The Health Quality of Older Americans
Obesity in OECD Countries:Trends, Economic Consequences and Possible Policy Initiatives
A Conversation with Berglind Ásgeirsdóttir, OECD Deputy Secretary / News Release
January 12, 2005
AARP Global Aging Program Idea Exchange Series
Washington, D.C.
In many OECD countries, the growth in obesity rates among children and adults is rapidly becoming a major public health concern. In the US, where more than 3 out of 10 adults are now obese, a recent study estimated that the cost related to obesity now exceeds the cost related to smoking for a set of chronic health problems (including asthma, diabetes and others). These, the opening comments from Deputy Secretary-General Berglind Ásgeirsdóttir of the OECD, highlight a major challenge to the physical and economic health of nations.
According to Deputy Secretary-General Ásgeirsdóttir, the 2004 edition of OECD Health Data (to be released in June 2005) highlights the trend rise in adult obesity rates over the past two decades. Although obesity rates have risen in nearly all OECD countries, they seem to be particularly high in certain English-speaking countries: For example, the US is “leading the way”, with obesity rates among adults now exceeding 30 percent; and in the United Kingdom, obesity rates among adults have tripled, up from 7 percent in 1980 to 22 percent in 2002.
In continental European countries, obesity rates appear to be significantly lower. However, OECD estimates of obesity rates in continental Europe are based on self-reported data, which is not the case for the US, Australia and the UK. Many studies in different countries have shown that self-reported data on height and weight are not as reliable as actual measures due to the fact that some people tend to over-estimate their height, while others tend to under-estimate their weight. One example, highlighted by Deputy Secretary-General Ásgeirsdóttir, is Germany where the obesity rate among adults was only 11.5 percent in 1999 according to self-reported data but, based on the actual measurement of height and weight; it stood at 20 percent. In sum, the estimates of obesity rates in many OECD countries considerably under-estimate the true prevalence of obesity because of reporting biases.
Deputy Secretary-General Ásgeirsdóttir said that if we look at global estimates, the number of obese adults has reached 300 million. Overweight and obese persons account for 1 billion of the worlds population. About 10 percent or 155 million young people aged 5-17 years were overweight in 2000.
Obesity is a known risk factor for many chronic diseases, including diabetes, hypertension, cardiovascular diseases, respiratory problems/asthma and musculoskeletal diseases. These diseases cause a tremendous amount of personal suffering and have significant economic costs. For example, healthcare costs in the United States that can be attributed to obesity were recently estimated at US$75 billion per year. This represents about 5 percent of total health spending in the US or 0.7 percent of GDP. In other countries (e.g., Canada, Australia and New Zealand), the cost of obesity is estimated to account for 2 to 3 percent of total health spending, and these costs are rising. One worrying feature is that there is a time lag of several years between the onset of obesity and related health problems, suggesting that the steep rise in obesity over the past two decades will mean higher healthcare costs in the future.
Deputy Secretary-General Ásgeirsdóttir remarked that the World Health Organization’s Global Strategy on Diet, Physical Activity, and Health is an excellent first step towards a long-term commitment on the part of international organisations, governments, industry, the medical community, and NGOs to work together to curtail the obesity epidemic.
She informed the Idea Exchange participants that OECD have not carried out yet any rigorous study on the cost-effectiveness of different measures to prevent or treat obesity and its health consequences. Therefore, the OECD does not have a “global strategy” to tackle the epidemic of obesity. Some of the possible instruments for governments include public education campaigns for healthy diets and physical activities. Promoting health in schools with physical activity programs could also be encouraged.
Deputy Secretary-General Ásgeirsdóttir said that NGOs must also actively engage with all stakeholders to encourage concrete actions and lending their resources and experience in communities and countries in order to fight obesity.
She also remarked that Industry must improve and simplify content labelling on all foods. They should aim at reducing portion sizes, reduce salt and sugar levels in the products. Food retailers, the transport sector and many others should help make healthy choices more easily available.
In her concluding statements, Deputy Secretary-General Ásgeirsdóttir, explained that it is not scaremongering to talk about an impending obesity “epidemic” given the relentless rise in obesity rates over the past two decades. The trend is costly both in terms of personal suffering and the associated economic costs. In order to minimise these costs, it is urgent to devote more research to finding cost effective responses to obesity.