Unhealthy Numbers: The Rising Cost of Obesity in the UK

Introduction

In our report, Fit for the Future: A Fair Deal on Food for a Healthier Britain, we emphasised that without government action, growth will continue to be hampered by the rising cost of obesity and overweight for society. The UK has one of the highest rates of obesity in Europe; almost three-quarters of people aged between 45 and 74 in England have overweight or obesity. Plus, prevalence of obesity has increased over time: in 1970 it was the case that one in ten British adults had obesity, compared with one in three today.

Obesity has several impacts on individuals, including an increase in the risk of diseases like type 2 diabetes and cancer. Understanding these costs is important, both to quantify the drag on the wider economy from inaction and to target policy interventions in the most cost-efficient way.

How significant is this challenge? Previously the most comprehensive estimate of the economic cost of obesity in the UK, in 2020, put the annual figure at £58 billion, equivalent to about 3 per cent of GDP. Updated estimates in 2021 indicate that the cost of obesity and overweight spiralled to £98 billion – equivalent to almost 4 per cent of GDP. This significant increase reflects three extensions to the previous analysis:

• The costs of overweight – a body-mass index (BMI) of between 25 and 29.9 – as well as obesity, which is a BMI of 30 or more.

• The losses from economic inactivity (as individuals with obesity and overweight are more likely to exit the labour force prematurely).

• Updated cost estimates to account for inflation between 2021 and 2023.

Of the £98 billion total cost to society, about two-thirds (£63 billion) falls on individuals with obesity (through fewer years of healthy life) and their families and friends (through additional informal caring responsibilities). By contrast, about one-third of the cost of obesity and overweight (£35 billion) falls on the state and wider society through higher NHS treatment costs and lower productivity; these are the costs most relevant to policymakers.

The overall cost is set to rise further. The UK’s ageing population, plus expected increases in the incidences of obesity, suggest that costs could increase by at least 10 per cent in real terms between now and 2040. Moreover, the UK’s high and rising rates of childhood obesity and overweight are a harbinger of future problems.

These spiralling costs will inevitably mean an ever-increasing tax burden, lower productivity and additional government expenditure just to maintain the status quo. This is unsustainable. To put the UK on a better path, the government must reimagine its approach to economic growth and recognise that early intervention to help address the UK’s obesity crisis will not only result in a healthier population but also support that growth.

Previous Estimates of the Cost of Obesity

There have been various studies with different methodologies that have estimated the cost of obesity. A 2022 study by Frontier Economics, commissioned by Danish health-care company Novo Nordisk, provided the most detailed and recent estimates of the costs of adult obesity and estimated the total annual cost to be £58 billion in 2020 (measured in 2021 prices), broken down as follows:

Within these costs, the majority (£45 billion) affect individuals with obesity themselves (who lose years of healthy life) and their friends and families (through lost time providing informal social care). However, the costs of obesity on wider society are also substantial, totalling almost £13 billion. It is this financial outlay that is most relevant to policymakers because it directly impacts NHS spending and productivity growth.

Updated Estimates of the Cost of Obesity and Overweight

As mentioned earlier in this commentary, we commissioned Frontier Economics to update and extend its original analysis to give a more comprehensive overview of the cost of adult obesity in the UK. As such, the revised estimated annual cost to the UK of obesity and overweight rises to £98 billion (see Figure 2). Again, most of these costs (£63 billion) fall on individuals (through fewer years of quality life) and their families and friends (through informal social cost).

But the costs to the NHS (£19 billion) and wider society through lower productivity (£16 billion) are substantial; the total, £35 billion, is equivalent to one-third of the UK’s education spend in 2022–23 and almost three times the size of the previous estimate. Of this total, £14 billion is attributable to the cost of overweight alone – a factor that has largely been excluded from previous obesity analysis.

Forecasts Towards 2040

These figures are expected to rise over time. Frontier Economics has produced a partial forecast for how the costs stemming from obesity and overweight could increase between now and 2040. These forecasts take account of the expected change in the size and age structure of the population (from the Office for National Statistics’ forecasts) and the Health Foundation’s data on how incidences of obesity are likely to evolve in the future. Accounting for these factors alone suggests the cost from obesity and overweight could rise by about 10 per cent in real terms between 2021 and 2040, from £97.9 billion to £109.4 billion.

Looking even further ahead, the costs of obesity and overweight in the UK could yet increase. The above forecasts do not include the impact of the recent spike in childhood obesity rates that will become apparent in adulthood (as most of today’s children with obesity and overweight will not reach an age where adverse health conditions require treatment until beyond 2040). In 2022, 38 per cent of Year 6 children (those aged 10 to 11) in England had overweight or obesity, up from 34 per cent just four years earlier.

Conclusion

Clearly the UK’s existing policy approach, focused on individuals taking responsibility for their own health, is not working. The rising prevalence of obesity and overweight in the UK is not only harming individual lives but also costing the NHS £19 billion a year – and the economy at least £15 billion in lost output. What’s worse, these costs look set to spiral even higher in the years ahead.

More than ever, a new approach is needed – and it must be focused on reforming the commercial food environment, embedding healthy food across government entities, and adopting new research, treatments and technologies. The prize is substantial: better health, higher economic growth and less pressure on the NHS. The time to act is now.

Analytical Methodology

The updated estimates in this report follow the same methodology as Frontier Economics’ 2022 report, with the following extensions:

• New estimates of the costs of overweight (a BMI of 25 to 29.9).

• New estimates of the losses from economic inactivity (as those who have obesity or overweight are more likely to exit the labour force prematurely).

• Updated cost estimates to account for inflation between 2021 and 2023.

• New forecasts to illustrate how the costs of obesity and overweight could evolve between now and 2040.

Frontier Economics’ work was undertaken over August and September 2023.

Read the full analysis from Frontier Economics.

Lead image: Getty