Tackling Obesity in England - National Audit Office

TACKLING OBESITY IN ENGLAND31 While the approach used may, for the above reasons,overestimate the indirect costs of obesity to theeconomy, the analysis nevertheless serves todemonstrate the substantial burden of obesity toindividuals in terms of sickness and mortality.Conclusion32 The direct cost of obesity to the National Health Servicein England in 1998 was at least £480 million, equivalentto about 1.5 per cent of NHS expenditure in that year.The direct cost is driven primarily by the costs of treatingthe secondary diseases attributable to obesity, whichaccounted for 98 per cent of the total. The mostsignificant cost drivers by far are hypertension, coronaryheart disease, and Type 2 diabetes, followed byosteoarthritis and stroke.33 Direct costs are probably under-estimated by thisanalysis due to the factors outlined in the discussionabove, in particular the potentially high costs associatedwith treating obesity-related depression and hyperlipidemia.It also excludes other public expenditure notborne directly by the National Health Service, such asthe costs of social care for obesity-related strokepatients.36Total cost of obesity in England in 1998Cost componentCost (£m)Cost of treating obesityGeneral Practitioner consultations 6.8Ordinary admissions 1.3Day cases 0.1Outpatient attendances 0.5Prescriptions 0.8Total costs of treating obesity 9.5Cost of treating the consequences of obesityGeneral Practitioner consultations 44.9Ordinary admissions 120.7Day cases 5.2Outpatient attendances 51.9Prescriptions 247.2Total costs of treating the consequences of obesity 469.9Total direct costs 479.4Indirect costsLost earnings due to attributable mortality 827.8Lost earnings due to attributable sickness 1,321.7Total indirect costs 2,149.5Grand total 2,628.934 The indirect cost of obesity in England in 1998represented by lost earnings was estimated to be£2,149 million, of which 61 per cent was due tosickness absence attributable to obesity, and theremainder to premature mortality. The amount ofsickness absence due to obesity may be under-estimateddue to the exclusion of back pain, a potentiallysignificant contributor. A friction cost approach tovaluing lost output would reduce the estimates,however.35 Combining our best estimates of direct and indirectcosts, the total cost of obesity in England in 1998 was£2.6 billion, or 0.3 per cent of UK Gross DomesticProduct. Direct costs accounted for 18 per cent of thetotal. The full results are summarised in Figure 36.appendix six61