What causes people to be overweight or obese?
Being overweight or obese are caused by excess calories being stored in the body as fat. It is often difficult to pinpoint one cause for this. There may be more than one contributing reason.
- Some people take medicines which might contribute to weight gain e.g. steroids or medicines used to treat mental health conditions.
- Some people struggle to eat healthily or take enough exercise.
- Some people’s genes affect how their bodies process calories and store fat.
- Some people have medical conditions which might contribute to weight gain e.g. having an underactive thyroid.
Being overweight or obese are increasingly common problems.
1 in 4 adults and 1 in 5 children are estimated to currently be living with obesity.
What are the risks of being overweight or obese
Being overweight or obese can affect your quality of life causing low self-esteem, poor confidence and can even contribute to mental health problems such as depression. It can also affect your daily life:
- Difficulty performing physical activity
- Tiredness and fatigue
- Joint aches and pains
- Sweating
- Snoring
- Breathlessness
Most importantly being overweight or obese can increase your risk of more serious health conditions such as:
- type 2 diabetes
- stroke
- heart disease
- some cancers
- issues with fertility in women
- high blood pressure
- osteoarthritis
- fatty liver disease
- kidney disease
Body Mass Index (BMI)
The most used tool to check if you’re overweight is body mass index (BMI).
BMI doesn’t take account of body composition, for example, muscle, fat, bone density. As such a BMI calculation is not a suitable measure for some people including children and young people under 18, pregnant women and athletes.
Although it does have its limitation, BMI is a useful indication of whether they’re a healthy weight.
For most adults, if your BMI is:
- under 18.5 – This is described as underweight.
- between 18.5 and 24.9 – This is described as the ‘healthy range’.
- between 25 and 29.9 – This is described as overweight
- between 30 and 39.9 – This is described as obesity
- 40 or over – This is described as severe obesity
Losing weight
If you are overweight, losing weight will help boost your energy levels, increase your confidence and help reduce the risk of other health conditions.
The best was to manage your weight is to eat healthily and exercise regularly. To lose weight at a safe and sustainable rate of 0.5 to 1kg a week, most people are advised to reduce their energy intake by 600 calories a day.
The best way to achieve this is to swap unhealthy and high-energy food choices – such as fast food, processed food and sugary drinks (including alcohol) – for healthier choices. Making small, simple changes to what and how much you are eating and drinking can really help you lose the pounds.
A healthy diet should consist of:
- fruit and vegetables
- meals based on potatoes, bread, rice, pasta and other starchy foods
- some milk and dairy foods or dairy alternatives
- some meat, fish, eggs, beans and other non-dairy sources of protein
- small amounts of food and drinks that are high in fat and sugar
Try to avoid foods containing high levels of salt because they can raise your blood pressure, which can be dangerous for people who are already living with obesity.
Weight Management Services
NHS weight management services adopt a ‘tiered’ approach.
Tier 1: Information, advice and support
Tier 1 weight management is self-care and there are several resources available to help you manage your weight, examples of which are below.
Lose weight – Better Health – NHS
NHS Weight Loss Plan – Free 12-week diet and exercise plan, available as an app on the App Store, Google Play, or as a printed version.
NHS Exercise – Exercise guidelines and workouts to help improve your fitness and wellbeing.
ManVFat – Diet tips and weight loss motivation for men
Tier 2: Weight management and lifestyle services
If you have tried self-care, and it has not worked for you, you may want to try getting help through the Tir 2 services. In this area this service is provided by Healthy Cornwall .
Further information can be found by clicking on the below link:
Healthy Eating, Getting Active & Healthy Weight – Healthy Cornwall
Alternatively if you have diabetes, high blood pressure (or both) you are eligible for the free 12 week online NHS Digital Weight Management Programme.
The link below gives further information:
NHS England » How to access the programme
Tier 3 &4 : Specialist dietary advice from a multi-disciplinary team and obesity related medications
Please use the link below for important information about weight loss injections
Weight Loss Injections – Oak Tree Surgery
If tiers 1 and 2 have not worked for you, tier 3 weight management services offer a more intensive approach to help you lose weight.
Tier 3 weight management services are delivered by health professionals including Doctors, Dieticians, Psychologists and Physical Activity Specialists to provide weight management and sustainable behaviour change.
However, a GP referral is needed to access tier 3 support.
Measurements including your height, weight, BMI, blood pressure and a series of blood tests are required prior to referral.
Eligibility:
- Must have engaged with a tier-2 weight loss intervention within the two years prior to referral to tier-3
- BMI equal or greater than 40
- BMI equal or greater than 35 with weight related co-morbidities, such as high blood pressure, type 2 diabetes or obstructive sleep apnoea
- BMI equal or greater than 30 with complex needs and has not responded to previous tier interventions
Exclusions:
- Anyone who has an active binge eating disorder or bulimia nervosa
- Anyone who has active psychosis or a significant mental health disorder that would prevent engagement with the service
- Anyone who has an active Substance Abuse Disorder (including alcohol)
- Patients who have undergone previous Bariatric Surgery
Tier 4: Bariatric surgery
Tier 4 weight management services, or specialist bariatric services, offer surgical management to help you lose weight.
If you are eligible under the tier 3 criteria and want to consider bariatric surgery, please contact us to discuss a referral to the weight management service in Cornwall
Bariatric, Obesity and Diabetes Surgery | Royal Cornwall Hospitals NHS Trust
Bariatric Surgery Abroad
We are seeing more and more patients who are choosing to have surgery abroad. The NHS has no way of ensuring these treatments are safe, individually suitable or performed by reputable practitioners.
It is important to do your research carefully. On the NHS pathway, the pre-op advice process is a yearlong for good reason. Short term fixes that only provide the surgery are much less successful and the operation is only a part of the answer.
Any private course of treatment should include the whole package, i.e. pre- assessment and counselling, surgery and follow up. For weight loss surgery, this is recommended for at least 2 years following surgery. This is to ensure the surgery has no complications and that your weight loss and nutrition is achieved and maintained safely.
NHS bariatric services are not able to provide this routine follow up if you have had your surgery abroad. This is also true for GP practices who will not be able to provide you with the regular recommended blood tests after your operation.
As such, the NHS will not be able to refer you for weight loss surgery after care or follow up, on the NHS within 2 years after treatment abroad. We ourselves are not able to deliver the specialist after care that is required, which includes regular blood test monitoring. We advise you to seek private follow up with UK specialists for weight loss surgery you may choose to have abroad. This will be at your own cost.
Please visit the following NHS website (Treatment abroad checklist) if you are thinking about getting surgical treatment abroad.