A shameful story about obesity

The figure above caused some animated discussion on Brockley Central, with many recondite hypotheses being advanced to explain the seeming kinship between South London and unimaginably remote parts of the North.

The first thing to do is to work out what this data is and what it might be telling us.  It certainly looks like Table 7.3, Finished Admission Episodes with a primary diagnosis of obesity, by Government Office Region (GOR) of residence, Strategic Health Authority (SHA) of residence, Primary Care Trust (PCT) of residence and gender, 2012/13 from the data here.  So what are these episodes about?  There are 10,957 of them, and there are 8,024 in Table 7.8 Finished Consultant Episodes with a primary diagnosis of obesity and a main or secondary procedure of ‘Bariatric Surgery’ by Government Office Region (GOR) of residence, Strategic Health Authority (SHA)  of residence, Primary Care Trust (PCT) of residence and gender, 2012/13.  While ‘Admission Episodes’ and ‘Consultant Episodes’ aren’t quite the same, it’s clear that T7.3 is largely about ‘bariatric surgery’, which includes stomach stapling, gastric bypasses and sleeve gastrectomy.  These procedures have traditionally had a fairly marginal place in the NHS, so we suspect that differences in the willingness to perform or to pay for these procedures may be the operative factor here.

There is data specifically on obesity here.  That gives a ‘Top 10’ as follows, which is rather different from the list we started with above–note that the sample for City of London is probably too small to draw definite conclusions.

TABLE OF TOP 10 ENGLISH LOCAL AUTHORITIES FOR OBESITY

Area Name Weighted Sample % Obese
Halton 309 35.2%
Barnsley 609 34.4%
South Holland 231 32.5%
Mansfield 274 32.4%
Telford and Wrekin 401 32.3%
North Lincolnshire 424 32.0%
Barking and Dagenham 409 31.6%
East Lindsey 363 31.6%
Thurrock 379 31.4%
City of London 20 31.4%

While not all of the areas in the two datasets are identical, we can make a reasonable job of combining them for London as below.

CHART OF OBESITY ADMISSIONS AGAINST PREVALENCE

CHART

Any relationship between the two is rather slight, and it does seem that Lambeth, Southwark and Lewisham have high rates of admission for their prevalence of obesity, rather than high obesity as such. It seems reasonable to conclude that we are seeing wide variations in the propensity to subject obesity to hospital treatments, rather than in obesity as such.

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