Patterns and trends in adult obesity These PowerPoint slides present key data and information on adult obesity in clear, easy to understand charts and graphics. These can be used freely with acknowledgement to Public Health England. A presentation of the latest data on adult obesity

Overweight and obesity among adults Health Survey for England 2010-2012 More than 6 out of 10 men are overweight or obese (66.5%) More than 5 out of 10 women are overweight or obese (57.8%) The published Health Survey for England data used to produce this graphic are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adult (aged 16+) overweight and obesity: BMI ≥ 25kg/m2 Patterns and trends in adult obesity

Obesity among adults Health Survey for England 2010-2012 One out of four men is obese (24.7%) The published Health Survey for England data used to produce this graphic are available from: http://www.hscic.gov.uk/catalogue/PUB13219 One out of four women is obese (25.7%) Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Patterns and trends in adult obesity

Adult BMI status by sex Health Survey for England 2010-2012 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 in men than in women. The published Health Survey for England data used to produce these charts are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adult (aged 16+) BMI thresholds: Underweight: <18.5kg/m2 Overweight: 25 to <30kg/m2 Healthy weight: 18.5 to <25kg/m2 Obese: ≥30kg/m2 Patterns and trends in adult obesity

Trend in obesity prevalence among adults Health Survey for England 1993-2012 (3-year average) Obesity prevalence continues to rise, but the rate of increase appears to be slowing for both sexes. Obesity prevalence remains higher for women, but the gap between men and women appears to have narrowed over time. The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Patterns and trends in adult obesity

Trend in excess weight among adults Health Survey for England 1993-2012 (3-year average) The prevalence of excess weight rose substantially between 1993 and 2002, but has remained relatively stable since that time for both men and women. Unlike for obesity prevalence, prevalence of excess weight is higher for men than women. The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adult (aged 16+) overweight including obese: BMI ≥ 25kg/m2 Patterns and trends in adult obesity

Trend in severe obesity among adults Health Survey for England 1993-2012 (3-year average) The prevalence of severe obesity (BMI ≥40kg/m2) has increased since 1993 for both men and women. Severe obesity prevalence is much higher for women than men. http://www.noo.org.uk/NOO_about_obesity/Morbid_obesity The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adult (aged 16+) severe obesity: BMI ≥ 40kg/m2 Patterns and trends in adult obesity

Change in the adult BMI distribution Health Survey for England 1991-1993 and 2008-2010 This chart shows the change in the BMI distribution among men and women aged 18 and over, using HSE data. Young adults aged 16 and 17 have not been included in this analysis, as the BMI distribution of people of this age is substantially different to that of the rest of the adult population. The data have been weighted to the English population at the time of measurement (i.e. 1991-1993 and 2008-2010). This means the distributions shown represent the BMI distribution within the adult population at that time. There have been minor changes in the age structure of the English population between 1991-93 and 2008-10, which could account for some of the differences between the BMI distributions shown for earlier years and the present day. However further analysis has shown that these changes account for only a very small proportion of the differences observed. The changes in the shape of the distribution since 1991-93 are therefore primarily due to increases in BMI rather than changes in the age structure. The analysis for this chart was produced using Health Survey for England data from the UK Data Archive, http://www.data-archive.ac.uk/. Adults aged 18+ years (population weighted) Patterns and trends in adult obesity

Adult obesity prevalence by age Health Survey for England 2010-2012 There are differences in obesity prevalence by both age and sex. Obesity prevalence appears to increase with age (in the age range 16 to 74 years), but then decreases above age 75 years. When broken down by age group, differences in obesity prevalence by sex are most noticeable in the 16-24 years and 75+ age groups. Here obesity prevalence is higher for women than for men. However between the ages of 45 and 64 years obesity prevalence appears to be higher among men than women. The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Patterns and trends in adult obesity

Prevalence of adult obesity by region Health Survey for England 2009-2011 (3-year average) Prevalence of obesity among adults varies by region in England. Adult (aged 16+ years) age standardised obesity prevalence by English Region. The data in this chart were produced to create time-series maps for the Obesity Knowledge and Intelligence website, therefore no confidence limits are provided with the prevalence estimates. http://www.noo.org.uk/visualisation/adult_obesity 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+) obesity: BMI ≥ 30kg/m2 Patterns and trends in adult obesity

Adult obesity prevalence by income Health Survey for England 2007-2011 The relationship between obesity prevalence and socioeconomic status differs by sex. Obesity prevalence among women tends to show a marked decrease as socioeconomic status improves, as shown above using equivalised household income. This pattern appears to be consistent across a number of indicators of socioeconomic status. The pattern is different for men. There is no apparent relationship between equivalised household income and obesity prevalence. However this relationship seems to vary between different indicators of socioeconomic status (shown in the following slides displaying obesity prevalence by educational attainment; area deprivation; social class). More information and analysis is available in the Adult Obesity and Socioeconomic Status data factsheet, available to download at http://www.noo.org.uk/NOO_pub/Key_data 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 95% confidence intervals Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Income measure is equivalised household income Patterns and trends in adult obesity

Adult obesity prevalence by education Health Survey for England 2007-2011 More information and analysis is available in the Adult Obesity and Socioeconomic Status data factsheet, available to download at http://www.noo.org.uk/NOO_pub/Key_data 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 95% confidence intervals Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Education measure is highest qualification attained Patterns and trends in adult obesity

Adult obesity prevalence by deprivation Health Survey for England 2007-2011 More information and analysis is available in the Adult Obesity and Socioeconomic Status data factsheet, available to download at http://www.noo.org.uk/NOO_pub/Key_data 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 95% confidence intervals Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Deprivation measure is Index of Multiple Deprivation (IMD) 2007 Patterns and trends in adult obesity

Trend in adult obesity prevalence by social class Health Survey for England 1994-2009 (5 year moving average) Men Women 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 2009; 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 prevalence in women between social class groups compared to men. Women in the unskilled manual class consistently have the highest prevalence of obesity. Social class of the survey respondent was not available in the 2010 HSE data, so this chart has not been updated. 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+) obesity: BMI ≥ 30kg/m2 Patterns and trends in adult obesity

Adult obesity prevalence by ethnic group Health Survey for England 2006-2010 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/. The chart shows 95% confidence intervals Adult (aged 16+) obesity: BMI ≥ 30kg/m2 Obesity prevalence is age standardised Patterns and trends in adult obesity

Adult waist circumference Health Survey for England Year of survey Mean waist circumference (cm) % with raised* waist circumference The prevalence of raised waist circumference is higher among women than men. Both sexes have seen an increase since 1993. For more information on waist circumference and other measures of central adiposity see: http://www.noo.org.uk/uploads/doc/vid_8864_MEASURES%20OF%20CENTRAL%20ADIPOSITY%20AS%20AN%20INDICATOR%20OF%20OBESITY%20August%2009_updated%20Dec%202010_.pdf The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adults aged 16+ years * Raised waist circumference is taken to be greater than 102cm in men and greater than 88cm in women % with raised waist circumference is a three year average for 1993-95 and 2010-12 Patterns and trends in adult obesity

Adult raised waist circumference by age Health Survey for England 2010-2012 The prevalence of raised waist circumference increases with age for both men and women. There is a greater prevalence of raised waist circumference among women, particularly in the older age groups. The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adults aged 16+ years * Raised waist circumference is taken to be greater than 102cm in men and greater than 88cm in women Patterns and trends in adult obesity

Trend in raised waist circumference among adults Health Survey for England 1993-2012 Increasing proportions of both men and women have raised waist circumference (defined as >102cm for men and >88cm for women), as can be seen in the trend from 1993 to 2012. There are signs of a stabilisation of the trend among men and a possible halt to the increasing trend among women. Waist circumference was not collected for the whole HSE sample in 1995, 1996, 1999, 2000, or 2004. The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adults aged 16+ years, the chart shows 95% confidence intervals * Raised waist circumference is taken to be greater than 102cm in men and greater than 88cm in women Patterns and trends in adult obesity

Health risk categories Health Survey for England/ NICE Both raised BMI and raised waist circumference are thought to be independent predictors of future obesity related ill heath. Both NICE and the 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 Clinical Excellence. Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children. http://www.nice.org.uk/guidance/CG43 (accessed 18/02/2011) Patterns and trends in adult obesity

Trend in prevalence of health risk categories Using both BMI and waist circumference; Health Survey for England This figure shows the change in the England population’s risk of future obesity related ill health between 1993 and 2012 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 between 1993 and 2012. Waist circumference was not collected for the whole HSE sample in 1995, 1996, 1999, 2000, or 2004. The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adults aged 16+ years. Using combined waist circumference and BMI classification, as recommended by NICE Patterns and trends in adult obesity

Change in prevalence of health risk categories Using both BMI and waist circumference; Health Survey for England 1993-1994 2011-2012 This figure shows the change in the England population’s risk of future obesity related ill-health between 1993-94 and 2011-12. Using the combined BMI and waist circumference categories, over 10% more (in absolute terms) of the adult population are now at increased risk of obesity related ill-health than in 1993-94. In both 1993-1994 and 2011-2012 men and women have similar proportions at ‘no increased risk’ and therefore also have similar proportions at ‘increased, high, and very high risk’, this is interesting as there are some differences in the prevalence of overweight and obesity by sex. The considerable increase in prevalence in the ‘very high risk’ category is the main contributor to this rise, for both men and women. The published Health Survey for England data used to produce this chart are available from: http://www.hscic.gov.uk/catalogue/PUB13219 Adults aged 16+ years Using combined waist circumference and BMI classification, as recommended by NICE Patterns and trends in adult obesity

For more information: www.noo.org.uk info@noo.org.uk Patterns and trends in adult obesity