By Anna Shlachter, MS, RD, LDN
September 19th, 2011
This part of the Lancet reviews goes into detail about the economic burden of obesity. We’ve already seen some of the implications but it is projected that medical costs will increase costs by $48-66 billion/year in the USA and by 1.9-2 billion/year in the UK by 2030.
• The obesity epidemic affects both high and middle to low income countries, which will cause stress on many health systems if the trend continues.
• The health conditions also continue to increase as obesity rises. There is expanding evidence that excess body weight is linked to many additional disorders. This spans from newborn to elderly.
• The cost of treatment for fatal and non-fatal death will increase as the number of overweight and obese utilizes treatments. It is estimated that obese individuals has medical costs 30% higher than normal weight individuals. In addition there will be costs associated with productivity (loss of time at work, ability to do jobs, etc).
• Combined with the shift in age structure (baby boomers) projections suggest that there will be 65 million more obese adults in the US in 2030 than in 2010 (and 24 million of whom would be older than 60 years). In the UK it is projected that up to 11 million more would be obese= (3.3 million would be older than 60 years) in 2030.
• The population’s healthy life span will be threatened. Estimated trends would lead to a present loss of 2.2-6.3 million quality-adjusted life years in the UK and 24.5-48.2 million in the USA in the next 20 years.
• Healthcare costs are sure to increase but would a decrease in obesity lead to net cost savings? The issue is one of debate about calculating costs related to obesity. However, we do know that obese individual have higher healthcare costs.
These estimations overall appear to be well calculated. These costs are startling, although not surprising! The article is full of figures if you’re a numbers person.
Tags: childhood obseity, Lancet
By Anna Shlachter, MS, RD, LDN
September 6th, 2011
The Lancet has created a series of articles, intended to state the case for action on obesity. The first article reviews the aspect of global drivers and local environments. The UN and its agencies will be meeting in September 2011 to discuss non-communicable diseases (NCDs) as it affects population health and development to help solve the obesity challenge.
Below are highlights from the article. We as health professionals already know many of these. I think the approach of looking at obesity in the large picture rather than pieces is long overdue. There have been many “smaller scale strategies” and some of those have been successful in targeted areas. I think the approach of looking at obesity in the large picture rather than pieces is long overdue. What does this really mean though?
We’ve all seen the numbers and generally are aware of the history of obesity. Obesity began in most high income countries in the 1970-80’s, but now most middle and low income countries also have obesity. Three years ago, in 2008, it was estimated that 1.46 million adults globally were overweight and 502 million were obese. Children were estimated at 170 million as overweight or obese. Other trends within obesity are prevalent as well, but these numbers tell the story.
A Hoad, Somerford and Katzenellenbogen article (Aust NZ J Public Health) drives home that obesity has overtaken tobacco as the largest preventable cause of disease burden in some regions.
What are some key indicators in this report?
- Economic Effects
- Sufficient wealth-this has been an enabler for obesity. This however, is not always indicative as shown in the Pacific Island nations and others.
- Some countries are faced with a substantial burden of undernutrition also has an emerging burden of overnurition and related diseases to both forms of malnutrition.
- Obesity is the result of people responding to the obesogenic environment and the obesogenic environments arise because governments and business are responding the economic and politic environments.
- Drivers of the obesity epidemic
- Several studies have shown that technological changes have created cheaper and more available food calories and have driven forces towards overconsumption.
- The “built environment” Changes in our overall habits- less physical activity (driving instead of walking) as well as increased of the food supply starting in the 70’s. Interestingly enough if everyone was following the fruit and vegetable recommendations of the dietary guidelines, there would not be enough fruits and vegetables for everyone. What does this say about the oversupply of food?
- Cultural preferences such as (body size) can have a significant effect in different regions.
- Marketing-On the marketing question-Is the market failing children”? You decide
- Genetics- an article by Bray GA states genetics loads the guns but the environment pulls the trigger.
- Approaches and implications to address obesity
- The figure below shows a framework to categorize determinants and solutions of obesity.
- Sustainability and affordability remain to challenges for programs.
- The major strategies available to directly affect behaviors aim to increase motivation to make healthy choices and include social marketing health education and promotion programs.
- Realistically policy interventions can be directed at the environment (rather than the individual).
- The article suggests the solution to obesity should be developed on a global level.
Stay tuned for reviews of the next articles in the series.
Tags: childhood obesity, Lancet
