“… we now live in a world in which more people are obese than underweight.”
– The Lancet
The Guardian’s Health editor, Sarah Boseley, reported (10 October 2017) that the global cost of obesity-related illness will reach €1.03 trillion euro per annum in less than a decade, unless urgent measures are taken.
Experts are describing global obesity as a health ‘pandemic’ and predict that the on-going health bill will be an enormous burden unless preventative measures are put in place immediately.
The UK’s National Health Service (NHS) chief executive, Simon Stevens, has warned that obesity threatens to bankrupt the NHS since the bill for obesity-related illnesses is set to rise from €16.25 billion to €26.5 billion by 2025.
Obesity and smoking are the two main drivers behind the soaring numbers of cancers, heart attacks, strokes and diabetes worldwide, grouped together officially as non-communicable diseases. They are the biggest killers of the modern world.
The USA faces by far the biggest treatment bill, with a rise from €278.5bn per year in 2014 to €475.5bn in just eight years time, driven by it high cost of medical care. But all countries, including Ireland, are looking at a very steep rise in costs that will be unaffordable for most.
Writing in the Irish Times on April 1, 2016, Paul Cullen drew from a report published in The Lancet, which predicted that within a decade Ireland is set to become the most obese country in Europe, with the UK.
Irish men, the study found, already have the highest body mass index (BMI) – a key measure of overweight – in Europe, while Irish women rank third.
“Almost one-fifth of the world’s obese adults (118 million) live in Ireland and five other high-income English-speaking countries – Australia, Canada, New Zealand, the UK and the US”, Cullen reported.
One-quarter of the world’s severely obese adults live in the same six countries.
By 2025, 37 per cent of Irish women will be obese, just behind 38 per cent in the UK, the study forecasts.
According to the World Obesity Federation (WOF), over the next eight years, obesity treatment will result in the following health expenditure, unless preventative measures are implemented:
USA – €3.6 trillion euro
UK – €203 billion euro
Germany – €334 billion euro
Brazil – €215 billion euro
The World Obesity Federation predicts there will be 2.7 billion overweight and obese adults worldwide by 2025, many of whom are likely to end up needing medical care. That means a third of the global population will be overweight or obese.
Boseley reports that the WOF’s estimates show adult obesity continuing its steady climb. In 2014, a third of men and women in the US were obese (34%). By 2025 that is predicted to be 41%. In the UK, more than a quarter of adults (27%) were obese in 2014 and that will rise to 34% by 2025. Egypt is predicted to go up from 31% to 37% of adults in the same period, while Australia and Mexico will rise from 28% to 34% if nothing changes.
“The annual medical costs of treating the consequences of obesity, such as diabetes and heart disease, is truly alarming,” said Prof Ian Caterson, the president of the federation. “Continual surveillance by WOF has shown how obesity prevalence has risen dramatically over the past 10 years and with an estimated 177 million adults suffering severe obesity by 2025, it is clear that governments need to act now to reduce this burden on their national economies.”
The World Obesity Federation has for the first time costed-in not just cancer, diabetes and heart disease but other harms, including damage to joints which may result in hip and knee replacements and back pain. “That’s why the figures are pretty astonishingly high,” said Tim Lobstein, its policy director. “Some poor countries are already swamped.”
Low income countries have healthcare systems that barely manage to cope with childbirth and infectious diseases, and have neither the money nor staff to deal with the epidemic of chronic illness such as cancer and heart disease that is being fuelled by obesity.
“For middle income countries we are going to see an enormous impact,” said Lobstein. “Countries in the Middle East and Latin America where health services are stretched are going to become highly stretched.” These are the regions where obesity among children and adults has soared in recent years.
But the increasing costs will be a problem for every country in the world. “This is going to be an enormous burden either on the state, the individual or the insurance services which simply won’t be able to cope. How high can an insurance premium go?” said Lobstein.
Sugary drink taxes are an important measure governments can take, said Johanna Ralston, the federation’s CEO. “Right now there is a big focus on sugar-sweetened beverages, which is fantastic. I think as with tobacco, you want to find something that is tangible that governments can do and is measurable. But it is not enough.”
The experts say spending more on treating and preventing obesity will save countries many millions in the long term. Bariatric surgery to reduce the size of the stomach is very effective in reducing appetite, and studies have shown it can reverse type 2 diabetes, dramatically improving people’s chances of a healthy life. But there is not enough treatment available, said Ralston.
“One of the reasons is that the consensus that obesity is a disease is only really emerging now,” she said. “That will also help with the stigma. Bariatric surgery is a fantastic intervention but realistically it will only be for a smallish proportion of the population. It has to be offered in concert with other forms of weight management. Every single individual has to be offered multiple interventions.”
The Irish Times article may be accessed by clicking here.