Obese people fall into six distinct categories, study suggests

Updated: 00:00 GMT, Jan 1, 1970 | Published: 05:58 GMT, Apr 18, 2015 |

Obese people fall into six distinct categories, a study suggests, leading scientists to call for bespoke treatment rather than a “one size fits all” approach to tackling the epidemic which costs the NHS £6 billion a year. Researchers have identified the groups as heavy drinking males, young healthy females, the affluent and healthy elderly, the physically sick but happy elderly, the unhappy and anxious middle-aged, and those with the poorest health.

The study, published in the Journal of Public Health, suggests that clinicians should not target all obese people in exactly the same way, but rather treat them according to which “type” they belong to. Scientists from the University of Sheffield’s School of Health and Related Research analysed data from the Yorkshire Health Study of 4,144 obese individuals with a body mass index (BMI) of 30 or above. They used a two-step cluster analysis to identify groups of individuals who shared common characteristics, and six groups emerged. Those in the “heavy drinking males” group had above average levels of physical exercise but also had high levels of alcohol consumption.

Meanwhile, “younger healthy females” generally did not have many associated health problems in addition to their obesity. Researchers said that advice for young men could focus specifically on cutting down on alcohol while young females could be told lose weight through traditional methods of exercise and change of diet. The “unhappy anxious middle-aged” group was mainly women with poor mental health and high levels of insomnia, anxiety, depression and fatigue. This group had a low sense of well-being and had the lowest alcohol consumption. The final three clusters showed different patterns among older people. A large proportion of the “affluent healthy elderly” had high blood pressure and above average alcohol consumption, although this group also displayed some healthy characteristics. The “physically sick but happy elderly” group had a higher prevalence of chronic health conditions, such as osteoarthritis, DIABETES and high blood pressure, but had low levels of anxiety and depression. Those in the “poor health” group had the highest average BMI, the most chronic health conditions and tended not to engage in healthy behaviors.

Dr Mark Green, who led the study, said that obese people should not be seen as one homogenous group, but rather treated in a bespoke manner according to which group they belong to. For example, the anxious middle-aged group could be advised to do more exercise and get counselling, while the poor health group may need to address their chronic health problems before tackling their obesity. “Policies designed to tackle obesity and encourage healthier lifestyles often target individuals just because they are obese,” Dr Green said. “But a focus on just the group as a whole is not very efficient. We are all different and different health promotion approaches work for different people. “Our research showed that those in the groups that we identified are likely to need very different services, and will respond very differently to different health promotion policies. “In the future, we hope that GPs will keep in mind these six groups when offering advice to their patients.” The report concluded that interventions by clinicians and policy makers should not target obese people “as a whole”, but rather should strategies should be tailored to suit the categories that individuals belong to.