1. www.hertsdirect.org Healthy weight – addressing the challenges of childhood and adult obesity Dr SJ Louise Smith Deputy Director of Public Health

2. Introduction What is obesity? Causes? Why does it matter? Size of the issue? So what can we do?

3. What is obesity? “Being fat” “Very overweight” “More than just a few extra pounds” “Weight 20% above normal” BMI >30 “A major problem in today’s society” “Multifaceted highly complex medical condition” “Accumulation of fat to the extent it may have adverse effects on health”

4. Causes When energy intake in the form of food and drink… …is greater than energy expenditure

5. Causes Lack of exercise Poor diet It develops gradually: poor diet & lifestyle choices Increased access to poor food

6. Causes Too much sugar The introduction of mass production of high-fructose corn syrup

7. Foresight 2007 Complex web of societal and biological factors… …over 100 variables that directly or indirectly influence..

10. Why does it matter? Compared with a non-obese man, an obese man is: 5 x more likely to develop type 2 diabetes 3 x more likely to develop cancer of the colon 2 ½ x more likely to develop high blood pressure

11. Micro Lives Life expectancy for 22 yr man = 79 –20,800 days –500,000 hours –1 million half hours 1 Micro Lives = 30 min 1 day = 48 Micro Lives

12. Micro Lives Bodies age faster when we do bad things to them –So micro lives can also be allocated to risk 1 Cigarette shortens life by 15 min 1 Micro Life –2 Cigarettes –2 Pints Strong Beer

13. 1 Micro Life Healthy waist size man = 37 inches –1 Extra inch on your waist line [every day] 39 - 40 inch waist = 2.3years = 76.7 life expectancy

15. Why does it matter: Children? Short term –emotional & psychological effects –low self-esteem; anxiety & depression –Type 2 diabetes Once established, notoriously difficult to treat: long term: –higher risk of morbidity, disability & premature mortality in adulthood

16. Adult obesity

17. Hertfordshire adult obesity

18. Children’s Obesity

19. Hertfordshire Children’s Obesity

20. What does it cost? Costs direct and indirect NHS 2.5% total spend [£1,000m] –Hertfordshire → £30 million Lost earnings £2.5bn –Hertfordshire → £45 million NICE reduce no obese by 1% → £51m –Hertfordshire → £1 million

22. www.hertsdirect.org Healthy weight – addressing the challenges of childhood and adult obesity Sue Beck

23. www.hertsdirect.org Discussion Is it worth it? – Can society turn obesity around? What works and what doesn’t work? What else could we do?