A recent article in Lancet discussed how the global obesity epidemic would "crush" the U.S. and U.K. health systems with its associated increased long-term, disease-associated costs (see: Obesity to crush health care systems globally: study). Although the use of the word "crush" may seem overly dramatic, I think that it's appropriate in this context. Below is a brief summary of the article:
Rising prevalence of obesity is a worldwide health concern because excess weight gain within populations forecasts an increased burden from several diseases, most notably cardiovascular diseases, diabetes, and cancers....These trends project 65 million more obese adults in the USA and 11 million more obese adults in the UK by 2030, consequently accruing an additional 6—8·5 million cases of diabetes, 5·7—7·3 million cases of heart disease and stroke, 492,000—669,000 additional cases of cancer, and 26—55 million quality-adjusted life years forgone for USA and UK combined.The combined medical costs associated with treatment of these preventable diseases are estimated to increase by $48—66 billion/year in the USA and by £1·9—2 billion/year in the UK by 2030. Hence, effective policies to promote healthier weight also have economic benefits.
I very much like the modest phrase at the end of this article:...[E]ffective policies to promote healthier weight also have economic benefits. In my opinion, we have tended to treat the current obesity epidemic with relatively modest public health campaigns and insipid regulations such as the listing of calorie counts in fast food restaurants (see: Fighting Obesity and the Perils of "Eating Out" Once a Week; Obesity Harmful to Heart Independent of Other Risk Factors; Obesity as a Cause of Death Recorded on Death Certificates; Research Study Documents that Obesity Cause Heart Inflammation; State Taxes on Soda Pop Gain Momentum; Does the End Justify the Means?). I place the legal campaigns in some states to place a tax on sugar-containing pop in the same category.
It seems to me that we have much more interest in treating the cardiovascular diseases, diabetes, and cancers that result from obesity than treating the obesity itself. I think that this is largely the result of the imperative of our healthcare system to focus on diseases rather than the antecedent cause, obesity. We also tend to put few dollars into preventive medicine programs (see: Will Large Health Systems Embrace Preventive Medicine and Wellness?; The Need for a Preventive Medicine Infrastructure in the U.S.).
I see only one solution to this problem on the horizon. We need to rigidly mandate some fixed percentage of our healthcare expenditures toward the prevention and treatment of obesity in addition to treating its related diseases. We also need to convince ourselves that this is not simply a consequence of bad dietary choices and lack of exercise. Rather, it's a critical challenge in society that needs to be treated and prevented now before the future costs overwhelm our entire healthcare system.