Eating ourselves to death: Britain's fat epidemic

The number of people whose deaths are directly related to obesity has leapt by 35 per cent since 2003, according to new figures obtained by The Independent on Sunday.

Obesity was cited on death certificates as a contributing factor in 1,203 deaths in England and Wales in 2007, highlighting how the incidence of related diseases such as diabetes, heart disease and blood clots continues to rise alarmingly. The outlook is believed to be as serious in Scotland.

Experts warn that these figures are the tip of the iceberg, as the majority of obesity-related deaths are not being recorded on death certificates.

Opposition politicians last night seized on the figures as the first statistical sign of obesity's increasing causal role in death. They accused the Government of "dithering" and failing to tackle the country's weight epidemic effectively.

Meanwhile, senior doctors called for guidance to help junior colleagues record obesity more consistently and provide better evidence for assessing the effectiveness of efforts to curb the problem.

Professor Alan Maryon-Davies, president of the UK's Faculty of Public Health, said: "These figures add to the growing evidence that obesity is increasing at an alarming rate and is associated with a whole range of fatal conditions. While the numbers may partly reflect a growing awareness among doctors about obesity and its effects, I'm in no doubt that they also represent a real increase in obesity-related deaths. Obesity is not something to joke about; it is a huge public health problem, a burden on the NHS, and it shortens people's lives."

Anne Milton, the shadow health minister who obtained the figures from the Office of National Statistics, said: "Labour has neglected the UK's obesity time bomb, and these figures demonstrate the awful consequences of their complacency. We urgently need action now, but unfortunately this Government's record has been one of obesity targets missed and scrapped, budgets for information campaigns being raided, and dithering over food labelling. It is about time the Government woke up and started to take obesity seriously."

A major report last year suggested that most adults in the UK are overweight, and obesity has roughly doubled since the 1980s. If the trend continues, obese and overweight people are predicted to cost taxpayers in England £50bn a year by 2050 in increased use of the NHS and other services.

Obesity increases the risk of many life-threatening diseases. A recent study found a 74 per cent rise in new cases of diabetes between 1997 and 2003; 80 per cent of people diagnosed with Type 2 diabetes are overweight, according to Diabetes UK. Heart disease is the biggest killer. According to the National Heart Forum around 6 per cent of deaths from coronary heart disease are due to obesity. Yet only 6 per cent of people understood the gravity of being overweight, most seeing fat as a vanity issue, said the Government's Chief Medical Officer, Sir Liam Donaldson.

Norman Lamb, the Lib Dem health spokesman, said: "This is the first indication that the worst possible consequence of the obesity epidemic is with us now. We already knew that obesity has led to an increase in very serious conditions, but these figures now show us that obesity is having an impact on death rates right now. The big worry is that if the epidemic is not brought under control, we could see life expectancy drop for the first time in decades. I don't believe these figures can be written off by claims of better recording. I fear this is a sign of things to come."

There have been longstanding concerns about the accuracy of death certificates, something the Government has promised to address in the Coroners and Justice Bill. A study in 2005 found that pathologists failed to mention obesity in two-thirds of cases, even when the individual was grossly obese with a BMI of over 40.

The pathologist: 'Doctors are being asked to lie'

Dr Emyr Benbow, histopathologist at Manchester Royal Infirmary and post-mortem expert at the Royal College of Pathologists, is concerned about a growing problem

"The number of severely obese people we see on the autopsy table has shot up in the past 10 years. Although we weigh and measure all those patients who have post-mortem examinations, so that BMIs can be calculated, we don't calculate trends. But we know there is change because we have to handle the bodies, something which has become a real hazard for our technical staff. A lot of hospitals have had to install wider fridges.

"Over the same period we have seen more cases of people in their thirties, forties and fifties with very high BMIs who have unexpectedly died in the community from conditions such as pulmonary embolism and deep vein thrombosis, in which obesity is very likely to play a part. These are significant changes and are reflected in the fact that my colleagues are increasingly willing to record obesity on the reports they make to the coroner.

"Many pathologists still do not record obesity on death certificates because they are worried about offending relatives. I know of a number of instances where doctors, including pathologists, and coroners have been asked to remove obesity from the death certificate because the family find the term stigmatising. But while the numbers may be an underestimate, the upward trend in these new figures is hugely important as we now know more people are dying of obesity and its effects.

"It is vital that doctors become confident about recording obesity. Unless we have accurate information it is very difficult to influence government policies."

The survivor: 'This killed both my parents – I've got to break the cycle for my daughters'

Mandie Preston, 32, has lost both parents and her older sister to obesity-related diseases in the past seven years. But it was seeing her mother's death certificate that gave her the impetus to change

"My dad Sid died first, in 2002. He was big, diabetic, and died from heart failure. Six months later I lost my mum, Carole, aged 64. She was a terribly, terribly big lady – 26 stone at her heaviest – and had struggled with her weight her whole life. We always knew it could end up killing her – the doctors had repeatedly told us so. But to read the phrase 'morbidly obese' on her death certificate still felt like a slap in the face. I knew she was fat, but here it was written down.

"Mum had Type 2 diabetes, kidney disease and a load of other problems related to her weight. It affected her health at every stage, so it was right for the doctor to record it on her death certificate. Then I lost my sister Fran, 34, from complications arising from her diabetes.

"Looking back, the words on my mum's death certificate sealed it for me. I knew then that if I didn't make changes I would end up going down the same route. I've been talking with my counsellor and I now understand why we had such an unhealthy relationship with food. I've lost two stone and am making sure my daughters have a very different relationship with food. Mum used it to comfort us and distract us if we were bored; I'm trying to break this cycle because it cost me my whole family."

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