In one of the earliest analyses, Colditz looked at the direct and indirect costs in the U. He estimated that in , obesity was responsible for 5. One widely-quoted estimate from Finkelstein and colleagues, based on data from the U. Spending on obesity-related conditions accounted for an estimated 8. Countries with lower obesity rates than the U. Several investigators have evaluated the cost of obesity on an individual level.
Thompson and colleagues concluded that, over the course of a lifetime, per-person costs for obesity were similar to those for smoking. It is possible that a clearer understanding of the cost of obesity will spur larger and more urgent programs to prevent and treat it. While the U. To make true advances, these initiatives should be part of concerted efforts by local and national governmental, health, and nonprofit organizations, food companies, advertisers, and individuals to make healthy weights the norm rather than the exception.
Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. Food Safety Glossary. See the infographic. Watch the Expert Answers video. Listen to the podcast.
Globally, there has been a shift in food consumption patterns towards more energy-dense foods at the same time as significant reduction in physical activity. Overweight and obese people are at significantly higher risk for non-communicable diseases. Obesity has a major impact on national economies by reducing productivity and life expectancy and increasing disability and health care costs.
In , more than 2 billion people worldwide were overweight or obese, and over 70 percent of them lived in low- or middle-income countries. Many low- and middle- income countries face a double burden: a high prevalence of both undernutrition and obesity. On the other hand, the mass effect of accumulating adipose tissue can result in cardiopulmonary disease due to obstructive sleep apnoea, joint disease due to osteoarthritis in addition to the psychological burden and stigma related to obesity.
Overall, obesity is directly related to increased mortality. After adjusting relative risks for ethnicity, socioeconomic background, smoking and alcohol consumption and running extra analyses to tackle possible confounders due to established comorbidities, mortality was reported to have increased by more than one fifth in overweight subjects and by 2- to 3-fold in the obese category.
The study, however, was limited by the fact that the BMI was calculated from self-reported weight and height rather than actual precise measurements.
A prospective cohort study in in Korea examined the association between body weight and overall mortality over year period. Over 80 thousand deaths from any cause in relation to the body-mass index BMI were reviewed and it was found that mortality from any cause had a direct association with BMI, irrespective of smoking status. The mortality was lowest among patients with a BMI in the normal range of Mortality from cardiovascular disease or cancer was higher among the higher BMI group.
Interestingly, their findings support that being on both sides of the extreme whether underweight or overweight increases mortality in both genders. The main causes of premature death in obesity is heart disease related to high blood pressure and Cardiac events. This risk worsens further with BMI greater than Much of the increase in the prevalence of heart attacks and strokes noticed in obesity can be due to high blood pressure, diabetes and abnormal lipid metabolism.
This has been recognised since in a prospective cohort that reviewed more than , female nurses in the their 30s to early 50s who did not have Diabetes 30 years prior to the study. It was noted that the risk of Diabetes surges even with minimal weight gain. There is a direct link between the amount of visceral fat tissue surrounding the intra-abdominal viscera and insulin resistance resulting in major defects in glucose metabolism and high insulin level in the fasting state.
An earlier Swedish prospective study from yielded similar conclusion. Their anthropometric measures including waist circumference were recorded at the age of Then at the age of 66, these measurements were re-examined and correlated to their risk of developing Diabetes.
Those with higher waist circumference had a higher risk of developing Diabetes and the study clearly demonstrated the role of central adiposity, as a metabolic risk factor for Diabetes. Another adverse health effect related to obesity is the risk of Gallstones.
Gallstones are much more prevalent in obese individuals, especially in women with BMI greater than Obesity seems to lead to more than six folds increase in the risk. Obesity is also a recognised risk factor for Non-alcoholic fatty liver disease. In addition, numerous types of cancer are more common in overweight individuals, including breast, gallbladder, ovarian, cervical and endometrial cancers in females and bowel and prostate cancers in males.
This mortality ratio for cancer was lower than for heart attacks, diabetes and gastrointestinal diseases. Increased fat accumulation in the soft tissues around the neck, thorax and trunk exerts adverse effect on the ability of the lungs to expand due to the mechanical restriction of thoracic wall movement and reduced contractility of the diaphragm. This in return reduces lung volumes and results in hypoventilation.
In the erect position, the hypoventilation is partially compensated for. It, however, worsens significantly in the supine position. In addition, obese individuals with obstructive sleep apnoea usually have narrower upper airway passage due to increased fat deposition subcutaneously around the larynx.
The combination of this in addition to mechanical restriction of thoracic wall movement and hypoventilation lead to episodic apnoeic attacks. Obesity at a relatively younger age can lead to increased risk of knee osteoarthritis later in life. The students were assessed for the risk of developing Osteoarhritis with self-reporting symptoms and clinical and radiological evidence. High BMI at young age was directly linked to a higher risk of developing knee osteoarthritis at a later stage.
This signifies that adverse effect of adolescent and early life obesity in the pathogenesis of osteoarthritis. In addition to the adverse outcomes of obesity on health. Obesity also adversely affects the mental and social well-being. Sullivan et al. The study sample included around obese men with BMI greater then Patients with chronic health conditions were set as the reference group.
The obese individuals evidently declared worse overall health status and lack of energy. They suffered with depression which was more prevalent in obese women. Anxiety, low confidence and self-esteem were more common in the obese group. Moreover, the general mental status was poorer than in patients with other chronic diseases. The main contributor to this was lack or reduced physical activity. The effort related to attempting to lose weight and body image issues were significant extra risk factors.
Prejudice in many cultures against obese individuals could be the driving factor for depression, anxiety and low mood. This even manifests in children in their early years of primary school. Obese individuals are discriminated against in both educational and workplace settings. In contrast, in cultures where obesity is not socially defamed this might not be the case. A study in Bangladesh by Asghar et al.
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