Unmet Health and Social Care Needs Among Obese Older Adults in England: A Mixed-Methods Analysis

<p dir="ltr"><b>Background</b><b><i>:</i></b> The increasing prevalence of obesity among older adults in England poses significant challenges to health and social care systems, where obesity is found to be associated with a higher risk of chronic diseases, functional impairments, and diminished wellbeing. Despite much existing research, there is a paucity of studies exploring the specific health and social care needs of obese older adults, focusing on their unmet care and support. This study aims to investigate the impact of obesity on health and social care needs among adults aged 50 and above in England.</p><p dir="ltr"><b>Methods:</b> A mixed-methods approach was employed. Quantitative data were derived from the English Longitudinal Study of Ageing (ELSA) and analysed using SPSS to assess associations between Body Mass Index (BMI), health status, and social care utilisation. Qualitative data were collected through semi-structured interviews with overweight and obese older adults recruited from a National Health Service (NHS) General Practice surgery. Narrative analysis was conducted to identify themes related to unmet care needs.</p><p dir="ltr"><b>Results:</b> Quantitative analysis revealed a positive correlation between higher BMI and increased functional impairments, as well as greater reliance on social care services. Qualitative findings highlighted several unmet needs among obese older adults, including emotional support deficits, social isolation, and inadequate access to tailored health and social care services. Participants expressed feelings of being a burden and reported barriers to engaging in social and recreational activities.</p><p dir="ltr"><b>Study Contribution</b>: A new conceptual framework has been developed that maps unmet care needs, whether needs are expressed or unexpressed, and whether they’re being met or ignored. It helps visualise “care invisibility” in a system that often assumes people will ask for help, but it’s not only about physical limitations, but also about feeling invisible, being judged, or excluded, and that is widening the gap between care demand and service provision.</p><p dir="ltr"><b>Conclusions:</b> Obesity significantly exacerbates health and social care challenges for older adults in England. The study underscores the necessity for integrated, holistic approaches that address both the physical and psychosocial aspects of care for this population. Policymakers and healthcare providers should consider implementing targeted interventions that encompass emotional support, social engagement opportunities, and customised care plans to effectively meet the complex needs of obese older adults.</p>