shows 95% confidence intervals * Very high waist circumference is taken to be greater than 102cm in men and greater than 88cm in women
- 20. Health risk categories Health Survey for England/NICE 20 Patterns and trends in adult obesity Low High Very high BMI Men: <94cm Women: <80cm Men: 94-102cm Women: 80-88cm Men: >102cm Women: >88cm Underweight (<18.5kg/m2 ) Underweight (Not Applicable) Underweight (Not Applicable) Underweight (Not Applicable) Healthy weight (18.5-24.9kg/m2 ) No increased risk No increased risk Increased risk Overweight (25-29.9kg/m2 ) No increased risk Increased risk High risk Obese (30-34.9kg/m2 ) Increased risk High risk Very high risk Very obese (≥40kg/m2 ) Very high risk Very high risk Very high risk Waist circumference
- 21. Trend in prevalence of health risk categories Using both BMI and waist circumference: Health Survey for England 21 Patterns and trends in adult obesity Adults aged 16+. Using combined waist circumference and BMI classification, as recommended by NICE
- 22. 22 Patterns and trends in adult obesity Adults aged 16+. Using combined waist circumference and BMI classification, as recommended by NICE 1993-1994 2014-2015 Change in prevalence of health risk categories Using both BMI and waist circumference: Health Survey for England
- 23. 23 Patterns and trends in adult obesity Data sources Health Survey for England (HSE) www.hscic.gov.uk/healthsurveyengland The HSE is a cross-sectional survey which samples a representative proportion of the population. The next report on the HSE 2016 is due to be published online in December 2017. The data should be available from the UK Data Archive in the summer following publication of the report.
- 24. 24 Patterns and trends in adult obesity For more information: PHE Obesity Intelligence Knowledge Hub: Register on https://khub.net/ and join the PHE Obesity Intelligence group PHE Obesity Intelligence Knowledge Hub public library (no need to join): https://khub.net/web/phe-obesity-intelligence/public-library PHE Web: https://www.gov.uk/guidance/phe-data-and-analysis-tools#obesity- diet-and-physical-activity noo.org.uk website archive: http://webarchive.nationalarchives.gov.uk/20170110165428/https:// www.noo.org.uk/ (snapshot as of Jan 2017, will not be updated) Email: obesity-riskfactorsintelligence@phe.gov.uk Twitter: @PHE_Obesity
- 25. 25 Patterns and trends in adult obesity About Public Health England Public Health England exists to protect and improve the nation's health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Public Health England Wellington House 133-155 Waterloo Road London SE1 8UG Tel: 020 7654 8000 www.gov.uk/phe Twitter: @PHE_uk Facebook: www.facebook.com/PublicHealthEngland © Crown copyright 2017 You may re-use this information (excluding logos) free of charge in any format or medium, under the terms of the Open Government Licence v3.0. To view this licence, visit https://www.nationalarchives.gov.uk/doc/open-government- licence/version/3/ or email psi@nationalarchives.gsi.gov.uk. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. Published July 2017 PHE publications gateway number: 2017234
Editor's Notes
- These PowerPoint slides present key data and information on adult obesity in clear, easy to understand charts and graphics. They have been produced by the Obesity Risk Factors Intelligence team in the Health Improvement Directorate and can be used freely with acknowledgement to ‘Public Health England’. These slides should be useful to practitioners and policy makers working to tackle adult obesity at local, regional and national level. For example they are regularly used to make the case for tackling obesity in presentations to health and wellbeing boards, other committees and to elected members as well as in regional and national conference and workshop presentations.
- Prevalence of overweight and obesity among adults, Health Survey for England 2013 to 2015 (three-year average) The published Health Survey for England data used to produce this graphic are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- Prevalence of obesity among adults, Health Survey for England 2013 to 2015 (three-year average) The published Health Survey for England data used to produce this graphic are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- Healthy weight prevalence is much lower for men than for women (even though obesity prevalence is marginally higher for women than for men). This is because there is a much higher prevalence of overweight among men than women. The published Health Survey for England data used to produce these charts are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- Obesity prevalence continues to rise, with prevalence for both men and women at its highest recorded level in the Health Survey for England. The gap between men and women has narrowed over time. The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- The prevalence of excess weight (overweight including obesity) rose substantially between 1993 and 2002, but has increased much more slowly in both men and women since that time. Unlike for obesity, prevalence of excess weight is higher among men than women. The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- The prevalence of severe obesity (BMI ≥40kg/m2) has increased since 1993 for both men and women. Overall, a very small proportion of the population are severely obese but the rise in prevalence has been substantial since 1993; a 6.2 fold increase for men (increasing from 0.3% to 1.9%) and a 2.5 fold increase for women (increasing from 1.5% to 3.7%). Severe obesity prevalence is much higher for women than men. http://webarchive.nationalarchives.gov.uk/20170110170048/https://www.noo.org.uk/NOO_about_obesity/severe_obesity The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- This chart shows how the prevalence of obesity and overweight among men changes with age. Prevalence of overweight and obesity combined is lowest in the 16 to 24 age group, increases with age until the 55 to 64 age group and declines in the older age groups. Obesity prevalence is lowest in those aged 85 and older, though this age group has the highest prevalence of overweight. The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22610
- This chart shows how the prevalence of obesity and overweight among women changes with age. Prevalence of overweight and obesity is lowest in the 16 to 24 age group and increases with age up to the 55 to 64 age group. Overweight prevalence increases in older age groups, but obesity prevalence remains lower compared to those aged 55 to 64 years. The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22610
- Adult (aged 16+ years) age standardised obesity prevalence by English Region. Prevalence of obesity among adults varies by region in England. The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22610
- Adult (aged 16+ years) age standardised obesity prevalence by equivalised household income quintile. Equivalised household income is a measure that takes account of the number of people in the household as well as the overall household income. For this analysis, households were split into five equal-sized groups banded by income level (income quintiles). Obesity varies by household income in women. Those in the second lowest quintile of household income have the highest prevalence of obesity. This decreases as income increases, as shown in the chart. Obesity is more than twice as common among these women as in women in the highest household income quintile (38.6% compared with 16.6%). In men there is only a small decrease in obesity prevalence in the two highest income quintiles. The relationship between obesity in men and socioeconomic status also varies when different socioeconomic indicators are used (as shown in the following slides displaying obesity prevalence by educational attainment; area deprivation; and social class). The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22610
- This chart shows that obesity prevalence varies with levels of educational attainment. It groups men and women according to their highest qualification, showing a general trend of higher obesity prevalence with lower levels of education. Both men and women with degree-level qualifications have lower rates of obesity than all others. Adults with the lowest levels of education have the highest rates of obesity. The relationship between obesity in men and socioeconomic status also varies when different socioeconomic indicators are used. The analysis for this chart was produced using Health Survey for England data from the UK Data Archive: http://www.data-archive.ac.uk/
- Adult (aged 16+ years) age standardised obesity prevalence by Index of Multiple Deprivation 2010 quintile. Women living in more deprived areas are more likely to be obese. A much less consistent pattern is seen in men with smaller differences between quintiles. The published Health Survey for England data used to produce this chart are available from: content.digital.nhs.uk/catalogue/PUB19295
- The trend in obesity prevalence by social class differs by sex. For all social classes prevalence of obesity among men has increased between 1994 and 2013; men from the skilled manual class consistently have the highest obesity prevalence and professional men the lowest prevalence. Women from the professional social class have the lowest prevalence of obesity. The apparent dip in prevalence in this group between 2001 and 2006 could be explained by the small sample size of women in this group during that period. There appear to be larger differences in obesity prevalence between social class groups among women compared to men. Women in the unskilled manual class consistently have the highest prevalence of obesity. Social class of the survey respondent was not collected in the 2010 HSE or the 2011 HSE. Therefore data presented as 06-10 are based on a four year average. Data presented for 07-11, 08-12 and 09-13 are based on a three year average. The analysis for this chart was produced using Health Survey for England data from the UK Data Archive: http://www.data-archive.ac.uk/
- The chart shows variation in prevalence of obesity by ethnic group and between sexes within ethnic groups. Prevalence of obesity is higher in women compared to men for black African and Pakistani ethnic groups. Prevalence of obesity is higher among women of black Caribbean, black African, and Pakistani ethnicities, compared to the other ethnic groups. The data have been age standardised to adjust for the different average age by ethnic group. In order to produce analysis as similar as possible to published HSE data the following ethnic groups have been combined: mixed white and black Caribbean combined with black Caribbean mixed white and black African combined with black African any other white background combined with white The analysis for this chart was produced using Health Survey for England data from the UK Data Archive: http://www.data-archive.ac.uk/
- There has been an increase in mean waist circumference among both men and women since 1993. There are well documented links between high levels of central adiposity in adults, as measured by waist circumference, waist-to-height or waist-to-hip ratio and risk of obesity-related conditions including type 2 diabetes, hypertension and heart disease. These links remain even once BMI is adjusted for, demonstrating that measures of central adiposity are independent predictors of future obesity-related ill health. For more information on waist circumference and other measures of central adiposity see: https://khub.net/documents/31798783/32039025/Measures+of+central+adiposity+as+an+indicator+of+obesity/4c335064-07d8-4203-9c61-c64bc50e7ee6 The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- Very high waist circumference is taken to be greater than 102cm in men and greater than 88cm in women The prevalence of very high waist circumference is much higher among women than men. Both sexes have seen a large increase since 1993. There are well documented links between high levels of central adiposity in adults, as measured by waist circumference, waist-to-height or waist-to-hip ratio and risk of obesity-related conditions including type 2 diabetes, hypertension and heart disease. These links remain even once BMI is adjusted for, demonstrating that measures of central adiposity are independent predictors of future obesity-related ill health. For more information on waist circumference and other measures of central adiposity see: https://khub.net/documents/31798783/32039025/Measures+of+central+adiposity+as+an+indicator+of+obesity/4c335064-07d8-4203-9c61-c64bc50e7ee6 The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- Very high waist circumference is taken to be greater than 102cm in men and greater than 88cm in women The prevalence of very high waist circumference increases with age for both men and women. There is a greater prevalence of very high waist circumference among women, particularly in the older age groups. There are well documented links between high levels of central adiposity in adults, as measured by waist circumference, waist-to-height or waist-to-hip ratio and risk of obesity-related conditions including type 2 diabetes, hypertension and heart disease. These links remain even once BMI is adjusted for, demonstrating that measures of central adiposity are independent predictors of future obesity-related ill health. The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- Increasing proportions of both men and women who have very high waist circumference (defined as >102cm for men and >88cm for women), can be seen in the trend from 1993 to 2010. Since then the trend has fluctuated and since 2014 may be rising again. This can be confirmed as future data is added. Waist circumference was not collected for the whole HSE sample in 1995, 1996, 1999, 2000 and 2004 as indicated by the dashed lines above. There are well documented links between high levels of central adiposity in adults, as measured by waist circumference, waist-to-height or waist-to-hip ratio and risk of obesity-related conditions including type 2 diabetes, hypertension and heart disease. These links remain even once BMI is adjusted for, demonstrating that measures of central adiposity are independent predictors of future obesity-related ill health. The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- Both raised BMI and very high waist circumference are thought to be independent predictors of future obesity related ill heath. Both National Institute of Health and Care Excellence (NICE) and the World Health Organization (WHO) have recommended the use of combined BMI and waist circumference categories for identifying an individual’s risk of obesity related ill health. This table shows how such categories can be used. Adapted from: National Institute of Health and Care Excellence. Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children. http://www.nice.org.uk/guidance/CG43 (accessed 17/03/2016)
- This chart shows the change in the England adult population’s risk of future obesity related ill health between 1993 and 2015 using the combined BMI and waist circumference categories. There has been a steady increase in the proportion of adults with an increased, high, and very high risk of obesity related ill-health since 1993. The three categories of combined increased risk peaked in 2010 (57% of adults surveyed had either increased risk, high risk or very high risk), and has fluctuated since then. However, the proportion of adults at very high risk in 2015 is at the highest recorded level in the Health Survey for England (25%). Waist circumference was not collected for the whole HSE sample in 1995, 1996, 1999, 2000 and 2004, indicated by the gaps in the chart above. The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616
- This chart shows the change in the England adult population’s risk of future obesity related ill-health between 1993 to 1994 and 2014 to 2015. Using the combined BMI and waist circumference categories, a larger proportion of the adult population are now at increased, high, or very high risk of obesity related ill-health than in 1993 to 1994. The proportion of men now at very high risk has almost doubled (from 11.3% to 22.3%) while for women the proportion at very high risk has risen over one and a half times (from 14.8% to 25.7%). The published Health Survey for England data used to produce this chart are available from: http://www.content.digital.nhs.uk/catalogue/PUB22616