Citerank: (7) 348767A potentially unsustainable financial burden on the health systemThe range of obesity's impacts makes accurate economic analysis challenging; however, a November 2014 study from the McKinsey Global Institute placed the annual economic impact on the UK at around $73bn (£46bn). Earlier analysis and modelling for the 2007 Foresight Report suggested a cost to the NHS of around £4.2bn annually to treat people with health problems related to elevated BMI and a total wider cost to the economy of around £15.8bn (rising to £27bn by 2015 and £49.9bn by 2050).57DE7179, 362031Financial cost of obesity – USAAnalysis [6] prepared for The Fiscal Times by Scott Kahan—director of the National Center for Weight & Wellness at George Washington University—puts the total national cost of obesity (including direct medical and non-medical services, decreased worker productivity, disability and premature death) at $305.1bn annually. Including the intangible costs associated with pain and suffering from obesity and obesity-associated conditions would add at least a further $300bn a year (Society of Actuaries).959C6EF, 370359Financial cost of obesity – international comparisons8FFB597, 399973A potentially unsustainable financial burden on the health systemThe range of obesity's impacts makes accurate economic analysis challenging; however, a November 2014 study from the McKinsey Global Institute placed the annual economic impact on the UK at around $73bn (£46bn). Earlier analysis and modelling for the 2007 Foresight Report suggested a cost to the NHS of around £4.2bn annually to treat people with health problems related to elevated BMI and a total wider cost to the economy of around £15.8bn (rising to £27bn by 2015 and £49.9bn by 2050).57DE7179, 399980What costs should be included in the financial analysis?What cost factors should be included in the assessment of the overall financial impact of obesity on the UK economy?8FFB597, 399981Financial cost of obesity – international comparisons8FFB597, 400007Financial cost of obesity – USAAnalysis [6] prepared for The Fiscal Times by Scott Kahan—director of the National Center for Weight & Wellness at George Washington University—puts the total national cost of obesity (including direct medical and non-medical services, decreased worker productivity, disability and premature death) at $305.1bn annually. Including the intangible costs associated with pain and suffering from obesity and obesity-associated conditions would add at least a further $300bn a year (Society of Actuaries).959C6EF

In the last decade, the prevalence of obesity has increased significantly in populations worldwide. A less dramatic, but equally important increase has been seen in our knowledge of its effects on health and the burden it places on healthcare systems. This systematic review aims to assess the current published literature on the direct costs associated with obesity. A computerized search of English language articles published between 1990 and June 2009 yielded 32 articles suitable for review. Based on these articles, obesity was estimated to account for between 0.7% and 2.8% of a country's total healthcare expenditures. Furthermore, obese individuals were found to have medical costs that were approximately 30% greater than their normal weight peers.

Although variations in inclusion/exclusion criteria, reporting methods and included costs varied widely between the studies, a lack of examination of how and why the excess costs were being accrued appeared to be a commonality between most studies. Accordingly, future studies must better explore how costs accrue among obese populations, in order to best facilitate health and social policy interventions.

Obesity imposes a significant human burden of morbidity, mortality, social exclusion and discrimination. There is also a significant healthcare cost associated with treating obesity and its direct consequences. And social care costs are higher for the obese. Higher levels of sickness and absence from work among the obese reduce productivity and impose costs on businesses. Premature mortality as a consequence of obesity reduces the national output relative to the level it would be in the absence of obesity.

Obesity also imposes other costs. Many people are not in employment as a direct result of obesity, either on health grounds or for other reasons, including, possibly, discrimination in the workforce. This, too, reduces national output, reduces tax revenue and increases government expenditure on incapacity benefit and unemployment benefit. In addition, obesity increases operating costs for some businesses, for example, the costs of larger seats and fuel for aircraft.

The private and social costs of obesity have many causes, and their consequences can be grimly predicted with only rough accuracy. Among the most devastating is the increased incidence of diabetes, of which 60% can be directly attributed to weight gain. There are now about one billion people worldwide who are overweight or obese, compared with 850 million who are chronically underweight. It is estimated that the number of people worldwide with diabetes will increase from 175 million in 2000 to 353 million in 2030, with India and China together accounting for 24% of the total in 2050.

Obesity and its economic costs are borne on three levels. At an individual level, obesity imposes costs by limiting personal opportunity in many ways, only some of which can be quantified. In the workplace (assuming the obese are employed, which they may not be, due in part to their condition), costs are borne by employers due to lost productivity, absences, underperformance, and higher insurance premia, which in the aggregate are quite large. Finally, obesity affects expenditures by local, state, and national governments, where programs compensate for or cover some of the private and workforce costs of illness and unemployment.

Citerank: (7) 348767A potentially unsustainable financial burden on the health systemThe range of obesity's impacts makes accurate economic analysis challenging; however, a November 2014 study from the McKinsey Global Institute placed the annual economic impact on the UK at around $73bn (£46bn). Earlier analysis and modelling for the 2007 Foresight Report suggested a cost to the NHS of around £4.2bn annually to treat people with health problems related to elevated BMI and a total wider cost to the economy of around £15.8bn (rising to £27bn by 2015 and £49.9bn by 2050).57DE7179, 362031Financial cost of obesity – USAAnalysis [6] prepared for The Fiscal Times by Scott Kahan—director of the National Center for Weight & Wellness at George Washington University—puts the total national cost of obesity (including direct medical and non-medical services, decreased worker productivity, disability and premature death) at $305.1bn annually. Including the intangible costs associated with pain and suffering from obesity and obesity-associated conditions would add at least a further $300bn a year (Society of Actuaries).959C6EF, 370359Financial cost of obesity – international comparisons8FFB597, 399973A potentially unsustainable financial burden on the health systemThe range of obesity's impacts makes accurate economic analysis challenging; however, a November 2014 study from the McKinsey Global Institute placed the annual economic impact on the UK at around $73bn (£46bn). Earlier analysis and modelling for the 2007 Foresight Report suggested a cost to the NHS of around £4.2bn annually to treat people with health problems related to elevated BMI and a total wider cost to the economy of around £15.8bn (rising to £27bn by 2015 and £49.9bn by 2050).57DE7179, 399980What costs should be included in the financial analysis?What cost factors should be included in the assessment of the overall financial impact of obesity on the UK economy?8FFB597, 399981Financial cost of obesity – international comparisons8FFB597, 400007Financial cost of obesity – USAAnalysis [6] prepared for The Fiscal Times by Scott Kahan—director of the National Center for Weight & Wellness at George Washington University—puts the total national cost of obesity (including direct medical and non-medical services, decreased worker productivity, disability and premature death) at $305.1bn annually. Including the intangible costs associated with pain and suffering from obesity and obesity-associated conditions would add at least a further $300bn a year (Society of Actuaries).959C6EF

Rising prevalence of obesity is a worldwide health concern because excess weight gain within populations forecasts an increased burden from several diseases, most notably cardiovascular diseases, diabetes, and cancers. In this report, we used a simulation model to project the probable health and economic consequences in the next two decades from a continued rise in obesity in two ageing populations—the USA and the UK. These trends project 65 million more obese adults in the USA and 11 million more obese adults in the UK by 2030, consequently accruing an additional 6 – 8·5 million cases of diabetes, 5·7 – 7·3 million cases of heart disease and stroke, 492,000—669,000 additional cases of cancer, and 26 – 55 million quality-adjusted life years forgone for USA and UK combined.

The combined medical costs associated with treatment of these preventable diseases are estimated to increase by $48 – 66 billion/year in the USA and by £1·9 - 2 billion/year in the UK by 2030. Hence, effective policies to promote healthier weight also have economic benefits.

Citerank: (28) 340964Tackling obesity in the UKWith concern growing that the Foresight analysis—that 50% of the UK population could be obese by 2050, at an annual cost to the nation of around £50 billion per year [2]—substantially underestimates the scale of the unfolding obesity crisis, the College of Contemporary Health is working with the wider policy community to develop a whole systems map of the obesity crisis and the potential responses.7F1CEB7, 348675Adopt a whole systems approach to obesityTackling obesity effectively—accomplishing a population wide-shift—requires a comprehensive and integrated whole systems approach, involving a range of measures focusing on individuals, social and other systems, including at the local and community level, and on the interrelated physical, physiological, social and cognitive factors that determine health outcomes.565CA4D9, 348688Impacts of obesityObesity presents a significant threat to the health of the UK population and a significant drain on the nation's financial resources. 24.9% of adults in England are obese—with a body mass index of over 30—62% of adults are either overweight or obese (with a BMI of over 25), and 32% of 10–11-year-olds are overweight or obese. The annual cost of obesity to the UK is estimated to be £27bn–£46bn [1], [2]; although international comparisons suggest that the true cost could be significantly higher.57DE7179, 348693Stakeholders – Groups & ActionsExplore the map via the different stakeholder groups and the measures each group can take to help tackle the obesity crisis.58D3ABAB, 348767A potentially unsustainable financial burden on the health systemThe range of obesity's impacts makes accurate economic analysis challenging; however, a November 2014 study from the McKinsey Global Institute placed the annual economic impact on the UK at around $73bn (£46bn). Earlier analysis and modelling for the 2007 Foresight Report suggested a cost to the NHS of around £4.2bn annually to treat people with health problems related to elevated BMI and a total wider cost to the economy of around £15.8bn (rising to £27bn by 2015 and £49.9bn by 2050).57DE7179, 348770Tackling obesityMany policy interventions have been suggested to address the obesity crisis across multiple studies—and indeed many such measures have been implemented, and are being implemented, now. There's recognition too that these interventions need to be part of a coherent and comprehensive whole systems strategy [4]; with some grounds for optimism that such an approach has the potential to accomplish a significant reduction in the prevalence of obesity in the UK across the next decade. [2]565CA4D9, 348775Modelling suggests the majority of UK population may be obese by 2050The prevalence of obesity in the UK more than doubled in the 25 years to 2007. In England, nearly a quarter of adults and about 10% of children were obese in 2007, with a further 20–25% of children overweight. The Foresight report extrapolated that 40% of Britons might be being obese by 2025, with Britain being a mainly obese society by 2050.1198CE71, 348776A profound impact on the health of the populationObesity is responsible for more than 9,000 premature deaths each year in England, reduces life expectancy on average by nine years, and is a major risk factor in wide range of serious health problems including Type 2 diabetes (5 x), cancer (3 x the risk of colon cancer), and heart disease (2.5 x).57DE7179, 348779Involve all stakeholders in the process of changeReversing the rising trend and addressing the prospect of the rising health burden and societal costs will be demanding and will necessitate major changes in behaviour – not only in individuals, but also in families, communities, organisations and economic markets.565CA4D9, 348780Causes of obesityUnderstanding the causes of obesity is critical to the success of prevention and treatment strategies. However, while (simply put) obesity occurs when energy intake from food and drink consumption is greater than energy expenditure through the body’s metabolism and physical activity over a prolonged period (resulting in the accumulation of excess body fat), in reality many complex behavioural and societal factors contribute systemically to the current crisis and no single influence dominates.555CD992, 351674Inequality of impactAlthough obesity occurs across all population groups, it impacts disproportionately on the socially and economically disadvantaged and some ethnic minorities. [8]57DE7179, 352390Industrial way of life is obesogenicRapid societal changes—for example, in food production, motorised transport and work/home lifestyle patterns—have placed human physiology (which has evolved to cope with an under-supply of food and high energy expenditure) under new stresses, and revealed an underlying genetic tendency to accumulate and conserve energy (i.e. gain weight) in a high proportion of the population. In this sense, obesity can be construed as a normal physiological response to an abnormal environment.555CD992, 352390Industrial way of life is obesogenicRapid societal changes—for example, in food production, motorised transport and work/home lifestyle patterns—have placed human physiology (which has evolved to cope with an under-supply of food and high energy expenditure) under new stresses, and revealed an underlying genetic tendency to accumulate and conserve energy (i.e. gain weight) in a high proportion of the population. In this sense, obesity can be construed as a normal physiological response to an abnormal environment.555CD992, 365986Foresight – Obesity System MapObesity occurs when energy intake from food and drink consumption is greater than energy expenditure through the body’s metabolism and physical activity over a prolonged period, resulting in the accumulation of excess body fat. However there are many complex behavioural and societal factors that combine to contribute to the causes of obesity.7F1CEB7, 366467Encourage active transport (walking and cycling)Government authorities redesign urban planning to facilitate and encourage walking and cycling.565CA4D9, 399546Tackling obesityMany policy interventions have been suggested to address the obesity crisis across multiple studies—and indeed many such measures have been implemented, and are being implemented, now. There's recognition too that these interventions need to be part of a coherent and comprehensive whole systems strategy [4]; with some grounds for optimism that such an approach has the potential to accomplish a significant reduction in the prevalence of obesity in the UK across the next decade. [2]565CA4D9, 399547Adopt a whole systems approach to obesityTackling obesity effectively—accomplishing a population wide-shift—requires a comprehensive and integrated whole systems approach, involving a range of measures focusing on individuals, social and other systems, including at the local and community level, and on the interrelated physical, physiological, social and cognitive factors that determine health outcomes.565CA4D9, 399557Involve all stakeholders in the process of changeReversing the rising trend and addressing the prospect of the rising health burden and societal costs will be demanding and will necessitate major changes in behaviour – not only in individuals, but also in families, communities, organisations and economic markets.565CA4D9, 399599Encourage active transport (walking and cycling)Government authorities redesign urban planning to facilitate and encourage walking and cycling.565CA4D9, 399887Causes of obesityUnderstanding the causes of obesity is critical to the success of prevention and treatment strategies. However, while (simply put) obesity occurs when energy intake from food and drink consumption is greater than energy expenditure through the body’s metabolism and physical activity over a prolonged period (resulting in the accumulation of excess body fat), in reality many complex behavioural and societal factors contribute systemically to the current crisis and no single influence dominates.555CD992, 399889Industrial way of life is obesogenicRapid societal changes—for example, in food production, motorised transport and work/home lifestyle patterns—have placed human physiology (which has evolved to cope with an under-supply of food and high energy expenditure) under new stresses, and revealed an underlying genetic tendency to accumulate and conserve energy (i.e. gain weight) in a high proportion of the population. In this sense, obesity can be construed as a normal physiological response to an abnormal environment.555CD992, 399889Industrial way of life is obesogenicRapid societal changes—for example, in food production, motorised transport and work/home lifestyle patterns—have placed human physiology (which has evolved to cope with an under-supply of food and high energy expenditure) under new stresses, and revealed an underlying genetic tendency to accumulate and conserve energy (i.e. gain weight) in a high proportion of the population. In this sense, obesity can be construed as a normal physiological response to an abnormal environment.555CD992, 399972Impacts of obesityObesity presents a significant threat to the health of the UK population and a significant drain on the nation's financial resources. 23% of adults are obese—with a body mass index of over 30—61% of adults are either overweight or obese (with a BMI of over 25), and 33% of 10–11-year-olds are overweight or obese. The annual cost of obesity to the UK economy has been estimated to be £27bn–£46bn [1], [2]; although international comparisons suggest that the true cost could be significantly higher.57DE7179, 399973A potentially unsustainable financial burden on the health systemThe range of obesity's impacts makes accurate economic analysis challenging; however, a November 2014 study from the McKinsey Global Institute placed the annual economic impact on the UK at around $73bn (£46bn). Earlier analysis and modelling for the 2007 Foresight Report suggested a cost to the NHS of around £4.2bn annually to treat people with health problems related to elevated BMI and a total wider cost to the economy of around £15.8bn (rising to £27bn by 2015 and £49.9bn by 2050).57DE7179, 399974A profound impact on the health of the populationObesity is responsible for more than 9,000 premature deaths each year in England, reduces life expectancy on average by nine years, and is a major risk factor in wide range of serious health problems including Type 2 diabetes (5 x), cancer (3 x the risk of colon cancer), and heart disease (2.5 x).57DE7179, 399978Modelling suggests the majority of UK population may be obese by 2050The prevalence of obesity in the UK more than doubled in the 25 years to 2007. In England, nearly a quarter of adults and about 10% of children were obese in 2007, with a further 20–25% of children overweight. The Foresight report extrapolated that 40% of Britons might be being obese by 2025, with Britain being a mainly obese society by 2050.1198CE71, 399980What costs should be included in the financial analysis?What cost factors should be included in the assessment of the overall financial impact of obesity on the UK economy?8FFB597, 399984Inequality of impactAlthough obesity occurs across all population groups, it impacts disproportionately on the socially and economically disadvantaged and some ethnic minorities. [8]57DE7179

Citerank: (7) 371756How to estimate the costs?What methods can be used to estimate the financial costs of obesity?8FFB597, 371759Prevalence-based estimationsIdentify the prevalence of diseases incurred by obese individuals, the proportion of these diseases attributable to obesity (population attributable risk, or PAR), and their associated costs (direct costs attributable to obesity = PAR x average medical expenditure among all cases).959C6EF, 371766Incidence-based estimationsIncidence-based estimations follow individuals in a study population, record their healthcare expenses over time, and compare the expenses of obese individuals with those of their normal-weight counterparts.959C6EF, 399980What costs should be included in the financial analysis?What cost factors should be included in the assessment of the overall financial impact of obesity on the UK economy?8FFB597, 400005How to estimate the costs?What methods can be used to estimate the financial costs of obesity?8FFB597, 400023Prevalence-based estimationsIdentify the prevalence of diseases incurred by obese individuals, the proportion of these diseases attributable to obesity (population attributable risk, or PAR), and their associated costs (direct costs attributable to obesity = PAR x average medical expenditure among all cases).959C6EF, 400024Incidence-based estimationsIncidence-based estimations follow individuals in a study population, record their healthcare expenses over time, and compare the expenses of obese individuals with those of their normal-weight counterparts.959C6EF

Although cost-of-illness analyses are common for many diseases, such analyses have proven challenging for obesity. Treatment for obesity itself with either medical or surgical therapies is rare, thus the costs associated with obesity are largely those that come from treating diseases linked to obesity, such as diabetes and cardiovascular disease. The constantly expanding list of medical conditions associated with obesity has made it difficult to accurately estimate the cost of obesity. Methodological issues also complicate estimation of obesity-related costs.

This article briefly describes the strengths and limitations of prevalence- and incidence-based methods for estimating obesity’s cost.