Mapping Obesity Care Pathways and Healthcare Resource Use From 2015 to 2019 in England

Objective: This observational study characterized obesity care pathways and healthcare resource use in England between 2015 and 2019. Methods: Data were obtained from Discover and the Salford Integrated Record (SIR), two databases of linked primary and secondary electronic health records in England. Adults with a body mass index (BMI) ≥ 30 kg/m2 who attended obesity clinics were included over 4 years (January 1, 2015 [SIR] and January 1, 2016 [Discover] to December 31, 2018). Results: Overall, 1698 people living with obesity were included from Discover and 561 from SIR. Most (74.9%-78.6%) received a lifestyle intervention as their first intervention, whereas 6.2%-16.3% received a pharmacological treatment or metabolic/bariatric surgical procedure. Time to first intervention was typically > 6 months, and most individuals remained in their baseline BMI group after 8 months' follow-up. Obesity-related complications resulted in high annual per-person direct healthcare costs, particularly for acute cardiovascular events such as myocardial infarction (Discover: 2285 GBP; SIR: 2194 GBP) and incident stroke (Discover: 3005 GBP; SIR: 1550 GBP). Conclusions: In conclusion, the time to first intervention can be considerable for people living with obesity in England and these individuals may incur high healthcare costs. There is an unmet need for timely and effective weight management in England. Keywords: database research; health economics; metabolic and bariatric surgery; obesity care; observational study; weight management.