Overweight and obesity in China: a growing economic burden

The rising prevalence of overweight and obesity (OAO) over recent decades has imposed substantial health and economic burden worldwide. OAO is a well-established modifiable risk factor that increases population risk of multiple chronic associated complications, and this study quantifies the economic burden of illnesses causally attributable to OAO among Chinese adults aged 20 years and above in 2023. We estimated economic impacts of OAO from a societal perspective. These comprised direct medical spending for treating OAO-associated chronic complications and productivity losses from disability and premature death caused by these disorders. We used population attributable fractions (PAFs) to isolate the share of disease burden linked to excess body weight, allowing us to generate independent disease-specific cost estimates for each included comorbidity. Unit costs and epidemiological data of associated complications were retrieved from published studies and global databases. Costs were quantified separately for each OAO-linked chronic disease to generate disease-specific burden estimates. Deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were performed to evaluate the robustness of the cost estimates. The economic burden of diseases attributable to OAO among Chinese adults aged 20 and above reached $174.27 billion in 2023, with indirect costs accounting for a larger share at 55.65% of total costs. Every 1% decrease in overweight prevalence is projected to save $626.45 million per year, and an equivalent 1% reduction in obesity prevalence would save an additional $312.62 million annually. This study offers comprehensive, nationally representative evidence of the economic burden attributable to OAO in China. Preventing OAO is a crucial step in reducing the economic burden, and our findings provide policymakers with evidence for resource planning and allocation.