Obesity inequalities in England have widened since COVID-19—with steepest increases in new cases in young adults

by Health Data Research UK

edited by Sadie Harley, reviewed by Robert Egan

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A study by researchers from the University of Cambridge, the British Heart Foundation Data Science Center at Health Data Research UK and The George Institute for Global Health is the first to analyze obesity trends from 2019 to 2025, using NHS England electronic health records covering nearly 55 million adults.

The scale and detail in the data allowed the researchers to gain new insight into how rates of new obesity cases recorded by health care professionals, and the percentage of people affected by obesity, differ by sex, age, socioeconomic status, ethnicity and geographical region.

The study has been published in The Lancet Diabetes & Endocrinology.

Robert Fletcher of the University of Cambridge, Health Data Research UK and The George Institute, and study co-lead, says, "Levels of obesity in England have worsened since the pandemic, with nearly one in three people now affected.

"We're also seeing large disparities across the country: the percentage of adults affected by obesity in northeast England is six times higher than in central London. Differences on this scale are rarely seen in other areas of public health.

"The rise in new cases among young adults of childbearing age is especially concerning. Beyond the implications for their own long-term health, obesity is associated with infertility, adverse pregnancy outcomes and child obesity, which may perpetuate intergenerational cycles of health inequality."

Key findings

Obesity is rising: Rates of new obesity cases increased overall by 4% in 2025 compared with before the COVID-19 pandemic.

Young adults hit hardest: The largest increases over time were seen in younger adults. Rates of new obesity cases rose by almost 20% in those ages 30–39, and by 16% in those ages 20–29, while rates fell among adults ages 60–79.

Risk rises with deprivation: Over the study period, rates of new obesity cases were 35% higher for people with the highest socioeconomic deprivation (those with the lowest incomes, highest unemployment and poorest housing) compared with people with the lowest socioeconomic deprivation. The gap was wider still for women, where new cases were 54% higher among the most deprived, and widest for Asian women, at 94% higher.

Ethnicity and deprivation compound: The percentage of people living with obesity ranged from 4% among the most affluent White men ages 18–19 to 66% among the most socioeconomically deprived Black women ages 60–69—nearly double the figure for the least-deprived White women of the same age.

Large geographical differences: The percentage of people affected by obesity in some areas of northeast England (48%) was nearly six times higher than that seen in the most affluent parts of central London (8.5%). The steepest increases over time were seen in areas with the lowest GDP per capita.

The person-level data analyzed in this study had all direct identifiers, such as names and NHS numbers, removed before researchers accessed the data, which is then accessible only within NHS England's Secure Data Environment. The data is accessible only by approved researchers working on approved, COVID-19-related research projects.

The researchers' definition of obesity was a recorded body mass index (BMI) of 30 or above, or a clinician's diagnosis of obesity in a person's health records. Their findings from this electronic health record study correspond well with the NHS Health Study for England, which samples households across the country, giving confidence in the extra depth of the insights this study is able to provide.

They looked at rates of new cases of obesity (incidence) and the percentage of people with obesity (prevalence) in the general population, as well as differences across sociodemographic groups and geographical regions.

Obesity is now more common than hypertension (high blood pressure) in the UK, and nearly three times as common as smoking. It is a chronic, complex disease linked with a whole host of conditions, including heart disease, stroke, cancer, diabetes and kidney failure, as well as affecting individuals' mental well-being and placing growing pressure on both the health care system and the economy.

These findings highlight the scale and urgency of the obesity crisis, and how it has worsened since the COVID-19 pandemic.

GLP-1 receptor agonist drugs, like Ozempic/Wegovy and Mounjaro, are known to be effective in managing obesity and are being more widely prescribed and used. The study did not set out to examine their impact.

"We don't see any obvious reduction in obesity in our data following the introduction of GLP-1 receptor agonists, at least not within the current study period," Fletcher says.

"However, the drugs on their own are unlikely to be the answer. At present, the majority are privately prescribed and the jabs are expensive, which poses a barrier for people from disadvantaged backgrounds. We need deep-seated change to the many social and economic factors that drive obesity in the first place."

Naveed Sattar, one of the co-authors, professor of cardiometabolic medicine at the University of Glasgow and chair of the Obesity Health Care Goals Program, agrees: "Obesity is not primarily about willpower. These new, powerful data indicate that those most at risk frequently reside in the most obesogenic environments and likely have the least agency to withstand such environments.

"To achieve lasting change, the UK must expand access to new treatments faster but also fundamentally reshape food and activity environments so that healthier choices occur with minimal conscious effort. Failure to act will drive further rises in multimorbidity and human suffering, with profound consequences for the NHS and the wider economy."

Study co-lead Angela Wood, professor at the University of Cambridge and associate director at the British Heart Foundation Data Science Center, says, "The COVID-19 pandemic has had a lasting impact on health and lifestyle behaviors. By analyzing electronic health records from the entire adult population of England before, during and after the pandemic, we have generated the most comprehensive evidence to date on how obesity risk and burden are increasingly diverging across multiple dimensions of inequality.

"These findings underscore the critical importance of secure access to whole-population health data to enable research, surveillance and timely action to address widening health inequalities."

Publication details

Whole-population trends in obesity across dimensions of inequality in England, 2019–25: a retrospective, longitudinal cohort study of 54 million adults, The Lancet Diabetes & Endocrinology (2026). DOI: 10.1016/S2213-8587(26)00120-8

Journal information: The Lancet Diabetes & Endocrinology

Key medical concepts

ObesityBody Mass IndexGlucagon-Like Peptide-1 Receptor AgonistsDiabetesHigh Blood Pressure

Clinical categories

Preventive medicineWeight managementFamily medicineHealthy livingCommon illnesses & Prevention Provided by Health Data Research UK Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Robert Egan

Bachelor's in mathematical biology, Master's in creative writing. Well-traveled with unique perspectives on science and language. Full profile →

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