A $4 trillion disease

A new report estimated the economic impact of obesity if current trends continue. The results are mind boggling.

Since 1975, obesity rates have been rising around the world, including among children. No country has reversed the trend, which is now growing fastest in low- and middle-income regions.

I wrote about what that means in terms of costs to society in a new piece for Stat, an excellent health news site out of the Boston Globe. The story focuses on a new report from the World Obesity Federation, the only group focused only on analyzing worldwide obesity trends. They drew on data from 161 countries to project both obesity prevalence and its global economic impact into the future. Here’s the main finding, in Stat:

Over half the world’s population will be either overweight or have obesity by 2035, the report projected, while the economic impact of a high BMI could reach $4.32 trillion annually, if current trends continue and policy inertia around the disease remains in place.

That equates to roughly 3 percent of global GDP — about as much as the economy grows in a year or the same impact as the Covid-19 pandemic in 2020, the report authors said.

There are few recent papers out there that bring together truly global obesity cost estimates in this way. But the figures square with another 2019 report, from the OECD, which looked at data from just 52 countries. They also concluded that excess weight and obesity will take a 3 percent chunk out of global GDP.

Numbers this big are difficult to wrap the brain around. So what do they mean at a human scale? They mean obesity is both driving up medical costs and hindering productivity. People are increasingly seeking healthcare for the myriad diseases related to obesity, such as type-2 diabetes and high blood-pressure, not able to work or perform on the job, and dying young. Notably, the estimates don’t take into account the cost of weight stigma — a key reason people, especially women, both receive poor medical care and are overlooked for jobs and promotions.

It’s important to take a step back to remember how we got here. As countries industrialize, and access to nutrition and healthcare improves, average body size, including weight, grows. But we got too good at feeding ourselves. It wasn’t too long ago that underweight and malnutrition were common scourges hampering health and productivity in rich countries. While mostly eliminated in places like the US, where 40 percent of adults have obesity, undernutrition problems now coexist alongside the rapidly rising obesity prevalence in low- and middle-income countries. In these settings, more than 80 percent of premature deaths are caused by chronic diseases, including obesity.

Yet, despite the human and economic toll, for a variety of reasons, obesity still hasn’t gained the global policy traction it deserves. We are having conversations that sound like the equivalent of the “balanced” climate discussion we once had, where both sides of the issue were given equal weight. On the one hand, people are blamed for their body size and their lack of will power to control what they eat. On the other, there’s a growing recognition that our physiology is meeting a food- and built-environment we weren’t equipped to handle — and it’s those external drivers that need urgent addressing. As said Johanna Ralston, CEO of the World Obesity Federation, told me for Stat, “Policies don't often change until there's an existential threat.” Perhaps the threat isn’t yet existential enough — but if the new report authors are right, it may well be soon.

You can read the whole story in Stat here.