Obesity: As costs soar, could tax credits incentivise people to lower their BMI?

The soaring cost of obesity and related health conditions is placing huge pressure on an NHS budget that is already stretched to the limit, warns BMA deputy chairman Dr Kailash Chand. Writing in a personal capacity, he asks whether a 'carrot and stick' approach could push people towards healthier lifestyles.

Chief medical officer Dame Sally Davies' annual report made the headlines last week with a call for the government to factor in obesity to its national risk planning.

Around two thirds of men and more than half of women in the UK are obese or overweight. About 40-50% of all consultations in GP practices are as a direct consequence of diet-related illness, like a new diagnosis of type 2 diabetes or its complications - heart disease, stroke, certain types of cancers and kidney failure.

The rising tide of obesity in the UK is fuelling a rise in diabetes - there are 2.3m people with type 2 diabetes - a condition in which obesity is the key factor. The annual cost to the NHS for health issues related to obesity is estimated to be £6bn.

NHS obesity costs

This kind of spending cannot be sustained by an NHS that is already facing a famine in funding over the next five years due to austerity. The best way to save the NHS money is for fewer people to need its services, and for the most part, obesity is the result of dietary and lifestyle choices.

Obesity and lack of exercise are the prime causes of many common diseases. Several types of cancer strike the inactive and the obese at a higher rate. Type 2 diabetes, which leads to heart disease, high blood pressure, kidney failure and erectile dysfunction is at epidemic proportions and is primarily a disease of the obese. This condition is occurring in younger and younger people.

It is estimated that the cost of obesity to the NHS in England in 2007 was £4.2bn and would rise to £6.3bn in 2015.

I would estimate that something like 50 per cent to 70 per cent of my patients' medical costs would not just be reduced but eliminated if their diets were healthier and they exercised more.

Public health plans

Reports that the government’s flawed Public Health Responsibility Deal has been ‘paused’ are welcome news. The National Obesity Forum has declared the scheme ‘a sham from its inception’, warning that the food industry should not have been allowed a role in public health and obesity policy. The deal should be replaced with strict mandatory targets for food companies to reduce sugar drastically.

So how do we save money on healthcare? We need to get out the old carrot and stick. How about a tax credit for those with a BMI of less than 26?. Or what about rewarding mothers who breast-feed for the first four months of their baby's life? Or a tax on sugar and fizzy drinks with little nutritional value?

Our health is largely in our own hands. Promoting knowledge about diet and exercise and taking responsibility for our own lifestyle choices are the best ways to cut down on healthcare costs, and to reduce the demand and pressure on GP surgeries and hospitals alike.

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