Elsevier

The Lancet

Volume 378, Issue 9793, 27 August–2 September 2011, Pages 815-825
The Lancet

Series
Health and economic burden of the projected obesity trends in the USA and the UK

https://doi.org/10.1016/S0140-6736(11)60814-3Get rights and content

Summary

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.

Section snippets

Threat to population health

Increased prevalence of overweight and obesity is a worldwide health concern.1 In a systemic analysis of epidemiological studies from 199 countries,1 1·46 billion adults worldwide were estimated to be overweight in 2008, and of these 502 million were obese. Despite signs of stabilisation in some populations,2, 3 the effects of consistently high prevalence of obesity on population health are far-reaching; societies are burdened by premature mortality, morbidity associated with many chronic

Health burden from rising obesity

The health burden from obesity is largely driven by an increased risk of type 2 diabetes, cardiovascular diseases, and several forms of cancer. For instance, every additional 5 kg/m2 in BMI increases a man's risk of oesophageal cancer by 52% and for colon cancer by 24%, and in women, endometrial cancer by 59%, gall bladder cancer by 59%, and postmenopausal breast cancer by 12% (the association is strongest in women in the Asia–Pacific region).8 Excess bodyweight also contributes to non-fatal

Economic cost of rising obesity

The many chronic and acute health disorders associated with excess bodyweight burden a society not only by negatively affecting the health-related quality of life12, 13 of its people but also by incurring substantial costs to the individuals affected and to society, notably from increased health-care costs and lost productivity.

The medical costs of obesity represent the monetary value of health-care resources devoted to managing obesity-related disorders, including the costs incurred by excess

BMI trends

We analysed two nationally representative surveys to obtain trends in BMI: the National Health and Nutrition Examination Survey (NHANES)27 from the USA and the Healthy Survey for England (HSE)28 from the UK. Both surveys contain objectively measured weight and height data (table 1 and panel). Separately for the two countries, a set of two projections were made to provide a probable range of the outlook of growth in obesity prevalence within populations in the next 20 years. The historic trend

Loss of productivity

The economic costs from the excess morbidity and mortality attributable to obesity-related diseases go beyond health-care costs alone, perhaps most notable are the consequent losses in productivity. The shortage of consistent and high-quality data precludes cross-country comparisons. We explored the size of this indirect cost burden for the USA alone in the context of the health-care costs projected by our model. After incorporation of estimates by Finkelstein and colleagues43 of the

Discussion

In this report, by drawing similar statistics from the USA and the UK into the same modelling structure, we have had the opportunity to describe how the seemingly similar obesity epidemic unfolds in two populations. In the years 2010–30, the continuing rise in obesity was projected to add a combined 6–8·5 million incident cases of diabetes, 5·6–7·3 million incident cardiovascular diseases, and more than half a million new cancers in the USA and the UK. In addition to compromising the

References (78)

  • B Rokholm et al.

    The levelling off of the obesity epidemic since the year 1999—a review of evidence and perspectives

    Obes Rev

    (2010)
  • MS Nichols et al.

    Decreasing trends in overweight and obesity among an Australian population of preschool children

    Int J Obes (Lond)

    (2011)
  • D Withrow et al.

    The economic burden of obesity worldwide: a systematic review of the direct costs of obesity

    Obes Rev

    (2011)
  • KL Thorpe et al.

    The impact of obesity on rising medical spending

    Health Aff (Millwood)

    (2004)
  • Y Wang et al.

    Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic

    Obesity (Silver Spring)

    (2008)
  • Franco Sassi

    Obesity and the economics of prevention: fit not fat

    (2010)
  • DP Guh et al.

    The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis

    BMC Public Health

    (2009)
  • KJ Stothard et al.

    Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis

    JAMA

    (2009)
  • SJ Olshansky et al.

    A potential decline in life expectancy in the United States in the 21st century

    N Engl J Med

    (2005)
  • P Muennig et al.

    Gender and the burden of disease attributable to obesity

    Am J Public Health

    (2006)
  • A Anandacoomarasamy et al.

    Influence of BMI on health-related quality of life: comparison between an obese adult cohort and age-matched population norms

    Obesity (Silver Spring)

    (2009)
  • EA Finkelstein et al.

    Annual medical spending attributable to obesity: payer-and service-specific estimates

    Health Aff (Millwood)

    (2009)
  • EA Finkelstein et al.

    State-level estimates of annual medical expenditures attributable to obesity

    Obes Res

    (2004)
  • EA Finkelstein et al.

    National medical spending attributable to overweight and obesity: how much, and who's paying?

    Health Aff (Millwood)

    (2003)
  • E Lévy et al.

    The economic cost of obesity: the French situation

    Int J Obes Relat Metab Disord

    (1995)
  • JC Seidell

    The impact of obesity on health status: some implications for health care costs

    Int J Obes Relat Metab Disord

    (1995)
  • L Segal et al.

    The cost of obesity: the Australian perspective

    Pharmacoeconomics

    (1994)
  • Tackling obesity in England. Appendix 6: estimating the cost of obesity in England

    (2001)
  • J Fry et al.

    The prevalence and costs of obesity in the EU

    Proc Nutr Soc

    (2005)
  • P Kopelman et al.

    Executive summary: Foresight ‘Tackling Obesities: Future Choices’ project

    Obes Rev

    (2007)
  • JG Trogdon et al.

    Indirect costs of obesity: a review of the current literature

    Obes Rev

    (2008)
  • BM Popkin et al.

    Measuring the full economic costs of diet, physical activity and obesity-related chronic diseases

    Obes Rev

    (2006)
  • EA Finkelstein et al.

    The costs of obesity in the workplace

    J Occup Environ Med

    (2010)
  • K Narbro et al.

    Economic consequences of sick-leave and early retirement in obese Swedish women

    Int J Obes Relat Metab Disord

    (1996)
  • National health and nutrition examination survey

  • Health Survey for England

  • US population projections

  • National projections

  • Incidence and prevalence: 2006 chart book on cardiovascular and lung diseases

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