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Weight of the nation

Unum Provident chief medical officer Professor Michael O’Donnell talks about the nation’s increasing problem of obesity in adults and children and how insurers must work with employers, the Government and health bodies to fight the epidemic

Obesity in both adults and children has significant implications for the insurance industry. More people are becoming obese which leads to all sorts of serious illnesses and diseases and at a much earlier age.

Diseases and illnesses caused or made worse by obesity include type two diabetes, heart disease, stroke, chest disease, osteoarthritis, depression, high blood pressure and some types of cancer.

The National Audit Office estimates that most Britons are overweight, with one in five classified as obese. It is estimated that the total cost to the economy of obesity, including NHS treatment, is 2.5bn a year and that, on average, each obese person dies nine years prematurely.

In 1998, the NAO estimated that obesity cost UK industry 18 million days in sickness absence and caused 30,000 premature deaths.

Childhood obesity has had much media and Government attention and statistics suggest that the prevalence of childhood obesity is at least four times higher today than it was 30 years ago. The critical issue is that obese children are more likely to become obese adults.

The condition known as metabolic syndrome is of great concern. It occurs when obesity, diabetes, high blood pressure and high cholesterol combine.

The condition is being seen in much younger cases, with instances of type two diabetes – a condition usually associated with middle-aged obese adults – being diagnosed in teen-agers and even children.

Type two diabetes is strongly linked to cardio-vascular disease, kidney failure, limb amputation and retinal damage leading to blindness.

In some adolescent clinics, type two diabetes represents up to half of new cases of diabetes. In the UK, the diabetic population is around 2.4 million and set to double in the next 10-15 years and many of these new cases will be children.

It has been predicted that healthy young adults could be the first to see their children die before they do. Indeed, the incidence and prevalence of diabetes is increasing worldwide to the extent that it is now being referred to as a global epidemic.

Insurers are alarmed at what this startling increase in obesity-related diseases such as diabetes could mean to the protection and life business. Employers are concerned by the effect that these illnesses will have on current and future staff.

Employers must realise that passive measures such as health screening are not enough. A range of simple initiatives such as promoting healthy food options in the cafeteria and providing access to individualised health and fitness advice and subsidised gym memberships can all form part of a package.

What seems to be impor-tant is commitment from the top of the company to conveying the message that they care about their employees’ health and well being. Although employers may not have a duty of care, it is in their best interests to foster a healthy working environment.

The future may seem bleak but much can be done to combat the obesity epidemic. The risk of obesity-related complications can be markedly reduced and perhaps prevented by appropriate interventions. When it comes to lifestyle interventions, the major challenge for the Govern-ment, employers and, to some extent, the insurance industry is to convince people with diabetes and other obesity-related illnesses that they have a significant role in ensuring that they remain healthy. Bio-psycho-social inter- ventions are the key, not pharmaceutical intervention, which has its place but cannot be the long-term answer.

Much can be done to prevent children becoming obese and therefore cut adult obesity in the future such as creating safer walkways or cycle tracks to school.

Another practical strategy would be to include a daily 30-minute walk in the school curriculum, which has been successfully achieved in Toronto.

Active children are more likely to become active adults, avoiding the health consequences associated with being obese.

The obesity epidemic and the multiple health complications it brings with it are obviously a significant worry for the insurance industry and the answer is to work actively with employers, the Government and the health profession to promote healthier lifestyles and address childhood obesity as an investment in the future.

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