Statistics on Obesity, Physical Activity and Diet, England, 2019

This part focuses on hospital admissions (inpatient settings only) relating to being obese. Data is taken from the Hospital Episode Statistics (HES) databank produced by NHS Digital. 

The association between obesity and increased risk of many serious diseases and mortality is well documented and has led to the National Institute for Health and Clinical Excellence (NICE) developing guidelines on identifying and treating obesity

Four measures are presented for the number of obesity related hospital admissions:

1. NHS hospital finished admission episodes (FAEs) with a primary diagnosis of obesity – referred to as admissions directly attributable to obesity.

2. NHS hospital finished admission episodes with a primary or secondary diagnosis of obesity - referred to as admissions where obesity was a factor¹.

3. NHS hospital finished consultant episodes (FCEs) with a primary diagnosis of obesity, and a primary or secondary procedure for bariatric surgery - referred to as obesity related bariatric surgery. 

4. NHS hospital finished consultant episodes (FCEs) with a primary diagnosis of obesity, and a primary or secondary procedure for bariatric surgery, but excluding maintenance, revisional, and removal procedures - referred to as obesity related primary bariatric surgery. In this measure most patients would only be counted once (for their initial procedure).  Though not commented on within the report, it is available in data table  3.1.

An FAE is the first period of inpatient care under one consultant within one provider.  An FCE is a continuous period of admitted patient care under one consultant within one healthcare provider. Please note that admissions do not represent the number of in-patients, as a person may have more than one admission within the year.

Bariatric surgery encompasses a group of procedures that can be performed to facilitate weight loss, although these procedures can also be performed for other conditions. It includes stomach stapling, gastric bypasses and sleeve gastrectomy. In general, such surgery is used in the treatment of obesity for people with a BMI above 40, or those with a BMI between 35 and 40 who have health problems such as type 2 diabetes or heart disease. 

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^{1.  A secondary diagnosis of obesity does not necessarily indicate obesity as a contributing factor for the admission, but may instead indicate that obesity is a factor relevant to a patient’s episode of care.}

Admissions directly attributable to obesity, by year and gender

In 2017/18 there were 10,660 hospital admissions with a primary diagnosis of obesity. This is similar to 2016/17 (10,705). 

Around 3 in every 4 patients were female (74%).

Admissions where obesity was a factor, by year and gender

In 2017/18 there were 711 thousand hospital admissions where obesity was recorded as the primary or a secondary diagnosis. This is an increase of 15% on 2016/17, when there were 617 thousand admissions. Some (though not all) of this increase may be due to hospitals being more likely to record obesity as a secondary diagnosis than they were previously. See the Data Quality Statement for more information.

Around 2 in every 3 patients were female (66%).

Admissions by age group

For admissions directly attributable to obesity, the number increases to middle age, peaking at 45 and 54, before declining in older age groups. 70% of patients were aged between 35 and 64.

For admissions where obesity was a factor, the age distribution is more uniform.

Admissions where obesity was a factor by primary diagnosis (top ten diagnoses)

Of those admissions where obesity was a factor, but it was not the primary diagnosis (main reason for the admission), the most common diagnoses related to joint issues (e.g. arthrosis of the knee or hip) and maternity issues. Others in the top ten diagnosis types were the formation of gallstones (Cholelithiasis)  and heart disease. 

Note that overall there were a large number of different primary diagnoses recorded for admissions where obesity was a factor, and collectively the top ten diagnosis types accounted for less than a quarter of all these admissions (152 thousand of 711 thousand).

Admissions where obesity was a factor by Local Authority (LA) - rate per 100,000 population¹

Admission rates ranged from 313 to 3,516 per 100,000 population, with the highest admission rate over 10 times greater than the lowest rate. The national rate was 1,323 per 100,000 population.

Nottingham and Wirral both recorded admission rates of over 3,000 per 100,000 population.

Wokingham, Reading, West Berkshire and Richmond upon Thames all recorded admission rates below 500 per 100,000 population.

LA rates for admissions directly attributable to obesity are available in table 1.3.

Additionally an interactive tool based on the LA data, including time series, is available at the following link: 

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^{1.  Admissions per 100,000 population have been age standardised and rounded to the nearest whole number.}

For more data relating to this section:

Obesity related bariatric surgery admissions, by year and gender

In 2017/18 there were 6,627 hospital admissions with a primary diagnosis of obesity and a main or secondary procedure of bariatric surgery. This is an increase of 2% on 2016/17 (6,492). 

Over three quarters (79%) of admissions were for females.

Obesity related bariatric surgery admissions, by age group

Over three quarters of patients (79%) were aged between 35 and 64.

Obesity related bariatric surgery admissions, by Local Authority (LA) - rate per 100,000 population¹

Admission rates ranged from 0 to 45 per 100,000 population. The national rate was 12 per 100,000 population.

Sunderland, South Tyneside, and Stoke on Trent recorded the highest admission rates (all over 40 per 100,000 population).

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^{1.  Admissions per 100,000 population have been age standardised and rounded to the nearest whole number.}

For more data relating to this section: