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Given this burden of obesity‐related disease identified in these analyses, policy makers asked obesity specialists to assess the financial damage done by gaining excess weight. These costs are composed of both direct healthcare costs and indirect costs to the community. Although people with obesity have higher rates of illness, the overweight nonobese group still makes a very substantial contribution to the overall hospital and general community cost of general medical care in the community because they make up a much larger proportion of the patient population. Lost productivity associated with failure to attend work because of back pain or other ailments precipitated by the excess body weight together with the loss of efficiency in those who attend work but are unable to work to their maximal capacity also need to be factored into the costings. Many countries have now undertaken an analysis of the costs of obesity to the economy, and it has proved to be alarmingly high. For example, overweight and obesity were responsible for 7% of the total health burden in Australia in 2011 and was estimated to have cost the Australian economy $8.6 billion, with the largest contribution coming from lost productivity [76].

Figure 1.6 The McKinsey Global Institute’s economic analysis of the social burdens generated by human beings. Obesity is one of the top three social burdens.

(Source: Reproduced from Dobbs et al. [79].)

Thinking about the economics of obesity is valuable as it alters the frame for decision‐making. Thus, for example, the prevention of childhood obesity, although valuable in itself, does not have a significant impact in preventing the cost of diabetes for about 40 years, whereas a marked reduction in overweight/adults with obesity by getting adults to lose at least 15% of their weight leads to a rapid economic gain as set out by the UK’s Chief Scientist’s inquiry into obesity [77]. This finding has been amplified by Lean and others’ new demonstration of the marked impact on diabetes of inducing at least a 15% weight loss with continuous very‐low‐calorie diets – 85% of recently diagnosed patients with diabetes return their glucose status to near normal levels [78].

Finally, the overall societal costs of overweight and obesity have been assessed on a global basis by the McKinsey Global Institute [79]. Their overview is summarized in Figure 1.6, which reveals the global costs of about $2 trillion per year – nearly equivalent to the cost of all global warfare and terrorism as well as the cost of smoking.