What is the economic impact of obesity?

Obesity is a global public health challenge with a severe impact on health, wellbeing and the economy. Obesity contributes to a range of non-communicable diseases, such as cardiovascular disease, cancer and diabetes. Obesity is associated with a higher risk of disease, disability, and death, with a risk for mortality similar to smoking. Globally, obesity accounts for over 5 million deaths per year.

Obesity also has a significant economic impact. The healthcare costs associated with treating obesity-attributable diseases are substantial. Individuals living with obesity are significantly more likely to have higher costs of care, need homecare services, have more outpatient visits, be prescribed more medications, be admitted to a hospital, have longer hospital stays and undergo surgery. There are also significant indirect costs associated with obesity which stem from lost or reduced productivity and human capital. Individuals with obesity miss more days of work, work at less than full capacity, and are at increased risk of unemployment.

Most of what we know about the economic impact of obesity comes from high-income countries. A ground-breaking new pilot study aimed to examine the economic impact of obesity across eight countries. To help build the body of economic evidence, RTI International and the World Obesity Federation funded this pilot study to examine the economic impact of overweight and obesity over the next 40 years across eight countries. These eight countries were selected as they represented a range of geographies and income levels.

The study estimates that in per capita terms, the costs of obesity in 2019 ranged from $17 in India to $940 in Australia. These economic costs are comparable to 1.8% of gross domestic product (GDP) on average across the eight countries, ranging from 0.8% of GDP in India to 2.4% in Saudi Arabia. By 2060, with no significant changes to the status quo, the economic impacts from obesity are projected to grow to 3.6% of GDP on average ranging from 2.4% of GDP in Spain to 4.9% of GDP in Thailand. If we can reduce obesity prevalence by 5% from projected levels, this will result in an average annual reduction of 5.2% in economic costs. If we can keep obesity prevalence at their current levels, this will translate into an average annual reduction of 13.2% in economic costs.

The World Obesity Federation offer 5 policy recommendations to reduce the public health and economic burden caused by obesity.

1. Firstly, we must recognise obesity as a disease – This will help to shift the public discourse away from an individual blame narrative. This shift in the narrative will encourage people to seek medical care, increase access to treatment for all that need it, foster investments in obesity research, and demonstrate the need to prioritise and improve the education of health professionals to prevent and manage obesity.

2. Secondly, we need to develop obesity surveillance and monitoring programmes and adopt evidence-based strategies for addressing obesity – All approaches to the prevention, management and treatment of obesity should be data-driven and evidence-based. Obesity monitoring and surveillance allows us to keep track of obesity trends and fully understand its determinants, treatment options, economic impact, and policy consequences.

3. Thirdly, we should implement obesity prevention and management policies across the life course – Investing in childhood obesity prevention and treatment is vital to halt a course of poor health and social outcomes in adulthood, while addressing adult obesity can prevent the risk of obesity being passed down through generations. Equally, addressing the commercial determinants of health and improving the environment we live in is essential for halting the rise in overweight and obesity. The World Obesity Federation recommends policy makers should create health-promoting environments, by restricting the marketing of foods and drinks to children, taxing sugar-sweetened beverages, mandating front of pack labelling, limiting portion and package size and increasing access to safe spaces for physical activity.

4. Fourthly, me must provide equitable access to treatment – Obesity treatment should be integrated into Universal Health Care. This would ensure that children, adolescents and their families have equitable access to adequate prevention and treatment services.

5. Fifthly, we must adopt systems-based approaches to address obesity – Interventions to address obesity require a whole-systems approach and actions from multiple sectors to create a healthier environment for all children and their families.

This study demonstrates that the economic impacts of obesity are substantial across countries, irrespective of economic or geographical context and will increase over time if current trends continue. These findings strongly point to the need for advocacy to increase awareness of the societal impacts of obesity, and for policy actions to address the systemic roots of obesity.

Sources:

1. Bray, G. A., Kim, K. K., Wilding, J. P. H., & World Obesity Federation. (2017). Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obesity reviews, 18(7), 715-723.

2. Prospective Studies Collaboration. (2009). Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. The Lancet, 373(9669), 1083-1096.

3. Collaborators, G. B. D., & Ärnlöv, J. (2020). Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396(10258), 1223-1249.

4. Okunogbe, A., Nugent, R., Spencer, G., Ralston, J., & Wilding, J. (2021). Economic impacts of overweight and obesity: current and future estimates for eight countries. BMJ global health, 6(10), e006351.

5. Wolfenstetter, S. B., Menn, P., Holle, R., Mielck, A., Meisinger, C., & von Lengerke, T. (2012). Body weight changes and outpatient medical care utilisation: Results of the MONICA/KORA cohorts S3/F3 and S4/F4. GMS Psycho-Social-Medicine, 9.

6. Zizza, C., Herring, A. H., Stevens, J., & Popkin, B. M. (2004). Length of hospital stays among obese individuals. American Journal of Public Health, 94(9), 1587-1591.

7. Cecchini, M. (2018). Use of healthcare services and expenditure in the US in 2025: The effect of obesity and morbid obesity. PLoS One, 13(11), e0206703.

8. Padula, W. V., Allen, R. R., & Nair, K. V. (2014). Determining the cost of obesity and its common comorbidities from a commercial claims database. Clinical obesity, 4(1), 53-58.

9. Biener, A., Cawley, J., & Meyerhoefer, C. (2018). The impact of obesity on medical care costs and labor market outcomes in the US. Clinical chemistry, 64(1), 108-117.

10. Segal, A. B., Huerta, M. C., Aurino, E., & Sassi, F. (2021). The impact of childhood obesity on human capital in high‐income countries: a systematic review. Obesity Reviews, 22(1), e13104.

11. World Obesity Federation, 2021. The Economic Impact of Overweight & Obesity In 8 Countries. Summary report. [online] Available at: https://data.worldobesity.org/publications/ [Accessed 3 November 2022].