The World Bank warns of the growing weight of obesity in public finances

The overweight and obesity of populations weigh heavily on the accounts of states around the world, and this increasingly massive phenomenon must be contained as soon as possible, warns the World Bank. In its latest study on the subject, published this Thursday, the institution is sounding the alarm and providing a battery of proposals to governments to help them lose weight.

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Growing rapidly, obesity now causes more than four million deaths each year, estimates the institution, which specifies that two billion people were either overweight or obese in 2016. A rapidly increasing ratio in all regions of the world since 1980. The causes of this increase are well known: sedentary lifestyle, development of the car favored by rampant urbanization, decline in sports, marketing and advertising for fatty foods, diets dominated by processed food… The World Bank also cites other cultural explanatory elements, such as the entry of women into the labor market, to be linked to the change in the mode of consumption of food: at lunch, employees are now in a hurry by time and indulge in "snacking" rather than taking the time to have lunch at home, the study points out.

In addition, weight gain no longer concerns only rich countries, on the contrary: more than 70% of populations with a body mass index that is too important for their health lived in a country with an average or low standard of living. Africa, the Middle East, East Asia, Latin America… All areas are affected, and certain countries, in sub-Saharan Africa as in Southeast Asia, even suffer a double penalty, fighting against malnutrition - especially infantile - on the one hand, and overweight on the other. Rural areas are also increasingly affected by this phenomenon.

Obesity will cost developing countries “$ 7 trillion” within 15 years

However, this "time bomb" represents a "growing concern for all countries" and a "huge and growing burden on public health" , worries the World Bank. Obesity weakens populations and causes 4 million deaths a year, or 7% of all deaths in a year, according to the Global burden of disease study. It contributes to serious illnesses, causing cardiovascular problems, diabetes and reduced life expectancy. In addition, the environment is also a victim of this predominance of unhealthy foods, reports the study, insofar as the sugar, which is very present in these products, "is one of the most water-hungry crops "

The fight against obesity will also have the significant advantage of relieving the portfolio of individuals and public authorities, argues the institution. Overweight affects economic activity, increasing mortality and illnesses on the one hand, and reducing life expectancy as well as productivity on the other. So many consequences that will increase the bill, directly and indirectly, for social security systems.

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Several estimates thus report that obesity has an increasing cost in the world: in Brazil, its weight for public finances should pass from 5.8 billion dollars in 2010 to 10.1 billion in 2050. In the United States, country particularly struck by this phenomenon, "estimates vary from $ 89 billion to $ 212 billion," depending on the methodology studied. In Germany, in 2008, the direct costs of obesity were estimated at 8.64 billion euros, an amount doubled by equivalent indirect costs, at 8.15 billion euros. "Two-thirds were driven by lost work days , " added the document.

In France, the cost of obesity and overweight was estimated in a range in 2007, between 2.36 billion and 7.12 billion dollars. In total, the cost of obesity for developing countries alone will reach "7000 billion dollars in the next fifteen years" , while the economic situation of these territories is already fragile, worries the institution .

The fiscal weapon, an effective tool against obesity

The World Bank therefore advises states to tackle "this discreet epidemic as a matter of urgency" for health, economic and environmental reasons. A battery of additional measures can be implemented by the authorities. The study therefore suggests protecting and educating consumers, by framing advertising, by training young people, especially in school cafeterias, and by prohibiting the sale of fatty foods in educational establishments. It also proposes to facilitate the practice of sport, to reinforce information by the media such as packaging (with elements on foods such as Nutriscore) and to reflect more broadly on the problem, by rethinking the way in which our cities are designed and organized, in order to fight against the misuse of the car.

However, to change consumption patterns, nothing beats the fiscal weapon: hitting citizens in the wallet is one of the solutions already implemented by many States, via behavioral taxes, with convincing results. A tax on sugary drinks already exists in Chile, the United Kingdom, South Africa, France and several American cities. In Mexico, the 10% tax is expected to reduce obesity by 2.5% by 2024, and will prevent tens of thousands of diabetes cases by 2030. It has also lowered sales of sugary drinks "by 6% the first year then 4% the following year" . In Philadelphia, the soda tax plummeted sales of sugary and sweetened drinks by 38%.

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"The tax must be high enough to trigger a change" among consumers, the study points out: its level must therefore be carefully thought out, otherwise buyers will turn to substitute products. The World Health Organization (WHO) offers a tax equal to 20%.

By establishing such national strategies, countries will be able to better inform consumers, have more control over the agri-food industry and can bring about a change beneficial to both the health of individuals and their portfolios. However, such a will will have to clash with the giants of this sector, warns the World Bank. However, the game is worth the candle: "reducing overweight and obesity is a public good for all," she concludes.