EU governments must ramp up obesity strategies or face fiscal crisis

DISCLAIMER: All opinions in this column reflect the views of the author(s), not of EURACTIV Media network.


European governments have to revisit their strategies to tackle obesity. [FBellon/flickr]

Only a few governments in Europe have a comprehensive strategy to reduce the obesity burden and the rapidly-rising associated healthcare costs, write Fredrik Erixon and Martin Koehring.

Fredrik Erixon is director of the European Centre for International Political Economy (ECIPE) and Martin Koehring is senior economist at the Economist Intelligence Unit.

Europe is facing an obesity crisis of epidemic proportions, one that threatens to overwhelm the EU’s already struggling economies and place a tremendous burden on its healthcare systems. Data from the World Health Organisation (WHO) indicates that the proportion of those who are overweight or obese will rise substantially in the EU over the next decade if the issue is not tackled.

It is a big fiscal challenge for governments because the growth of obesity in Europe has reached such proportions that it inevitably will drive up healthcare costs in the future. What adds more significance to the challenge is that past and current policies to reduce the incidence of obesity have largely failed – and that few governments have new ideas for how to tackle it.

It is remarkable that governments take a lax attitude. It is well established that obesity causes several non-communicable diseases such as Type 2 diabetes and cardiovascular problems. Population ageing will exacerbate the issue as elderly people with obesity demand far more healthcare than those without the condition. 

The exact healthcare costs of obesity today can only be estimated, but governments know that costs are growing. The OECD estimates that average healthcare expenditure for an obese person is 25% higher than for someone of normal weight. 

In the UK, the government’s Foresight study from 2007 estimated that obesity will represent 13% of total healthcare costs by 2050.

Few governments in Europe have a comprehensive strategy to reduce the obesity burden and the rapidly rising associated healthcare costs. As highlighted by The Economist Intelligence Unit’s recent report, Confronting Obesity in Europe: Taking action to change the default setting, policymakers have focused on preventing healthy people from becoming obese. And indeed, lifestyle-focused programmes have an important role to play in preventing obesity in people with a healthy weight. 

However, a policy focus on prevention has failed those who are already severely obese.

Prevention policies can work well when there are serious investments in the ability of health authorities to motivate people to change behaviour – including for example more physical exercise and better diets – and change infrastructure to that effect, e.g. by building more bicycle lanes in cities. The advanced stage of the obesity burden now, however, makes the sole focus on prevention grossly inadequate. A focus on prevention policies is of little help to those who already suffer from obesity – and can even exacerbate the problem because prevention programmes sometimes increase the stigmatisation of obese and overweight people.

A change in the default setting is crucial as the big expected increases in future healthcare expenditures will predominantly come from such patients – people that have already developed obesity or are serious overweight. More co-ordinated intervention is needed for those struggling with the problem. This means comprehensive treatment that addresses the complexity of obesity and creates a more targeted and supportive environment for those who are already obese and unlikely to benefit from behavioural change alone. 

A combination of intervention, along with broader changes in societal attitudes to how we eat and exercise, are likely to have the best effect.

EU governments have to revisit their strategies to tackle obesity. Right now, obesity is a big potential fiscal liability sitting on the balance sheet of governments. 

It desperately needs attention if already cash-strapped healthcare systems in Europe want to avoid a health crisis in Europe to also become a fiscal crisis. Investing in a comprehensive approach to tackling obesity means governments are likely to make significant savings in the decades to come by reducing obesity rates as well as rates of associated diseases.

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