A new report on
obesity from the Organisation for Economic Co-operation and Development (OECD) makes for grim reading; it details that even just being overweight will slash almost 3 years from life expectancy, on average, with this figure rising to 4 years in the United States.
A decade ago, across the 36 nations in the OECD, on average one in five individuals was obese. That figure now stands at one in four, meaning an additional 50 million people live with obesity. And three of five people living in wealthy nations are considered overweight.
In some countries the statistics are even worse. In the UK, for example, two in three people are overweight and one in three is obese. And in the United States, as
figures revealed last month, almost 40% of adults and nearly 20% of kids are obese.
In this, its first report on obesity for 10 years, the OECD stresses how nations can reap economic benefits, as well as public health gains, from investing in effective strategies to combat rising obesity rates.
"Policies aimed at reforming the obesogenic environment are the most important, and they are an excellent investment," Michele Cecchini, lead economist for public health at OECD, told a London press briefing held yesterday to launch the report and to coincide with World Obesity Day on October 11.
"Since our initial report a decade ago, we have made quite a lot of progress — certainly in terms of awareness [about obesity], and certainly in terms of government policies and awareness of industry," added Francesca Colombo, head of the Health Division at the OECD.
"But what we have done is not enough. Overweight and obesity take a heavy toll on the economy. It's really quite a striking picture," she emphasized.
"And childhood and morbid obesity have gone from a rare event to a common occurrence. Obesity now poses an alarming burden on individuals, societies, and economies in OECD countries and beyond," the report concludes.
Obesity Will Reduce Economic Growth; Can Physicians Help?
In the
250-page document entitled, "The Heavy Burden of Obesity: The Economics of Prevention," the OECD predicts how obesity and its related health complications will reduce annual economic growth in its
member nations, which include the United States, UK, Belgium, France, Germany, Italy, Portugal, Spain, Chile, and Mexico.
On average, 50% of people have an unhealthy diet, 40% of waking time is spent in sedentary activities, one in three people don't do enough physical activity, and two in five don't eat enough fruit and vegetables.
As a result, unless the tide is turned, over the next 30 years nearly 60% of all new diabetes cases will be caused by overweight, as well as 18%, 11%, and 8% of all cases of cardiovascular disease, dementia, and cancer, respectively.
This will result in 462 million new cases of cardiovascular disease and 212 million cases of diabetes.
OECD countries will therefore spend, on average, $209 per person annually on treating high body mass index and its related conditions.
The United States, Germany, and the Netherlands will spend the most on obesity, at $645, $411, and $352 per head respectively.
For OECD countries on average, this equates to 8.4% of total health spending, although this is highly variable across nations.
The United States alone will spend nearly 14% of its health budget on obesity and overweight, for example.
Asked by
Medscape Medical News at the press briefing what role physicians and other healthcare workers can play, Jason Halford, PhD, of the University of Liverpool, UK, and chair of the European Association for the Study of Obesity, said: "By and large, physicians believe their patients are not motivated or interested [in losing weight]. The doctors think nothing seems to work, and the patient takes the blame."
And Cecchini said healthcare professionals need more man hours and motivation to start to enact change.
"Doctors, especially general practitioners, don't have time to spend on counseling [for weight reduction] and we don't give them the right incentives," he said.
There was overall agreement that labeling obesity as a disease can only help in this regard, although Halford noted that "it hasn't necessarily driven policy change yet."
"There is bias in the health system and huge provider bias against obesity," he asserted.
Societal Costs: Every $1 Spent Tackling Obesity Will Save $6
The spiraling rate of obesity around the world is primarily "a response to obesogenic environments," Johanna Ralston, chief executive of the World Obesity Federation, told the assembled press in London.
Cecchini stressed that it is only with a range of policies — such as regulation of advertising, food and menu labeling, mass media campaigns, prescription of physical activity, mobile apps, school-based programs and workplace wellness schemes — enacted together that the needle will really start to move.
"Every dollar spent on preventing obesity generates an economic return of up to six dollars, making prevention interventions an excellent investment," said Cecchini.
"All of these interventions could pay for themselves," he stressed
"Properly implemented policies do make a difference. We know what works but we are not implementing it to the extent that it makes a difference," said Colombo.
For example, cutting the calorie content in fattening foods such as potato chips (crisps) and candy by 20% would avoid more than 1 million cases of chronic disease per year.
However, "Any one thing is not the answer. You've got to do a lot. But if you start doing it, you will see changes," Halford emphasized.
"But the good news is that there is momentum, and growing awareness," said Columbo.
"We Know What Works...The Devil Is in the Detail"
To show that there is hope if governments and other stakeholders take action, the experts gave examples of policies that are working well, while nevertheless stressing the tremendous amount of work that still remains to be done.
Among the most effective initiatives for fighting obesity is regulation of advertising of unhealthy food, with more than $5 in return investment for each $1 spent, the OECD said.
Almost as effective are food labeling initiatives and efforts to make workers less sedentary.
"When it comes to ticking boxes" enacting policies, "the devil is in the detail," Cecchini emphasized.
"How is the policy designed and implemented? There are large gaps. For example, only a tiny minority of countries makes front-of-label packaging regarding nutrients compulsory," he noted.
Making such policies compulsory is deemed essential for effecting real change, said Corrina Hawkes, direct of the Centre for Food Policy, City, University of London, UK.
Also essential, she added, is action "in all countries," otherwise the five to six major multinational companies that produce most processed food worldwide will just seek other markets, as they did with tobacco products, she noted.
She believes "regional collaboration" is best; for example, the whole of Latin America working together, or Europe, or Asia. "Global is too big," she said.
The experts also emphasized how important the targeting of childhood overweight and obesity will be for the bigger picture, and for the future.
Children with obesity are over five times more likely to have obesity as adults, with all the attendant problems.
Conversely, healthy weight children are 13% more likely to report good school performance.
And even though the outgoing chief medical officer in the UK has just this week
called for more concerted action on
childhood obesity, Ralston said yesterday that the strategy in the UK, including its "Atlas of Childhood Obesity," is one of the best so far in the world and "is to be emulated."
A Long Way to Go but Is There Is Light at the End of the Tunnel?
Over 46 countries in the world now regulate the marketing of unhealthy foods to children and 59 countries have implemented taxes on sugar-sweetened beverages.
But the majority of that regulation of advertising to children "is still focused on traditional old media," said Cecchini, and "new media" — which is increasingly what children consume — is not being regulated for the most part, although he singled out South Korea and the Canadian province of Quebec for their efforts in this area.
Meanwhile, Columbo singled out Chile, Mexico, and Finland for praise on food labeling, "which has to be easy to understand," she explained.
And Chile's Ministry of Agriculture works with a federation of street vendors to provide access to healthy foods in underserved areas and disseminate information on healthy diets.
In 2008, the European Union Council of Agriculture introduced a program to provide free fruit and vegetables to school children. A milk program was added in 2017.
And in the United States, the Department of Agriculture ran a Healthy Incentives Pilot program in 2011 and 2012 to increase the consumption of fruit, vegetables, and other healthy food among people who rely on a federal subsidy, known as the Supplemental Nutrition Assistance Program (SNAP).
People received 30 cents back for every $1 they spent on selected fruit and vegetables, and participants consumed 26% more fruit and vegetables than those who had SNAP benefits but were not given the incentive to buy produce.
Meanwhile, examples of places that have tried to make it easier for people to exercise include an Austrian program providing free yoga, Pilates, and fitness classes to people of all ages.
And cities such as Copenhagen, London, Amsterdam, Paris, Vienna, and New York have dedicated cycle lanes and bike-sharing programs.
Singapore has already banned consumption of anything other than water on public transport, and various other countries have some restrictions, Cecchini said.
The Japanese government gives prizes each year for employers that make work environments healthier, and some organizations in the United States and South Africa are advocating the use of standing desks as standard for employees.
Each action in and of itself only has a small impact, but it is the combination of them that will make the difference, said Columbo.
"There is no room for complacency. We hope next time we are here [in another decade], we will be able to show a decrease in obesity rates," she concluded.
The speakers have reported no relevant financial relationships.
https://www.medscape.com/viewarticle/919771#vp_1
