Economic impact of adult obesity on health systems: a systematic review

Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Mancuso, Agostino; Ianuale, Carolina; Parente, Paolo; Capri, Stefano; Ricciardi, Walter

doi:10.1093/eurpub/cku170

Cited by 72 publications

(45 citation statements)

References 25 publications

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“…In addition, all are independently associated with significantly greater direct health care costs (insurance companies and government); however, the indirect (eg, work days lost, impact on family caregivers) impact of these conditions/diseases has not been evaluated 46,47. Thus, the combined condition of OSO could be associated with greater direct and indirect health care costs.…”

Section: Impactmentioning

confidence: 99%

Osteosarcopenic obesity in women: impact, prevalence, and management challenges

Jafarinasabian¹,

Inglis²,

Kelly³

et al. 2017

IJWH

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Osteosarcopenic obesity syndrome (OSO) has recently been identified as a condition encompassing osteopenia/osteoporosis, sarcopenia and obesity. OSO is especially deleterious in older adults (even if they are not obese by conventional measures), due to age-related redistribution of fat and its infiltration into bone and muscle. Osteoporosis and bone fractures in elderly increase the risk of sarcopenia, which, through decreased mobility, increases the risk of more falls and fractures, creating a vicious cycle. Obesity plays a dual role: to a certain extent, it promotes bone and muscle gains through mechanical loading; in contrast, increased adiposity is also a source of pro-inflammatory cytokines and other endocrine factors that impair bone and muscle. As the elderly population increases, changes in lifestyle to delay the onset of OSO, or prevent OSO, are warranted. Among these changes, dietary patterns and physical activity modifications are the first ones to be implemented. The typical Western diet (and lifestyle) promotes several chronic diseases including OSO, by facilitating a pro-inflammatory state, largely via the imbalance in omega-6/omega-3 fatty acid ratio and low-fiber and high-processed food consumption. Nutritional modifications to prevent and/or alleviate the OSO syndrome include adequate intake of protein, calcium, magnesium and vitamin D and increasing consumptions of foods containing omega-3 polyunsaturated fatty acids and fiber. Certain types of physical activity, often decreased in overweight/obese women and in elderly, might preserve bone and muscle, as well as help in reducing body fat accrual and fat infiltration. Habitual daily activities and some alternative modes of exercise may be more appropriate for older adults and play a crucial role in preventing bone and muscle loss and maintaining optimal weight. In conclusion, older adults who suffer from OSO syndrome may benefit from combined efforts to improve diet and physical activity, and such recommendations should be fostered as part of public health programs.

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Section: Impactmentioning

confidence: 99%

Osteosarcopenic obesity in women: impact, prevalence, and management challenges

Jafarinasabian¹,

Inglis²,

Kelly³

et al. 2017

IJWH

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“…Patient Activation Measurement (PAM) is an internationally well-known, unidimensional 13-item questionnaire designed to capture patients' knowledge, skills and confidence for self-management while living with chronic conditions [18]. It is widely used [19]- [21] and has been translated and validated for use in Norway [18]. Each item has four response categories with scores from 1 to 4: "strongly disagree" (1), "disagree" (2), "agree" (3) and "agree strongly" (4).…”

Section: Measurementsmentioning

confidence: 99%

Relationships between Emotional Well-Being, Patient Activation and Social Support among Adults with Severe Obesity Who Have Undergone Gastric Bypass Surgery

Solberg¹,

Aarflot²,

Skotnes³

et al. 2015

OJN

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Objective: To examine the relationship between emotional well-being, patient activation and social support in a cohort of adults with severe obesity who underwent gastric bypass surgery from January to December 2012. Design: Cross-sectional survey. Subjects: Of a total population of 129 people, aged 18-68 years, at a local hospital in central Norway, 64 (50%) responding to the questionnaire, 52 (81%) being women. Main Outcome Measures: The World Health Organization-Five Well-Being Index (WHO-5), the 13-item Patient Activation Measure (PAM-13), a 16-item instrument on the frequency and content of social support, and demographic and clinical data. Results: A significant positive association was found between higher level of patient activation and better emotional well-being (P = 0.02) in linear regression analysis. A higher level of family support was significantly associated with better emotional well-being (practical social support from the family (P = 0.04), emotional social support from family (P = 0.01) and from friends (P = 0.005)). Conclusion: Screening tools for emotional well-being should be used systematically in postoperative consultations to recognize those who need a more individually tailored post-surgery follow-up care after gastric bypass surgery. In addition, health care providers in both specialist and primary health care settings should consider assessing the level of social support as part of regular follow-up routines.

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“…Besides excess health care expenditure, obesity also imposes costs in the form of lost productivity and foregone economic growth as a result of lost work days, lower productivity at work, mortality and permanent disability. It has been described in recent studies and reviews that there is a gradient between increasing BMI and costs attributable to obesity [9,10,11,12]. …”

Section: Introductionmentioning

confidence: 99%

“…Two recently published systematic reviews have attempted to explore the problems associated with the methodological heterogeneity of studies [10] and performed a quality appraisal of the analysed studies [12]. Nevertheless, there is still a methodological heterogeneity within COO studies and a lack of systematic reviews examining the different obesity-related diseases included in these studies.…”

Section: Introductionmentioning

confidence: 99%

Economic Burden of Obesity: A Systematic Literature Review

Tremmel

Gerdtham

Nilsson

et al. 2017

IJERPH

864

546

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Background: The rising prevalence of obesity represents an important public health issue. An assessment of its costs may be useful in providing recommendations for policy and decision makers. This systematic review aimed to assess the economic burden of obesity and to identify, measure and describe the different obesity-related diseases included in the selected studies. Methods: A systematic literature search of studies in the English language was carried out in Medline (PubMed) and Web of Science databases to select cost-of-illness studies calculating the cost of obesity in a study population aged ≥18 years with obesity, as defined by a body mass index of ≥30 kg/m², for the whole selected country. The time frame for the analysis was January 2011 to September 2016. Results: The included twenty three studies reported a substantial economic burden of obesity in both developed and developing countries. There was considerable heterogeneity in methodological approaches, target populations, study time frames, and perspectives. This prevents an informative comparison between most of the studies. Specifically, there was great variety in the included obesity-related diseases and complications among the studies. Conclusions: There is an urgent need for public health measures to prevent obesity in order to save societal resources. Moreover, international consensus is required on standardized methods to calculate the cost of obesity to improve homogeneity and comparability. This aspect should also be considered when including obesity-related diseases.

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Economic impact of adult obesity on health systems: a systematic review

Abstract: The review confirmed that obesity absorbs a huge amount of health-care resources. Further research is therefore needed to better understand the economic impact and to identify and promote public health strategies to tackle obesity.

Cited by 72 publications

References 25 publications

Osteosarcopenic obesity in women: impact, prevalence, and management challenges

Osteosarcopenic obesity in women: impact, prevalence, and management challenges

Relationships between Emotional Well-Being, Patient Activation and Social Support among Adults with Severe Obesity Who Have Undergone Gastric Bypass Surgery

Economic Burden of Obesity: A Systematic Literature Review

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