Being overweight is not only bad for one’s health – it also costs society a lot of money. Every year, the Belgian government loses at least 4.5 billion euros due to the direct and indirect costs linked to excessive weight and obesity. As with COVID-19, this issue needs to be tackled as a public health concern: the responsibility of both individuals and policymakers.
By Brecht Devleesschauwer
Belgians on the scales
To learn about the health of the Belgian population, the Belgian institute for health Sciensano organizes a large-scale survey every 5 years, where more than 10,000 Belgians fill in a questionnaire about their health status, their lifestyle, and how often they consult a health service (such as a general practitioner or healthcare specialist).
As part of this survey, participants are asked about their weight and height to see if they are within a healthy weight range, calculated using their Body Mass Index (BMI). For example: a person whose height is 160cm and weight is 60kg has a BMI of 23.4 (within the healthy range). Being overweight corresponds to a BMI of ≥ 25, whereas being obese corresponds to a BMI of ≥ 30.
Excessive weight not only carries a steep personal cost in terms of health concerns like cardiovascular disease, cancer, and type 2 diabetes – the issue also weighs heavy on healthcare systems.
Based on the self-reported weight and height of Belgians in 2018, the survey showed that 49% of the adult Belgian population was overweight and 16% was obese, with more overweight men (55%) than women (43%).
Of course, not everyone is entirely honest when putting their weight down on paper. Which is why, in 2018, a nurse made home visits to a part of the previously interviewed Belgians for more accurate measurements. These measurements revealed that the extent of the issue had indeed been underreported, with no less than 55% of adult Belgians being overweight and 21% being obese. Women in particular had been more likely to fill in a weight and height that did not correspond to the objective measurements.
The financial burden of obesity
Excessive weight not only carries a steep personal cost in terms of health concerns like cardiovascular disease, cancer, and type 2 diabetes – the issue also weighs heavy on healthcare systems. Following the 2018 survey, researchers from Sciensano and UGent were able to determine how much tax money the Belgian government spends on the reimbursement of outpatient care, hospital care, and medicines for people with overweight or obesity, by linking the data from the health survey to health insurance data from 2013 to 2017. They calculated the healthcare costs per weight category: underweight, normal weight, overweight, and obese.
In 2018, 55% of adult Belgians were overweight and 21% were obese.
To no surprise, the results showed that Belgians who are overweight or obese suffer from more chronic conditions – and therefore also have higher medical costs – than Belgians in the normal weight category. The added burden is significant, with the Belgian government spending an average of 3.3 billion euros annually on costs linked to excessive weight, representing about 13.5% of annual healthcare costs. High blood pressure alone accounts for about 13% of the relationship between obesity and health expenditure, with the reimbursement of high blood pressure medication being a significant direct government cost.
The hidden costs of excessive weight
Unfortunately the price of these extra kilos doesn’t end with direct expenditure – there are also the indirect costs. The health survey shows that obese employees were absent from work due to illness more often than those in a healthier weight range. By multiplying the number of sick days by the national average daily labor cost, we can see that the expense of this absenteeism is much higher for obese individuals (87% higher) compared to normal-weight individuals. In total, excessive weight indirectly results in an annual average loss of 1.2 billion euros in Belgium.
In Europe, an estimated 70 billion euros is spent every year on healthcare and work absence due to obesity.
Indeed, Belgium is not alone in this struggle: other countries have made similar calculations and come to the same staggering conclusions. The Organisation for Economic Co-operation and Development (OECD) calculated that the average healthcare expenditure for obese people is 25% higher than for people of normal weight. In Europe, an estimated 70 billion euros is spent every year on healthcare and work absence due to obesity.
The obesity pandemic: everyone’s responsibility
The corona crisis introduced many new terms to our language, one of them being “corona kilos”. However, this new coinage conceals a trend that has been going on for much longer than the pandemic. Like COVID-19, the continued rise in obesity weighs heavily on health systems worldwide. People who are overweight are more likely to develop chronic diseases (type 2 diabetes, cardiovascular disease, cancer), have higher medical costs, be absent at work, and to have a reduced quality of life. Not only does this issue take a financial toll; it more importantly entails an enormous burden on society and people.
Read this article to find out how changing diets gave rise to the world’s deadliest diseases
As with any public health concern, the control and prevention of obesity is the responsibility of both individuals and policymakers. No country has yet succeeded in reversing the trend towards excessive kilos. Like COVID-19, besting the obesity pandemic will require international collaboration as well as a complementary approach across policy levels. This growing issue needs to be tackled as the serious threat that is represents to our health and livelihoods.
Read more about the health status of the Belgian population on the website www.healthybelgium.be.
The calculation of the direct and indirect costs linked to overweight and obesity can be found in the article ‘Health care costs and lost productivity costs related to excess weight in Belgium’.
