Bracknell Forest JSNA Joint Strategic Needs Assessment

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Healthy weight: adults

A JSNA deep dive for Bracknell Forest

What is driving overweight and obesity among adults in Bracknell Forest, from diet and activity to the food environment, and where the system could act.

This chapter covers adults. Healthy weight in children and young people is covered in a companion chapter: Healthy weight: children and young people.

At a glance

30% of adults are living with obesity, up from 18% in 2018/19 Active Lives Survey, 2023/24

32% of GP-registered residents are classified as obese or severely obese GP-registered population review

25–46% range in adult obesity rates across the borough's wards GP-registered population review

£126bn estimated wider societal cost of overweight and obesity in the UK Frontier Economics for Nesta, 2025

Overview and analysis

What is Healthy Weight and why is it important?

Healthy weight refers to a person’s Body Mass Index (BMI) that is within the range of 18.5 to less than 25 kg/m² based on the World Health Organization’s (WHO) BMI classification for adults. While BMI is the primary population-level measure, it has recognised limitations in capturing health risk across different ethnic groups and age ranges, local intelligence and clinical judgement should complement population-level data.

Overweight and obesity are defined as “abnormal or excessive fat accumulation that presents a risk to health” by the WHO and have been identified as a key long-term health challenge in England that affects both adults and children.¹ Adults with BMI over 25 kg/m² are considered overweight, and obese for those whose BMI is over 30kg/m². Conversely, those whose BMI falls under 18.5kg/m² are considered underweight.

Maintaining a healthy weight is crucial for overall wellbeing, including improved health-related quality of life, and a reduced risk of health conditions such as heart disease, type-2 diabetes, liver disease and some cancers.²

Figure 1 Obesity harms adults

Source: Public Health England

Read a description of this diagram

A Public Health England infographic headed "Obesity harms adults", setting out four harms side by side, each with an icon.

A briefcase carrying a pound sign: less likely to be in employment.

A head in profile with a spiral inside it: discrimination and stigmatisation.

A first aid kit: increased risk of hospitalisation.

Two human figures of different sizes: obesity reduces life expectancy by an average of 3 years, and severe obesity reduces it by 8 to 10 years.

A recent study highlighted the estimated wider societal costs associated with overweight and obesity in the UK to be around £126bn.³

This JSNA profile provides an overview of the national and local policy context, a detailed epidemiological analysis, a high-level description of pathways and local services, and a summary of insights from stakeholders including adults with lived experience.

National and local policy context

The UK government has made several attempts to address rising obesity in the past 30 years although most of these policies focus on individual behaviour rather than wider structural drivers of obesity.

These have mainly been set out across three chapters of its childhood obesity plan published in 2016, 2018, and 2019 committing to an ambition to halve childhood obesity by 2030⁴. The previous government published its strategy for Tackling Obesity in 2020 in the context of the Covid-19 pandemic.² The pandemic highlighted the widening health inequalities alongside the emerging link between excess weight and poorer outcomes. Shortly after the strategy was published, the previous government set out to systematically address risk factors such as obesity to narrow the disparities in health outcomes or levelling up between the richest and poorest areas.⁵

Tackling Obesity strategy aimed to empower both children and adults to make healthier food choices. This includes a commitment to legislate the end the promotion of foods high in fat, salt or sugar, by restricting volume promotions such as “buy one get one free”, and the placement of these foods in locations intended to encourage purchasing, both online and in physical stores in England.

The National Food Strategy⁶, published in 2021, also identified ‘Reducing Diet-related Inequality’ as a key theme in its recommendations which include extending eligibility for free-school meals, funding Holiday Activities and Food (HAF) programme, expanding the Healthy Start scheme, and trialling a ‘Community Eatwell’ programme which would enable GPs to prescribe fruits and vegetables alongside food-related education.

Most recently, the new 10 Year Health plan⁷ reflects the ambition to end the obesity epidemic through a range of policy levers including:

• Restriction of junk food advertising targeted at children,
• Ban of selling high-caffeine energy drinks to under 16-year-olds,
• Consider reforms to the soft drinks industry levy to drive reformulation, and
• Introduction of mandatory healthy food sales reporting for all large companies in the food sector

These policies complement and support the place-based approaches the many local authorities have adopted towards building a health promoting environment for its population.⁸

The new NICE-approved weight management medications (GLP-1)⁹ represent a significant shift in the treatment landscape and will have implications for local primary care capacity, referral pathways and equity of access. At present, access to these medications within the NHS are restricted. NICE guidelines outline specific thresholds for prescribing these medications (e.g. high BMI with co-occurring weight-related health conditions). Analysis by The Health Foundation found that the limited availability within the NHS has led to an increase in inequalities in access through private prescription.¹⁰

Bracknell Forest are working towards adopting a whole-systems approach to tackling obesity which focuses on four Strategic Actions Initiative (SAI):

• Mapping and improving the food environment
• Enabling changes in diet
• Develop a network of ‘health champions’ and self-help groups
• Plan and deliver a feasibility test to understand how store placement affect people’s shopping decisions

What does it look like in Bracknell Forest?

People living with overweight and obesity are increasing nationally and locally.

Based on Active Lives survey data, the prevalence of adults living with obesity shows a slight decrease between 2015/16 and 2018/19 but increased significantly from 18% of adults in 2018/19 to 30% in 2023/24.

Figure 2 Prevalence of obesity in adults, trend over time (Active Lives survey data)

Source: Sport England Active Lives Survey

View the data as a table

period	Bracknell Forest	England
2015/16	21.93	22.63
2016/17	22.86	23.13
2017/18	21.41	23.10
2018/19	18.73	23.50
2019/20	22.82	24.36
2020/21	22.86	25.21
2021/22	24.98	25.93
2022/23	27.26	26.24
2023/24	29.97	26.50

A recent review of GP-registered population data shows a similar proportion of GP-registered residents classified as obese and severely obese at 32%.

The highest obesity rate is observed in Owlsmoor & College Town (46.2%), while the lowest is in Binfield North & Warfield West (25.0%). Obesity QOF register (2022) shows that prevalence is highest in the 50 to 79 age group.

Dashboard — link to come A Power BI dashboard covering children and adult obesity, with prevalence and trends by ward and map, by sex, and benchmarked against the South East will be published alongside this chapter. The link will be added here once it is live.

Local drivers of obesity

Obesity is a complex problem, affected by factors that encompass dietary, environmental, behavioural and physiological factors. Our norms within society and culture also interact with and compound the impact of these determinants. For this reason, a system-wide approach is needed that makes obesity everybody’s business and is tailored to local needs and works across the life course.

This section describes the local picture and drivers of overweight and obesity in adults.

Healthy weight in pregnancy

Healthy weight before, during and after pregnancy is identified as a high impact area for promoting health in children, young people and families.¹¹ This is due to a strong relationship between maternal obesity and the birth of babies above a normal weight range, and the subsequent development of childhood obesity.

The prevalence of obesity in early pregnancy in 2023/24 is 27% in Bracknell Forest, higher than both the national and South East prevalence of 26.2% and 25.1% respectively.¹²

NICE guidelines (NG247) highlights the importance of healthy eating and physical activity during pregnancy. Pregnant women who have a BMI of 40kg/m² should be referred to a specialist obesity service or practitioner who can provide tailored advice.

Adults and wider environment

Healthy diet and physical activity are seen as key drivers of obesity¹³ and are therefore central to interventions for preventing and managing obesity.¹⁴ Resident engagement undertaken as part of Whole Systems Approach work highlighted mental health as a contributing factor to successful and sustained engagement with services.

Diet

Fruit and vegetable consumption in Bracknell Forest was consistently lower than the England average until recently. Engagement undertaken by Thriving Communities highlighted residents’ concerns around the costs of buying and preparing healthy meals. Parents of small children reported that while healthy start vouchers can help with the costs of buying milk, fruits and vegetables for their family, it does not go very far.

Figure 3 Percentage of adults meeting the '5-a-day' fruit and vegetable consumption, trend over time

Source: OHID Public Health Profiles, Fingertips

View the data as a table

period	Bracknell Forest	England	South East
2020/21	30.6	34.9	37.7
2021/22	29.4	32.5	35.2
2022/23	29.3	31.0	33.2
2023/24	28.3	31.3	34.6
2024/25	34.4	31.4	35.0

Nationally, ultra-processed food (UPF) consumption is a growing concern with UPFs accounting for around 56% of total energy intake in UK adults, with consumption highest among younger adults and those in lower socioeconomic groups.¹⁵ UPF consumption is independently associated with increased risk of obesity, type 2 diabetes, cardiovascular disease and some cancers, over and above the effect of energy intake alone.

Evidence gap Expanding local dietary intelligence for example through inclusion in local health and wellbeing surveys would strengthen the evidence base for future JSNA updates and intervention design.

Physical activity

The proportion of adults who are physically active has decreased from 71% before the Covid-19 pandemic to 65.6% in 2023/24 before increasing again in 2024/25.

Figure 4 Percentage of physically active adults, trend over time

Source: Sport England Active Lives Survey

View the data as a table

period	Bracknell Forest	England	South East
2015/16	68.1	66.1	68.7
2016/17	72.2	66.0	68.9
2017/18	73.9	66.3	69.8
2018/19	71.8	67.2	70.2
2019/20	71.1	66.4	69.5
2020/21	65.5	65.9	69.2
2021/22	69.6	67.3	70.5
2022/23	68.4	67.1	70.2
2023/24	65.6	67.4	70.5
2024/25	73.1	68.0	70.9

Residents recognise and appreciate the wealth of green spaces and parks available in Bracknell Forest however there are practical barriers that they highlighted that prevent them from using these spaces, such as transport and lack of time. Life transitions such as becoming a parent is associated with reduced physical activity particularly for mothers.¹⁶ Feedback from parents of small children to Thriving Communities highlight the challenges in engaging in physical activity including:

• Awareness of available services
• Lack of affordable activities or opportunities
• Childcare issues and additional costs associated with paying for childcare

The data also points to the social gradient impacting with the proportion of physically inactive adults higher in most deprived areas while the proportion of adults who are physically active is higher in least deprived areas (see Figure 5). Findings from Active Lives Survey also highlight that people from the Asian, black, and ‘other’ ethnic groups were less likely to be physically active than the national average.¹⁷

Figure 5 Percentage of physically active and inactive adults by Index of Multiple Deprivation (IMD) deciles

Source: Sport England Active Lives Survey

View the data as a table

measure	period	Deciles 4 to 7	Deciles 8 to 10
Physically active	2015/16	62.5	69.8
Physically inactive	2015/16	21.6	16.4
Physically active	2016/17	70.1	67.9
Physically inactive	2016/17	20.5	18.0
Physically active	2017/18	67.8	72.7
Physically inactive	2017/18	21.3	15.5
Physically active	2018/19	56.9	74.6
Physically inactive	2018/19	28.7	11.9
Physically active	2019/20	61.4	73.0
Physically inactive	2019/20	25.3	15.0
Physically active	2020/21	51.5	66.2
Physically inactive	2020/21	36.6	21.2
Physically active	2021/22	62.3	69.5
Physically inactive	2021/22	25.5	17.9
Physically active	2022/23	55.3	66.2
Physically inactive	2022/23	26.7	19.4
Physically active	2023/24	57.1	64.2
Physically inactive	2023/24	32.0	22.0

Older adults

Local intelligence highlights that obesity prevalence is highest in the 60 to 79 age group in Bracknell Forest however the relationship between weight and health in older adults is complex and differs from that in younger adults in important ways.

The complexity includes the co-occurrence of excess fat mass with low muscle mass and strength or sarcopenic obesity which is increasingly common in older adults and carries greater health risk than obesity alone.¹⁸ Standard BMI thresholds may underestimate health risk in older people because BMI does not distinguish between fat mass and muscle mass. NICE guidelines recommend interpreting BMI with caution in people aged 65 and over, taking into account comorbidities, conditions that may affect functional capacity and the possible protective effect of having a slightly higher BMI when older.¹⁹

Intentional weight loss in older adults can lead to loss of lean muscle mass as well as fat, which may worsen frailty outcomes if not accompanied by adequate protein intake and resistance exercise. Weight management interventions for older adults therefore need to be tailored to preserve muscle mass and function, rather than simply reduce overall body weight.³³

This is particularly relevant in the context of Bracknell Forest’s healthy ageing agenda and the JSNA frailty chapter’s findings on the importance of physical activity and nutrition from mid-life onwards.

Wider food environment

The food environment including the density, placement and marketing of food outlets and products shapes dietary behaviours in ways that go beyond individual choice. Evidence consistently shows that greater exposure to fast food outlets is associated with higher rates of obesity, particularly in more deprived communities.²⁰

The e-food desert index map presented in this chapter (see Figure 6) demonstrates meaningful variation in food access across Bracknell Forest wards, with worse access in the north & east of the borough and pockets of food desert in the west. This geographic inequality in the food environment is an important structural driver of inequalities in healthy weight outcomes.

Local authorities have a range of planning and licensing powers that can be used to shape the food environment, including policies in Local Plans to restrict the density of hot food takeaways (high fat, salt and sugar, or HFSS, outlets) in certain areas, particularly near schools, and conditions on planning applications. Bracknell Forest’s whole-systems approach work has identified mapping and improving the food environment as a strategic action and this should include an assessment of the current distribution of HFSS outlets relative to areas of highest obesity prevalence and deprivation.²¹

Alcohol is a frequently overlooked contributor to excess calorie intake and weight gain in adults. Alcoholic drinks are calorie-dense and not required to carry nutritional labelling, making it difficult for consumers to make informed choices. Regular alcohol consumption is associated with increased risk of overweight and obesity, independent of dietary quality.²²

This is relevant in Bracknell Forest given the existing evidence on alcohol-related harms in the borough and the strong co-occurrence of alcohol use with other health behaviours.

Figure 6 Map of e-food desert index by LSOA (deciles), 2025

Source: Consumer Data Research Centre, e-Food Desert Index 2025. Explore the interactive map

Read a description of this diagram

The map covers Bracknell Forest and its immediate surroundings, with each Lower Super Output Area shaded by its e-Food Desert Index decile. The index combines several drivers of grocery accessibility, including proximity to shops, transport, and access to online delivery.

The scale runs from the highest scoring decile in dark red, meaning the worst food access, through orange and pale yellow in the middle, to the lowest scoring decile in dark blue, meaning the best access. Areas with no data are grey.

The red and orange areas — the worst access — lie in the north and east of the borough, in and around Winkfield, Warfield and North Ascot, with a further pocket in the west. Central Bracknell and the area south towards Crowthorne and Sandhurst are mostly blue, indicating better access.

Key local services and assets

Early years

• Universal health visiting service provide evidence-based advice on infant feeding and introduction to solid foods as part of five statutory reviews. Targeted support if needed.
• Healthy Start Vouchers for eligible families
• All families with children up to age 4 years are offered free vitamin drops and free vitamin tablets for any pregnant or breastfeeding parent in Bracknell Forest.
• Family hubs hold activities including Active play sessions, Baby Peep to support with weaning, Baby and mum group to facilitate social connection, and breastfeeding advice
• Upcoming Best start in life programme which includes a range of offer for parents and their children and digital solutions
• Nursery and early years settings adhere to government guidance nutrition²³ guidance along with safeguarding rules around safer eating
• Child development centre offer choose food workshops for families with children aged 0-5 with SEND

Schools

• NCMP which includes a follow-up call if child’s BMI centile is out of healthy weight
• Chat Health
• Schools outreach to raise awareness and improve ‘healthy weight literacy’
• Active Travel and extra-curricular sports activities offers for schools
• Sport in Mind offer open-access sessions

Community

• Thriving Communities
• Stepping Stones cookery course offer for young adults as part of building practical life skills
• Social prescribing enables people to be referred to activities in the community where available e.g. exercise groups

Green spaces

• Bracknell Forest boasts a high level of green space with 39% woodland coverage and over 150 parks.

Areas for improvement

• Promote healthy weight across the perinatal period using a whole-family approach. Given the strong link between maternal weight, early feeding practices and childhood obesity, investment in preconception and perinatal healthy weight support is among the highest-impact actions available to the system.
• To continue to deliver a whole-system approach to healthy weight programme in Bracknell Forest. The current programme consists of three strategic action areas
  • Healthy Environments and Policy
  • Targeted Healthy Eating and Community Prevention (this workstream will include commissioning of a tier 2 weight management and physical activity service)
  • Active Travel, Active Environments and Open Spaces
• Use planning and licensing powers more actively to shape the local food environment. Bracknell Forest should develop a Health Impact Assessment framework for planning decisions relating to food outlets, with particular focus on restricting new HFSS outlets near schools and in wards with the highest obesity prevalence.
• Address food deserts and improve access to affordable, healthy food. Targeted action in these areas should include working with local retailers and community food providers, supporting community growing initiatives, and exploring food prescription or community eatwell models for residents at highest risk. Partnerships with major supermarkets operating in the borough including those with existing community commitments should be explored as a mechanism for improving healthy food access and affordability.
• Increase accessible, affordable and inclusive physical activity opportunities, with particular focus on adolescents and adults in deprived areas. The data consistently shows a social gradient in physical activity, with adults and children in more deprived wards significantly less active. Barriers identified locally include cost, transport, childcare, digital exclusion, and a lack of young-person-friendly and inclusive spaces.
• Reduce inequalities in healthy weight outcomes across Bracknell Forest wards through targeted outreach and provision prioritised for the communities or wards identified. Ward-level monitoring of overweight and obesity trends should be embedded in the local outcomes framework and reported to the Health and Wellbeing Board.
• Adopt a weight stigma-aware approach across all services and settings. All professionals working with children, young people and adults on healthy weight issues should receive training in weight stigma-aware practice, using person-first language and health-behaviour-focused rather than weight-focused approaches.
• Close intelligence gaps to support better targeting and monitoring. Key data gaps identified in this chapter include local Healthy Start scheme uptake; the dietary patterns of children and young people beyond physical activity data; screen time and sedentary behaviour in children; outcomes from NCMP follow-up contacts; ward-level adult obesity data disaggregated by ethnicity; and the reach and outcomes of HAF provision locally. These gaps should be addressed through inclusion in local health surveys, improved data sharing across partners, and engagement with national data collections where local data is unavailable.
• Embed Making Every Contact Count (MECC) across the workforce for healthy weight. Professionals working across health, social care, education and the voluntary sector represent a significant asset for brief healthy weight conversations. Consistent implementation of MECC for healthy weight including training, clear messaging frameworks and up-to-date knowledge of local referral options should be embedded across the workforce.
• Monitor and plan for the implications of new weight management medications. The NHS rollout of GLP-1 receptor agonists for obesity management will generate new demand on primary care and specialist services. Bracknell Forest should monitor local prescribing trends, assess the equity of access to these medications across the borough, and ensure that pathways into behavioural and lifestyle support are maintained alongside pharmacological treatment, in line with NICE guidance.

References

1. Tackling obesity: empowering adults and children to live healthier lives (2020)

2. Bhaskaran K, dos-Santos-Silva I, Leon DA, Douglas IJ and Smeeth L, ‘Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK’, The Lancet Diabetes and Endocrinology, 2018, vol. 6, no. 12, pp. 944–953

3. Frontier Economics (2025) The Economic And Productivity Costs Of Obesity And Overweight In The UK, Commissioned by Nesta. Available at: online

4. Childhood obesity: a plan for action chapter 2 (2018)

5. Levelling Up the United Kingdom White Paper (2022)

6. National Food Strategy (2021). Available at: online

7. 10 Year Health Plan for England: Fit for the Future. Available at: online

8. PHE (2019) Whole systems approach to obesity: A guide to support local approaches to promoting a healthy weight. Available at: online

9. Overweight and obesity management (2025) NICE guideline NG246

10. The Health Foundation (2026) GLP-1 drug prescriptions for obesity. Available at: online

11. PHE (2020) Maternity high impact area: Supporting healthy weight before and between pregnancies. Available at: online

12. OHID (2026) Public Health Profiles: Obesity in early pregnancy. Available at: online

13. House of Common Library (2023) Obesity policy in England. Available at: online

14. NICE guideline NG246 (2025) Overweight and obesity management. Available at: online

15. Mutebi, N. (2024). Health impacts of ultra-processed foods. Parliamentary Office of Science and Technology. Available at: online

16. Corder K. et al (2020) Becoming a parent: A systematic review and meta-analysis of changes in BMI, diet, and physical activity. Obesity Review 21(4)

17. Department for Digital, Culture, Media and Sport (2024) Ethnicity facts and figures: Physical Activity. Available at: online

18. Tong Ji, Yun Li, Lina Ma. Sarcopenic Obesity: An Emerging Public Health Problem. Aging and Disease. 2022, 13(2): 379-388

19. NICE guideline NG246 (2025) Overweight and obesity management.

20. Burgoine T, et al. (2014) Associations between exposure to takeaway food outlets, use, diet, and body weight in humans: systematic review and meta-analysis. BMJ, 348, g1464.

21. OHID (2019) Whole systems approach to obesity: a guide to support local approaches to promoting a healthy weight.

22. Traversy G and Chaput JP (2015) Alcohol consumption and obesity: an update. Current Obesity Reports, 4(1), 122-130.

23. DfE (2025) Early Years Foundation Stage nutrition guidance. Available at: online