News Release

65 million more obese adults in the USA and 11 million more in the UK by 2030 if historic trends continue

Peer-Reviewed Publication

The Lancet_DELETED

The second paper in The Lancet Obesity Series analyses obesity trends in the USA and UK, and their impact on prevalence of diseases and healthcare spending. The paper is by Dr Y Claire Wang, Mailman School of Public Health, Columbia University, New York, NY, USA, and Professor Klim McPherson, New College, University of Oxford, UK, and colleagues.

The authors say that the many chronic and acute health disorders associated with excess bodyweight burden a society—not only by negatively affecting the health-related quality of life but also by incurring costs to the individuals affected and society as a whole, notably from increased health-care costs and lost productivity. The US and the UK have the highest obesity rates among OECD countries, a trend set to continue in the coming decades. There are currently 99 million obese individuals in the USA and 15 million in the UK. Prevalence differs according to sex and ethnicity. In the USA around a quarter of all men are obese (regardless of ethnicity). Almost half of black American women (46%) are obese, compared with a third of Hispanic women and 30% of white women. In the UK, the proportion of obese white men (19%) is slightly higher than black men (17%) and much higher than Asian men (11%). A third of black UK women are obese, compared with 1 in 5 white women and 1 in 6 Asian women.

The authors looked at several possible scenarios in their modelling, using the UK Foresight Group's methodology*. In the first, they used US data from 1988 to 2008 and UK data from 1993 to 2008 to construct historic trends. Continuation of these trends to 2030 would see US obesity prevalence rise from 32% (2008) to around 50% (2030) for men, and from 35% to between 45% and 52% for women. In the UK, male obesity prevalence would increase from 26% to between 41—48%, and female from 26% to 35—43%. This would mean an estimated 65 million additional obese adults in the USA in 2030 (raising the total to 164 million who are obese), while in the UK an extra 11 million would be obese (giving a total of 26 million obese people in the UK). This would increase costs of treating obesity-related diseases by $66 billion per year in the US by 2030 (a 2.6% increase in overall health spending).In the UK, the increased cost would be £2 billion per year, increasing overall health spending by 2%. In the USA, spending specifically on obesity-related causes would increase by 13-16% per year across the 2 decades, with one quarter (or 4% in that 16%) due to population ageing; in the UK, the spending on obesity-related health would increase more rapidly due to its older population (average age of men in USA is 36 years but in UK it is 38 years). Thus in the UK, obesity health spending would rise 25% per year, with two fifths (or 10%) within that due to ageing only.

The above scenario would mean 7.8 million extra cases of diabetes in the USA by 2030, along with 6.8 million cases of coronary heart disease and stroke, and 539 000 extra cancer cases. In the UK, an extra 668 000 cases of diabetes, 461 000 of coronary heart disease, and 130 000 cancer cases would result.

But the report stresses while no action would have the catastrophic consequences described above, a population level decrease in BMI by 1% (representing just 0.9kg for the average 90kg adult) would avoid some 179 000 to 202 000 cases of diabetes, 120 000 cases of heart disease and stroke, and 32000 cancer cases in the UK. In the USA, such action would prevent 2.05 to 2.4 million diabetes cases, 1.4 to 1.7 million cases of heart disease and stroke, and 73 000 to 127 000 cancer cases. The authors say that whether or not the US and UK have turned a corner or plateaued will not be clear until survey results over the next few years provide additional data points, since population weight changes are slow to manifest.

A contentious issue is also discussed in this paper: the suggestion that obese people die earlier, thus saving the likely expected social and health-care costs if that person survives to old age. But the authors conclude: "Without a doubt, health-care expenditure is high for elderly people, but these costs should not be used to justify the cost-savings of dying younger, or to suggest that obesity prevention has no benefit."

###

Dr Y Claire Wang, Mailman School of Public Health, Columbia University, New York, NY, USA. T) +1 212 305 7359 E) ycw2102@columbia.edu

Professor Klim McPherson, New College, University of Oxford, UK. T) +44 (0) 1865 558743 / +44 (0) 7711 335993 E) klim.mcpherson@obs-gyn.ox.ac.uk

Note to editors: *Initiated by the UK Government's Chief Scientific Advisor, Foresight is a program of work anticipating the future consequences of changing phenomena affecting the UK population. In 2007 Foresight produced a report for the UK Government's Office of Science on strategies for tacking rising obesity prevalence.


Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.