LGA urges HCPs to overcome fears of weight-related stigmas to tackle obesity and rising council care costs

The Local Government Association (LGA) has published a new report, which urges healthcare professionals to overcome fears of weight-related stigmas in order to tackle obesity, warning of the impact it is having on adult social care.

The national membership body for local authorities across England 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.

Entitled ‘Social Care and Obesity’, the study predicts that up to 33 percent of adults will become obese by 2024 in England, sparking concerns over the costly health and care interventions inherent with weight-related illnesses, including type 2 diabetes, hypertension, heart disease, stroke and musculoskeletal conditions.

According to the LGA, councils are concerned that fear of offence and a lack of referral services for severely obese people are preventing the true extent of obesity on demand and cost in adult social care to be realised.

The association says that some health practitioners only record a person’s condition, such as diabetes or stroke, in data and not obesity or Body Mass Index (BMI), despite this often being the underlying issue.

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.”

Additionally, the report notes that practitioners 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.

An interview with a head of operations for long-term conditions and musculoskeletal health within a local authority referenced in the report highlights the problem.

“Patients with long-term conditions such as diabetes and MSK have complex comorbidities, immobility, often they are obese and have a reduced quality of life,” says the head of operations.

“Obesity is a rising challenge with hidden costs and lack of data. We’ve seen a huge rise in specialist wheelchair requests; this is definitely driven by obesity, the burden of care, and pressures on services. Costs have increased and are getting worse as a result.”

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 reveals 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.

The study also underlined that obesity levels have led to a rise in demand for specialist bariatric equipment, with some councils reporting a 47 per cent increase in spend on these products – which it emphasises is considerably more expensive than standard care equipment.

In response, 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. The association also suggests that weight is routinely recorded in data collection to help inform prevention work and ensure that services are tailored to population need.

It says a “frank approach” has become more urgent because severe obesity rates have soared seven-fold for men and almost trebled for women since the mid-90s. In addition, in light of widening health inequalities, obesity rates have increased most among those from more deprived backgrounds and among different ethnic groups.

“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,” adds Cllr Hudspeth.

The LGA is calling on the 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.