Weight-related stigmas need tackling to help prevent rising levels of obesity and severe obesity from having a significant impact on demand and cost pressures in adult social care, the Local Government Association urges today in a new report.
Up to a third of adults are predicted to be obese by 2024. The LGA says council care costs are rising as levels of obesity increase with more people living longer in ill-health with multiple and complex needs, requiring costly housing adaptations, specialised equipment and personal care.
Councils are concerned that a fear of offence and a lack of referral services for severely obese people sees some health practitioners only record a person’s condition, such as diabetes or stroke, in data and not obesity or Body Mass Index (BMI) even though that is often the underlying issue.
Practitioners also often compensate for the loss of mobility in obese clients with more equipment – which means they move about even less and their problems are compounded, increasing their likely long-term reliance on social care services.
In its new report, “Social Care and Obesity”, the LGA is urging doctors and health professionals to have an honest conversation about people’s weight when they consider it to be the underlying cause of a condition and for weight to be routinely recorded in data collection to help inform prevention work and ensure that services are tailored to population need.
It says this “frank approach” has become more urgent considering that severe obesity rates have soared seven-fold for men and almost trebled for women since the mid-90s, and in light of widening health inequalities, which have seen obesity rates increase most among those from more deprived backgrounds, and among different ethnic groups.
Obesity is linked to diseases including type 2 diabetes, hypertension, some cancers, heart disease, stroke, liver disease and musculoskeletal conditions. This affects people’s ability to live independently, leading to increased benefit costs and demand for social care which is already under significant stress.
Research shows that the yearly cost of council funded community-based social care for a severely obese person is nearly double the cost of a person with a healthy BMI, which equates to an extra £423,000 in annual excess social care costs for a typical council. Further research shows that obese people are 25 per cent more likely to be using some form of long-term care in two years’ time, than those with a healthy BMI.
Increasing obesity levels have also led to a rise in demand for specialist bariatric equipment, for heavier patients, with some councils reporting a 47 per cent increase in spend on this equipment – which is considerably more expensive than standard care equipment.
The LGA says tackling obesity through prevention, early intervention and provision of appropriate social care will improve people’s health and wellbeing, pre-empt future health and social care issues, promote independence and reduce the pressures on social care and the NHS and narrow health inequalities.
The LGA is calling on government to restore a reduction of more than £700 million in the public health grant to councils between 2015/16 and 2019/20 to help prevention efforts and increase the grant to at least £3.9 billion a year by 2024/25 so it matches the growth in overall NHS funding, as part of the NHS Long-Term Plan.
It says that the impact of obesity has been focused on the NHS instead of adult social care and that the COVID-19 pandemic has renewed the urgency for long-term reform and sustainable funding for adult social care, which needs to be addressed in the Government’s forthcoming Spending Review and long-awaited plan for the future of care and support.
Cllr Ian Hudspeth, Chairman of the LGA’s Community Wellbeing Board, said:
“Obesity is a ticking timebomb for the nation’s health and is one of the most serious public health challenges of the 21st century, but its impact on adult social care is largely overlooked.
“Unless we tackle the stigma and serious challenge of obesity, the costly and debilitating major health conditions it causes could bankrupt adult social care and NHS services.
“Health professionals need to start having frank conversations about their people’s weight if it could be an underlying cause of their condition and routinely record it; individuals need to take responsibility for their own decisions and government needs to support them to do so.
“Obesity needs to be tackled head-on, otherwise people’s health will continue to suffer, health inequalities associated with obesity will remain and the economic and social costs will increase to unsustainable levels.”