Obesity - A recipe for disaster

Obesity and weight-loss surgery are serious and growing problems for underwriting insurances, as Nicky Bray explains

We will all have seen the numerous articles in the press over recent years about the obesity epidemic and rising numbers of people undergoing gastric surgery in an attempt to lose weight. This trend has ramifications for protection business and has underwriting implications.

Since 1980, the number of obese people in the UK has nearly tripled. There are now 2% of UK adults severely (morbidly) obese with a Body Mass Index (BMI) of more than 40. Studies published in The Lancet in 2009 suggested that a BMI between 30 and 35 reduced the life expectancy of individuals by two to four years, while a BMI between 40 to 50 reduced life expectancy by eight to ten years.

Common symptoms associated with being overweight or obese include being constantly tired, short of breath even at rest, suffering from insomnia, excessive snoring and back and joint pains often affecting mobility. 

These symptoms can have a significant impact on someone’s quality of life and their ability to work or carry out normal daily activities. 

The fundamental cause of obesity is an imbalance between calories consumed and calories expended. The increases in obesity in the UK and across the world are attributable in part to a shift in diet to energy-dense foods high in fat and sugar combined with a trend towards decreased physical activity.

Sport England’s Active People Survey (2009-10) showed increasing proportions of adults over the age of 34 are now participating in regular moderate intensity activities each week. Looking on the bright side, perhaps the messages about the importance of keeping fit and the warnings of increased risks of illness and disability due to obesity are finally being heard and appreciated by the older sections of the population.

Less encouraging is the survey statistic that showed no change in the level of exercise being performed by adults aged 16 to 34. Recent results from The National Child Measurement Programme 2009-10 support this alarming trend in the rise in obesity amongst youngsters.

Its findings showed that 23.1% of children in reception year (age 4-5) were either overweight or obese. By Year 6 (age 10-11), 18.7% of children were obese, with rates of up to 21.8% in Year 6 children in the London Strategic Health Authority.

This rising incidence of childhood obesity with no change in levels of physical activity is clearly storing up a problem of reducing life expectancy as well as increased morbidity and disability rates in future generations of customers.

Surgical dispirit

So it’s not surprising that we are now seeing more people resort to surgery to treat the problem. The number of people undergoing bariatric (weight-loss) surgery has increased significantly in recent years, with numbers rising from about 470 in 2003-04 to more than 6,500 in 2009-10 – a 14-fold increase in just six years.

However, there are estimated to be about one million people in England who would currently meet the National Institute for Health and Clinical Excellence’s (NICE) criteria for surgery. Therefore, we are likely to see more and more customers who, when applying for their protection cover, are awaiting or have undergone some form of bariatric surgery.

Alternative weight loss strategies, such as lifestyle or dietary changes and increased exercise, usually produce a temporary loss of only 5-10% of body weight. Drug treatment is available – this works by blocking the enzyme that helps digest and absorb fat, thus reducing calorie intake. However, this should be used only temporarily.