Economic impacts of overweight and obesity: current and future estimates for 161 countries.

INTRODUCTION: The scope of the challenge of overweight and obesity (OAO) has not been fully realised globally, in part because much of what is known about the economic impacts of OAO come from high-income countries (HICs) and are not readily comparable due to methodological differences. Our objective is to estimate the current and future national economic impacts of OAO globally. METHODS: We estimated economic impacts of OAO for 161 countries using a cost-of-illness approach. Direct and indirect costs of OAO between 2019 and 2060 were estimated from a societal perspective. We assessed the effect of two hypothetical scenarios of OAO prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS: The economic impact of OAO in 2019 is estimated at 2.19% of global gross domestic product (GDP) ranging on average from US$20 per capita in Africa to US$872 per capita in the Americas and from US$6 in low-income countries to US$1110 in HICs.If current trends continue, by 2060, the economic impacts from OAO are projected to rise to 3.29% of GDP globally. The biggest increase will be concentrated in lower resource countries with total economic costs increasing by fourfold between 2019 and 2060 in HICs, whereas they increase 12-25 times in low and middle-income countries. Reducing projected OAO prevalence by 5% annually from current trends or keeping it at 2019 levels will translate into average annual reductions of US$429 billion or US$2201 billion in costs, respectively, between 2020 and 2060 globally. CONCLUSION: This study provides novel evidence on the economic impact of OAO across different economic and geographic contexts. Our findings highlight the need for concerted and holistic action to address the global rise in OAO prevalence, to avert the significant risks of inaction and achieve the promise of whole-of-society gains in population well-being.

Preventing Non-Communicable Diseases Using Pricing Policies: Lessons for the United States from Global Experiences and Local Pilots

Preventing non-communicable diseases (NCDs) in an effective and sustainable way will require forward-looking policy solutions that can address multiple objectives. This was true pre–COVID-19 and is even more true now. There are already examples from across the globe and within the United States that show how these may be possible. Although there are still many unknowns around how the design, targeting, level, sequencing, integration, and implementation of fiscal policies together can maximize their NCD prevention potential, there is already clear evidence that health taxes and particularly sugar-sweetened beverage (SSB) taxes are cost-effective. Nonetheless, policies alone may not succeed. Political will to prioritize well-being, protections against industry interference, and public buy-in are necessary. If those elements align, pricing policies that consider the context in question can be designed and implemented to achieve several goals around reducing consumption of unhealthy SSBs and foods, narrowing existing nutritional and health disparities, encouraging economic and social development. The US and its local and state jurisdictions should consider these pricing policy issues and their contexts carefully, in collaboration with community partners and researchers, to design multi-duty actions and to be prepared for future windows of opportunities to open for policy passage and implementation.

Obesity Paradox Related to Severe COVID in Diabetes

The "obesity paradox" refers to an association between obesity and better outcomes (contrary to expected worse outcomes) . For example, lower mortality has been observed in diabetes patients with obesity compared to normal/overweight. An analytical cohort of n=5712 patients with diabetes was selected from the RUSH COVID Registry and electronic medical records data, spanning 21 months. Sociodemographic and diabetes characteristics were obtained on or before COVID diagnosis. Severe COVID was defined as fatal or requiring hospitalization. After excluding 23 cases without BMI, univariate and multivariate logistic regression with restricted cubic spline models were conducted to evaluate the association of BMI with severe COVID after adjustment for age, sex, race/ethnicity. The resulting diverse cohort included 37.6% Latino, 37.5% Black, 19.5% White, and 5.3% other;53.7% were women. Type 1 diabetes was identified in n=140, Type 2 diabetes in n=2730, and other/hybrid diabetes in n=2820. After adjustment for sex, age, race/ethnicity, diabetes type, and A1c a U-shaped relationship was observed between BMI and severe COVID with a nadir at BMI=30-45 kg/m2 (see figure) . A similar U-shaped relationship was seen in the association of fatal COVID in British diabetes patients with a nadir at BMI=25-29 kg/m2. The proposed explanation for the "obesity paradox" may be related to unintentional weight loss in diabetes patients with multimorbidity.

Economic impacts of overweight and obesity: current and future estimates for eight countries.

BACKGROUND: Obesity is a growing public health challenge worldwide with significant health and economic impacts. However, much of what is known about the economic impacts of obesity comes from high-income countries and studies are not readily comparable due to methodological differences. Our objective is to demonstrate a method for estimating current and future national economic impacts of obesity and apply it across a sample of heterogeneous contexts globally. METHODS: We estimated economic impacts of overweight and obesity for eight countries using a cost-of-illness approach. Direct and indirect costs of obesity from 2019 to 2060 were estimated from a societal perspective as well as the effect of two hypothetical scenarios of obesity prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS: In per capita terms, costs of obesity in 2019 ranged from US$17 in India to US$940 in Australia. These economic costs are comparable to 1.8% of gross domestic product (GDP) on average across the eight countries, ranging from 0.8% of GDP in India to 2.4% in Saudi Arabia. By 2060, with no significant changes to the status quo, the economic impacts from obesity are projected to grow to 3.6% of GDP on average ranging from 2.4% of GDP in Spain to 4.9% of GDP in Thailand. Reducing obesity prevalence by 5% from projected levels or keeping it at 2019 levels will translate into an average annual reduction of 5.2% and 13.2% in economic costs, respectively, between 2020 and 2060 across the eight countries. CONCLUSION: Our findings demonstrate that the economic impacts of obesity are substantial across countries, irrespective of economic or geographical context and will increase over time if current trends continue. These findings strongly point to the need for advocacy to increase awareness of the societal impacts of obesity, and for policy actions to address the systemic roots of obesity.

Strengthening resistance to the COVID-19 pandemic and fostering future resilience requires concerted action on obesity.

Initial observations showed that people with chronic noncommunicable diseases were at heightened risk of severe COVID-19 and adverse outcomes. Subsequently, data from various countries have revealed obesity as an independent and significant factor, with people who are overweight/have obesity significantly more likely to be hospitalized, require ICU treatment, and to die. Notably, this additional risk applies to younger people relative to the general COVID-19 risk profile. This paper sets out the evidence of greater risk of poor COVID outcomes for people who are overweight/have obesity, indication of reduced treatment and support for obesity self-management where it existed prior to COVID-19, and highlights the dearth of specific guidance and measures to mitigate the impacts of COVID-19 upon people with obesity. We identify the health, social and economic impacts that this specific vulnerability creates relative to COVID-19 outcomes. Reduced national and global pandemic resilience due to high obesity prevalence should spur governments and funders to provide urgent specific protection and support for people with overweight/obesity, and to commission rapid research to identify effective prevention and reduction measures. We set out priorities for action on obesity to begin compensating for years of underfunding and inadequate policy attention in the face of escalating obesity across countries of all income groups and world regions.