"How dare people who have large bodies cost us money" - the people who sell weight loss drugs say

Here I am looking into the study behind the cost of fatness headlines you have seen on the newspapers and on This Morning this week.

Content warning - Use of stigmatising language, talk of weight stigma, poverty and racism.

Also a note, that when I use the word “fat”, I use it in a completely neutral way as a descriptor. Just like I would use tall, or brown eyed. I am a mid fat, white, cis gendered, non disabled potentially neurodivergent woman for full clarification of my privilege.

I know this study is doing the rounds in the main newspapers this week have seriously impacted quite a few people. People wondering if fat acceptance and not dieting is actually the way to go, people feeling like their bodies are wrong and bad. Anti fatness is an ugly beast that rears it’s head and we can’t help but take notice, it’s natural for us to. Living in a body that is not socially accepted, that people actively try to eliminate, means that when we see these study’s and the huge headlines, our fight or flight response in triggered. It’s natural to have a response to this, no matter where you are in terms of body acceptance.

I wanted to take this time to break it all down. To show you the problem’s with study’s that try to explore the cost of fatness. The media have a field day with this kind of thing.

FAT PEOPLE COST THE NHS MONEY……. HOW DARE THEY.

How dare we have needs for quality healthcare.

The article talks about this study that has had the information taken from 2.4 million people living in the North West of London. The results of this study was presented to the European Congress on Ob*sity very recently, so no matter how much I have searched for this study, I cannot find it. So what I will be talking about here is what absolutely should be taken into consideration, but probably wasn’t. In time, when I can access the study, I will write a follow-up to really analyse the work in front of me.

The articles have statements like “the NHS spent an average of £1,375 annually on morbidly obese patients with a body mass index (BMI) of more than 40” and “If everyone were a healthy weight, the study suggested, the NHS would save nearly £14bn annually.”

Let’s take these figures and discuss them for a while. Although we do not know how the figures were created right now, we can make some safe assumptions from the media articles. This data was mainly derived from the health complications that are assumed to be caused by fatness (I say assumed here because a correlation does not equal causation). The articles quote that people deemed a “healthy weight” costs the NHS £638 annually and “ob*se patients” cost the NHS £979 annually. We can’t argue that there is something wrong here.

Yes, people in straight sized bodies also fall ill from the same complications that fat people do, but do these headline figures really prove that it is from having a large body alone?

I have managed to find the collaboration page which has a little of the context around the study. The data is pulled from a 5 year research partnership with Imperial College London and Chelsea and Westminster Hospital NHS trust. The page refers to the area the data is being collected from as being from “one of the most diverse areas in the UK, both in terms of ethnicity and of income”.

I am not the person here to educate on the impact of racism on a person’s health, being a white person. But there are plenty of studies to show that the experience of racism, has an impact on a person’s health. Does this study consider the impact systematic racism has on someone’s health and therefore the cost of fatness? I seriously doubt it. If you want to learn more, Jessica Wilson MS RD and her book “It’s Always Been Ours” is a great starting point. It is also worth noting that everything that I talk about in this article impacts the BIPOC community much more due to the impact of racism.

Then we have the issue of the vast socioeconomics that are in the North West of London. There is a lot of poverty and many people who have been struggling in these areas. When there is poverty, we see a decline in health. The life expectancy gap between our most rich and our most poor in the UK is a huge 19 years. This to me is wild in 2023.

This infographic shows how poverty and deprivation is measured. Having low comes, smaller opportunities for employment, lower education, all have an impact on a person’s health. Food wise, food is not accessible right now. Many people are living a life of feast and famine. Food deserts (times without food) are abundant. This has a massive impact on mental health as well as physical. When someone is not getting the food and nourishment they need in their bodies, recovery from illnesses are slow, the immune system is not supported as much as usual. Impacts from not having a fridge or freezer or not affording to turn them on (which is a reality to many people) are recurring food poisoning and limited variety of foods. If you are assuming that these will make someone lose weight, remember to check that internalised anti fatness. Some fat people may lose weight and they will still be fat. Some fat people won’t lose any weight at all. But poverty and the effects will still be there.

Does this study take into account the impact of poverty on health? The Centre for Health Economics found that the cost of poverty to hospital inpatient care was £4.8 billion annually. If we add all social care and NHS costs together it is £29 billion per year. This is a significantly larger number than the £14 billion we could apparently save if everyone was thin. I wonder why their priorities sit with fatness rather than poverty. Other potential priority’s are alcoholism with a cost of £3.5 billion and smoking £2.6 billion according to the NHS but I could write a whole series on all of these priorities and the problems behind these numbers (remember that weight loss surgery can cause alcoholism and also that many alcoholics tend to live in secret for a long time, even until they are too ill for treatment).

The thing I can almost 100% guarantee they have not accounted for in their research is the impact of weight stigma that a fat person experiences in day to day life as well as within the NHS. Studies find that the experience of weight stigma can reduce the mortality rate by up to 60%. Weight stigma increases the prevalence of depression, anxiety and body dissatisfaction in fat people. Yes, you have probably read that being fat it self causes that, well actually it’s the stigma we experience that causes that, not ourselves. Weight stigma also increases the risk of cardiovascular disease, diabetes, high blood pressure and some cancers. These also sound similar to the things that people blame on being fat. The research we have is not conclusive at all when we look in to illnesses and diseases and fatness, things are far more complicated than that. But that doesn’t sell diets, weight loss drugs and surgery, but I digress.

But the question that arises from considering what weight stigma may cause in fat people is, how much of this cost they are reporting on can be attributed to weight stigma?

There is a history of health care professionals ignoring the needs of fat people. Studies show that when data was adjusted for the potential delay of medication for fat people during swine flu, a potential indicator of weight stigma, that more fat people were not ill from swine flu or worse. This may indicate that weight stigma caused more severe illness in fat people, not being fat itself.

Surely leaving people waiting for essential healthcare shouldn’t be a thing. Unfortunately it is. People in large bodies actively put off seeing a doctor because of the traumatising experiences they have from doctors not giving them the healthcare they need and giving them weight loss advise instead. They put off seeing a doctor because they are afraid of being judged, shamed and not heard. Those people who do see a doctor may not be listened to first time round in regards to their health issues. So it may take 2, 3, 4 or even more times to be heard about their health issues. Sometimes it can take years to be taken seriously.

We can question this cost here. How much money are these multiple appointments costing the NHS? And to make it clear, it is not the fault of the person trying to seek the healthcare they deserve and need, the fault is with the doctor and their anti fatness and fat phobia. Then if these issues have been going on for a long time, and smaller issues develop into bigger issues because of the time it takes to be taken seriously (or to lose weight and to still have the same health problem), isn’t that surely increasing the amount of money that the NHS has to pay for that person.

Within this breakdown, we have considered the cost of the impact of racism and poverty. We have explored how weight stigma may have an impact on that figure they have come up with. Unless this study is taking these into account, we have some pretty meaningless figures. All they have measured is a lose correlation. They could have found that blonde hair and increased costs were correlated.

“NHS spends £1375 on people who need health care regardless of their size because all humans are worthy of quality healthcare” isn’t a punchy headline.

“NHS could save more than £14 billion if Weight Stigma, Poverty and Racism were eradicated” still not the thing they want to talk about.

And why is that so important? A punchy headline that shows how bad fat people are. How us horrible fat people are costing the NHS so.much.money.

When I started researching to find the study, I did a search on the lead researcher, Dr Jonathan Pearson-Struttard. On one of his recent 2023 studies, I found a disclosure.

Yes, he takes personal fees from Novo Nordisk, the pharmaceutical company behind the new weight loss injection. The person doing the study on how much fat people cost the NHS, receives money from the company making and selling weight loss drugs. The bias is unreal here.

You can imagine the rage when I discovered that. But it goes further unfortunately. The article online reporting on this study explains that the findings were presented to the European Congress of Ob*sity. Guess who they are funded by……..*drum roll* Novo Nordisk.

There is a reason why this study exists as it does and a certain demographic and certain data is being chosen for inclusion in this study. There is a reason why this study ended up in front of the European Congress of Ob*sity. There is a reason why this is being reported on in the news. They need more people hating on their bodies, thinking that their bodies are wrong and are a burden on the society. They do this so people will seek out more support through diets and eventually the weight loss injections. Framing people’s bodies are inherently wrong and then providing a “cure” for that is a tale that has been repeated in this capitalist society.

What if the “cure” actually begins with governments taking proper responsibility of the state of the healthcare system, for improving the cost of living right now, tackling social justice issues like racism and weight stigma. How long will it take to see headlines like….

“The NHS recognises that weight is a poor indicator of health” rather than focusing on a over-sensationalised potentially inaccurate figure that ultimately stigmatises so many people in the UK.