Obesity: introduction

Obesity is commonly defined as a condition of excess or abnormal accumulation of body fat (or adipose tissue) to such an extent that it impairs health (WHO 2000).  

In 2007, the UK Government Office for Science published the Foresight Tackling Obesities Report. This represented the most comprehensive summary of up to date evidence of the causes of obesity in the UK population. It demonstrated that there are many behavioural and societal factors that combine into a "complex web of societal and biological factors that have, in recent decades, exposed our inherent human vulnerability to weight gain". A Scottish Health Survey topic report (Keenan et al 2011) presented an investigation into the significant behavioural, socio-demographic and economic factors associated with adult obesity using data from the 2008-2010 surveys.

Obesity is a major cause of disease and death in the population of Scotland. It has a part to play in the development of a range of diseases such as type 2 diabetes, hypertension, heart disease, cancers of the colon, ovary and breast, gall bladder disease, female infertility, osteoarthritis, stroke, and dementia. Tackling and preventing obesity is a key public health priority in Scotland and recent policy initiatives to address the problem in Scotland are detailed in the policy context section. These policies draw on the 2007 Foresight Tackling Obesities Report. 

It was estimated that in 2001 the cost to the NHS of the treatment of obesity and obesity-related diseases was £171 million (Walker, 2003). This refers to the costs of treatment only, so excludes non-treatment costs, and wider social costs, which include its impact on employment, production levels and infrastructure planning. More recently, the Scottish Government has estimated that the total cost to Scottish society of obesity in 2007/08 was in excess of £457 million and it is likely that this is an underestimate (Scottish Government 2010). Of this, in excess of £175 million was the estimated cost to the NHS in Scotland (approximately 2% of the budget allocated to Boards); the majority being associated with the health consequences of obesity, mostly type 2 diabetes and hypertension. The most recent estimates of the cost of obesity to Scotland put the total economic cost between £0.9 billion to £4.6 billion per year (SPICe Briefing 2015).^a

^a Estimating the costs of obesity is difficult as its impact on society is wide ranging. While estimates vary between studies, partly due to methodological differences, they all indicate that obesity has a significant financial impact on society. The increasing prevalence of obesity in Scotland has contributed to greater costs over the years. . See Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight  (Scottish Government 2010) and the SPICe Briefing Obesity in Scotland (2015) for further discussion.

Obesity prevention efforts should focus on changes to the ‘obesogenic environment’ and the upstream wider determinants of health.