Rose-Marie Boylan
Dietitian, health & consumer economics/policy researcher health equity
Global Burden of Illness of Obesity
The global economic impact and disease burden of obesity is roughly estimated at $2.0 trillion. That is about 2.8 percent of the global GDP. That is a lot of money spent on something preventable. (1, 2, 3, 4, 5, 6, 7)
This is almost equivalent to the global economic impact of smoking and/or armed violence, war, and terrorism. Armed conflict carries an economic burden of $2.1 Trillion. The economic consequence of tobacco use is $2.1 Trillion. This has huge personal, social, and economic costs. Obesity is responsible for around 5 percent of all global deaths. (1, 2, 3, 4, 5, 6, 7).
The good news is that 80% or more of all healthcare spending in the U.S. is tied to the treatment of conditions rooted in poor lifestyle choices. Chronic diseases and conditions like hypertension, heart disease, stroke, type 2 diabetes, obesity, osteoporosis, multiple types of cancer—are among the most common, costly and preventable of all health conditions. (1)
Stress has created an epidemic of eating, smoking, drugging and drinking our worries, emotions & loneliness away and transmuting it into illness and death. We now take drugs without considering prevention and/or modifying our lifestyle choices.
Type 2 diabetes alone is a looming global pandemic with crippling economic and mortality consequences for economies and populations alike. Type 2 diabetes is caused by innefficient use of insulin in the body due to excess fat and adipose tissue in the body. Being overweight or obese means your body mass index is over 25 according to the World Health Organization standards.
About 2%-7% of all healthcare spending in developed countries is related to obesity. That figure goes up to 20% by some estimates when we look at the diseases associated with obesity.
Evidence is suggesting that the productivity of employees is being marginalized by obesity, compromising the ability for companies to compete.
The United States had the highest rate of obesity within the OECD grouping of large trading economies. ... A second study from the National Center for Health Statistics at the CDC showed that 39.6% of US adults age 20 and older were obese as of 2015-2016 (37.9% for men and 41.1% for women). The increase in chronic diseases (non-communicable diseases NCDs) and associated healthcare spending in the United States, Canada and the West has reached unsustainable proportions. The problem of obesity is not being addressed. It has not been addressed for over 30 years. As children we would have nutrition tours and milk programs to encourage eating all 4 food groups. In Canada 1 in 6 children according to UNICEF do not have access to food security.
1.9 billion adults aged 18 years and older were overweight. Of these over 650 million adults were obese.
Direct and Indirect Costs of Obesity
Two types of costs are associated with the treatment of obesity and obesity-related conditions:
Direct costs are those that result from outpatient and inpatient health services (including surgery), laboratory and radiological tests, and drug therapy.
Indirect costs, which have been defined as “resources forgone as a result of a health condition,”(2) fall into various categories:
Value of lost work. Days missed from work are a cost to both employees (in lost wages) and employers (in work not completed). Obese employees miss more days from work due to short-term absences, long-term disability, and premature death than nonobese employees. (3) They may also work at less than full capacity (also known as presenteeism).
Insurance. Employers pay higher life insurance premiums and pay out more for workers’ compensation for employees who are obese than for employees who are not. (4)
Wages. Some studies have shown that obesity is associated with lower wages and lower household income. (5)
Indirect costs are harder to identify and measure than direct costs.
Obesity Costs Are Rising Overall In one of the earliest analyses, Colditz looked at the direct and indirect costs in the U.S. of six common obesity-related conditions-type 2 diabetes, high blood pressure, cardiovascular disease, gallbladder disease, colon cancer, and postmenopausal breast cancer-and determined what percentage of those costs were due to obesity. He estimated that in 1986, obesity was responsible for 5.5 percent of the direct and indirect costs associated with these common medical conditions, or about $39 billion. (3) Subsequent reports on obesity-related medical spending (direct costs) have charted a steady rise in obesity’s cost over the years, as the epidemic has grown. (6)
One widely-quoted estimate from Finkelstein and colleagues, based on data from the U.S. Medical Expenditure Panel Survey (MEPS), found that obesity was responsible for about 6 percent of medical costs in 1998, or about $42 billion (in 2008 dollars). (7) By 2006, obesity was responsible for closer to 10 percent of medical costs—nearly $86 billion a year. Spending on obesity-related conditions accounted for an estimated 8.5 percent of Medicare spending, 11.8 percent of Medicaid spending, and 12.9 percent of private-payer spending. In the absence of lifestyle medicine interventions, behaviour change practices, mindful eating training for 8 weeks and daily coaching and check-ins, weight loss efforts generally lead to failed outcomes.
For a lifetime I have watched overweight and obese women struggle with their weight. My mother was a chronic dieter and locked the fridge so the smaller people, notably me could not eat the healthy food. As a result of her using the "scarcity principle" regarding healthy foods, I have only craved healthy foods that are low fat, not junk food. This may indicate that food addictions to high fat high sugar foods is programmed into us.
Addressing the underlying emotional comfort issues that food provides as a refuge is likely the only method for changing obesity outcomes.
Victims of violence and/or sexual violence may need the weight to feel safe. Because psychiatry and the DSM was created and endorsed by an 80% male team, they do not understand obesity in women. Issues with food addictions, weight gain or weight loss require treatments which involve western medicine as a consideration, mindfulness as a must and stress-based mindful eating training.
2.1 billion of the world population are obese. That is 30% of the global population.
It was stated before 2020 that up to 20% of the population would fall below the poverty line by 2020 because of an Non Communicable Disease, a chronic illness like obesity. So here we had a Covid pandemic a communicable disease & non-communicable diseases. This makes persons suffering from chronic obesity particularly vulnerable. Poverty and obesity go hand in hand, so do stress, wealth-building and obesity. Not surprising most humans rich or poor have obsessions and addictions to food.
Obesity as an eating disorder: Malnutrition
Obesity is an eating disorder like anorexia nervosa and bulimia nervosa. It is based on constitutional make-up in the nervous system and DNA plays a role as it does in anorexia and bulimia.
The Vedic studies I did supplemented my Western studies as a dietitian because the nutrition studies done in the West never addressed the psychological issues and nervous system issues associated with obesity. For this reason interventions rarely work for permanent weight loss. Research indicated that what one generation eats at one time may impact the DNA up to 7 generations in the future.
Food insecurity in Canada affects 1 in 6 children according to UNICEF, that is one of the worst of all the wealthy nations. Household food insecurity is the inadequate or insecure access to nutritious food due to financial constraints. "Canada ranks 37th out of 41 rich countries in food security." (UNICEF Canada)
Both anorexia nervosa and bulimia nervosa appear to be different than obesity because the organism loses weight while the other one gains it so we see them as separate in terms of treatment protocol. This may be wrong and explains why the problem just keeps getting worse. On the spectrum of emotions and stress arousal in the nervous system, they are similar in terms of approach required to modify unhealthy relationships with food. Feeling powerless with an object is an addiction disorder oftentimes the result of trauma. Food provides immediate comfort based on social conditioning, trauma, anxiety and fear.
Magnitude of Consequence
Obesity is one of the top three global social burdens generated by humans. It is preventable but little is done to teach populations about "Mindful eating". Little is done to address the psycho-physiological factors which lead to food addictions and eating disorders. It is not just about healthy food choices. Our constitutional make-up and the emotions that govern an individual's nervous system play a critical role in whether we will be skinny, overweight and/or obese.
The World Health Organization estimates that 2.8 million global deaths a year are attributable to high BMI on a base of 59 million total global deaths per year. An article in the Economist in October, 2014 discussed research on home economics and obesity discrimination. They stated that being obese is almost the same as not having an undergraduate degree. A paper showed the economic fortunes of Swedish men who enlisted in compulsory military service in the 1980s and 1990s. They show that men who are obese aged 18 grow up to earn 16% less than their peers of a normal weight. Even people who were overweight at 18—that is, with a body-mass index from 25 to 30—see significantly lower wages as an adult.
In many countries the poorest people tend to be the most overweight. One study found that Americans who live in the most poverty-dense counties are those most prone to obesity.
Epidemiology:
"Worldwide obesity has nearly tripled since 1975.
In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese.
39% of adults aged 18 years and over were overweight in 2016, and 13% were obese.
Most of the world's population live in countries where overweight and obesity kills more people than underweight.
41 million children under the age of 5 were overweight or obese in 2016.
Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016.
Obesity is preventable.
In 2016, 39% of adults aged 18 years and over (39% of men and 40% of women) were overweight.
Overall, about 13% of the world’s adult population (11% of men and 15% of women) were obese in 2016.
The worldwide prevalence of obesity nearly tripled between 1975 and 2016." (1, 2, 3, 4, 5, 6, 7, 8).
WHO response Adopted by the World Health Assembly in 2004, the "WHO Global Strategy on Diet, Physical Activity and Health" describes the actions needed to support healthy diets and regular physical activity. The Strategy calls upon all stakeholders to take action at global, regional and local levels to improve diets and physical activity patterns at the population level.
WHO has also developed the "Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020" which aims to achieve the commitments of the UN Political Declaration on Noncommunicable diseases (NCDs) which was endorsed by Heads of State and Government in September 2011.
References
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