Understanding how pre‑clinical and clinical obesity are distributed across the population, how they vary by socio‑economic factors, and how they affect physical, mental and social outcomes across the life course directly informs policymaking and drives the prioritisation of clinical and public health interventions.
Why is the research needed?
In the UK, almost one in three adults is living with obesity, with higher prevalence observed in the most deprived areas. Obesity increases the risk of serious health conditions, including heart disease, type 2 diabetes, certain cancers, and premature death and it is linked to poorer mental health. Despite the evidence, there is a wide debate on whether obesity is a disease itself or simply a risk factor for other conditions. The 2025 Lancet Commission tried to unpack this providing objective criteria to diagnosis obesity as a condition of illness that directly results from the effect of excess adiposity on the function of organs and tissues. Understanding the distribution of the burden of pre-clinical and clinical obesity, their socio-economic distribution, and the impact across the life course in terms of physical, mental, and social outcomes is essential to inform decision making and facilitate identification of priorities for clinical and public health interventions to prevent the transition from pre- to clinical obesity.
What are we doing?
We are using nationally representative surveys (the UK Household Longitudinal Study and the English Longitudinal Study of Ageing) to estimate how common pre‑clinical and clinical obesity are and how they are distributed across different parts of the UK. The work will describe inequalities in obesity by age, sex, education and ethnicity, and examine how clinical obesity is associated with physical and mental health, as well as social outcomes such as employment and retirement, across the life course. Analyses will be stratified to understand group‑specific impacts and to identify policy‑amenable factors that could reduce the burden of obesity.
To support this, the project includes a literature review, disease‑mapping and multilevel modelling to explore geographical patterns, and cross‑sectional and longitudinal analyses using GLMs, mixed‑effects regression and structural equation modelling. Alongside the analytical work, we will run public engagement workshops to co‑design interventions and hold an end‑of‑project workshop to share findings and support future action.
How are we working with communities, services and organisations?
During the second part of the project, we will engage with regional and national stakeholders, including member of the community through a public engagement workshop to co-design interventions and we will hold a workshop with Directors of Public Health, Regional ICB teams, and providers to discuss the intervention.
What will the impact and benefits of this research be?
This work will strengthen decision‑making and prevention efforts across the system by helping local authorities and integrated care systems prioritise resources more effectively and by supporting the co‑design of preventative interventions. It will also generate additional data and evidence to inform the developing approach to prescribing obesity medications such as GLP‑1RAs. At a national level, the findings will contribute to the implementation of the three shifts in the NHS 10‑year plan, particularly the move toward more personalised approaches to preventing obesity.
What do we have planned for knowledge mobilisation and implementation?
We will disseminate our findings through public engagement workshops, where community members help co‑design interventions, and through a dedicated workshop with Directors of Public Health, regional ICB teams and providers to discuss how the evidence can inform local decision‑making.
Related papers, outputs and resources
Read the paper titled, 'Definition and diagnostic criteria of clinical obesity'
Who is involved?
- Principal Investigator: Professor Mariachiara Di Cesare, University of Essex
- Professor Meena Kumari, University of Essex
- Dr Cara Booker, University of Essex
- Dr Laura Ai Sim Tan, University of Essex
Get in contact
Email Mariachiara Di Cesare at m.dicesare@essex.ac.uk.
