The Cost of Overweight and Obesity on the Island of Ireland

• Project start date: 1 February 2011
• Project status: Completed
• Project type: Nutrition
• Discipline: Obesity
• Author/s: Prof Ivan Perry, University College Cork
• Collaborator/s: Dr Anne Dee, HSE Department of Public Health, Limerick, Prof Ciaran O’Neill, National University of Ireland, Galway, Prof Frank Kee, Queens University Belfast, Prof Anthony Staines, Dublin City University, Prof Kevin Balanda, Institute of Public Health in Ireland, Dublin, Dr Linda Sharp, National Cancer Registry, Cork

Research objective

• To review the international literature on cost of obesity studies with a particular focus on those published since 2001, with a view to guiding and informing the approach adopted in the current project.
• To determine the health service related costs of overweight and obesity in Ireland and Northern Ireland from a public health care payer perspective.
• To estimate the cost, due to sickness, absence and premature mortality, related to overweight and obesity in both Ireland and in Northern Ireland.
• To examine the combined health service and lost production costs associated with overweight and obesity, and examine variations in these estimates across illnesses and jurisdictions.
• To make recommendations based on the findings, including recommendations on measures that will facilitate ongoing work on the cost of overweight and obesity on the island of Ireland drawing on both routine data collection in health and social care services and specific population-based research programmes.

Research report

• Title: The cost of overweight and obesity on the Island of Ireland
• Publication date: 5 November 2012
• Summary: The overall aim of the project was to provide a comprehensive assessment of the cost of overweight and obesity on the island of Ireland.
• Findings:
  • The findings from the literature review suggest that obesity as opposed to overweight is the main driver of direct healthcare costs, with costs escalating sharply in the obese group.
  • The literature suggests that relative to those of normal weight, costs are increased by approximately 10% in the overweight group and by approximately 30% in the obese group.
  • The combined direct healthcare cost of overweight and obesity account for up to 9.1% of total health expenditure in the US and between 0.6% and 4.6% of total health expenditure in other countries.
  • Indirect costs were greater than direct healthcare costs accounting for 51% to 84%.
  • The extent to which the costs rise with increasing BMI varies between countries.
  • For Ireland, the direct and indirect costs of overweight and obesity in 2009 were estimated at €1.13 billion and for NI, the estimated cost was €510 million.
  • In Ireland, 35% of these costs were direct healthcare costs, and 65% were indirect costs. For NI, 25% of the costs were direct healthcare costs, and 75% were indirect costs.
  • The main drivers of direct costs due to drugs and hospital inpatient and day case care are cardiovascular disease, type 2 diabetes, colon cancer, stroke and gallbladder disease, although there are differences in how these costs are distributed between the two jurisdictions.
  • In terms of absenteeism, low back pain is the main driver, and for productivity loss due to premature mortality the primary driver of cost is coronary heart disease.
• Recommendations:
  1. Urgent public health action is required to address the burden that overweight and obesity are placing on both the health services and the general economy.
  2. A population-wide approach to reducing the problem of overweight is required.
  3. Targeted action is required to reduce the burden being placed by the very obese on the health service.
  4. Workplace interventions to reduce the burden of absenteeism related to back pain in the overweight and obese is required.
  5. Overweight and obese should be targeted specifically in the colorectal cancer screening programme.
  6. We note and reiterate the recommendations from the National Taskforce on Obesity which reported in 2005 in ROI and the Fit Futures for All Framework published in 2012 in NI.
  7. Policy makers need to consider whether there is a need to extend regulatory framework in the food sector to address the effects of diet on health and wellbeing.
  8. Need for significant investment in research to examine the influence of fiscal and other Government policies on consumer purchasing and their impact on overweight and obesity.
  9. There is a need for work on modelling the future burden and costs of overweight and obesity over the next decade.
  10. There is a  need for ongoing national health and lifestyle surveys to continue to monitor the progress of the epidemic of overweight/obesity and related chronic disease.
  11. Data on uptake of health services and illness-related productivity loss, which is vital to the conduct of cost of illness studies and related health economic analyses, should form a core element in ongoing national health and lifestyle surveys.
  12. There is a need for a primary care database which would serve as a longitudinal cohort, from which estimates of use and cost of health services would be based on patient level data, and which could be used in the evaluation of public health and other interventions to reduce population level BMI.

  You can download the report below.

Other outputs

Hamilton D, Dee A, Perry IJ. The lifetime costs of overweight and obesity in childhood and adolescence: a systematic review. Obes Rev. 2018 Apr;19(4):452-463. doi: 10.1111/obr.12649. Epub 2017 Dec 22. PMID: 29271111.

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