Our study reveals that adult obesity cost Malta
€36 million in 2016. Costs are likely to increase even if the 2015 rate of obesity (25%) is maintained over the next few years. Active action is required on the part of all stakeholders to address this reality and improve the wellbeing of our population.
the costs of adult obesity in Malta in 2016, based on self-reported measures of Body Mass Index, which increase to €56 million when measured rates of BMI are used
the adult rate of obesity in Malta in 2015 has increased from 22% in 2008, making the achievement of the target rate of 18% set for 2020 more challenging
costs analysed in this study, including primary care, hospital care, and the costs of absenteeism and presenteeism
obesity-related costs borne by individuals and private sector employers
Malta has one of the highest rates of adult and childhood obesity worldwide. Over a quarter of the Maltese adult population over 15 years is obese. The prevalence of obesity increased from 23% in 2002 to 25% in 2015 – moving farther away from Malta’s 2020 target rate set at 18%.
The study reveals that adult obesity cost Malta €36 million in terms of direct and indirect costs, on the basis of self-reported measures of Body Mass Index. The costs are even more pronounced when measured rates of BMI are applied resulting in an additional annual cost of €20 million. Obesity poses a challenge to society, not only in terms of the additional healthcare spending but also in terms of the opportunity costs to Government, individuals and society.
‘Weighing the Costs of Obesity in Malta’ calls for active action on the part of all stakeholders, with the objective of marshalling resources, sustaining efforts and implementing successful interventions targeted at improving the wellbeing of Malta’s population. A number of strategies and policies have already been laid out by Government, these including the ‘A Healthy Weight for Life: A National Strategy for Malta’ and a ‘Whole School Approach to a Healthy Lifestyle: Healthy Eating and Physical Activity Strategy’. Effective interventions are expected to improve the health and quality of life of individuals, whilst resulting in numerous cost savings on health spending. In fact, in other territories, PwC has estimated that the implementation of a number of obesity-related interventions over a ten-year period results in a benefit-to-cost ratio of 1.7.
PwC would like to thank the Ministry for Health for its assistance in the compilation of this publication.
70% of the obese population is classified within the Obese Class I category*, 21% within the Obese Class II category, while the remaining 9% fall within the third obese class. Based on the 2015 EHIS, women are less likely to be obese than males in all categories except for Obesity Class III. Furthermore, obesity is more pertinent among individuals between the age of 55 and 74.
|*Obese Class||BMI Category|
|I||30.00 – 34.99 kg/m²|
|II||35.00 – 39.99 kg/m²|
|III||≥ 40.00 kg/m²|
The excess cost of obesity for individuals over the age of 15 on a per capita basis amounts to €97 in 2016. Representing 0.4% of Malta’s annual Gross Domestic Product, the costs of obesity are absorbing 8.1% of annual public recurrent health expenditure.
The direct costs of obesity include primary care, pharmaceutical care and hospital care. Hospital stays for obese individuals are longer than in the case of normal weight individuals, leading to an estimated excess of €4.5 million in terms of inpatient and day patient stay costs. On the contrary, indirect financial costs include the costs of absenteeism, presenteeism, forgone earnings and forgone taxes. By way of example, there is a direct relationship between an individual’s BMI and the average number of hours of sick leave taken in a year. The cost of absenteeism stands at €6.5 million.
In addition to financial costs, obesity leaves lasting adverse impacts on mental health, whilst also leading to a number of non-communicable diseases, including hypertension and diabetes. It is estimated that overweight and obesity are responsible for 17% of total deaths in Malta. Moreover, obese individuals may also experience injustice and prejudicial treatment, this possibly resulting in emotional or psychological harm, and potentially, lower earnings owing to education and employment discrimination.
It is estimated that 50% of the world’s adult population could be either overweight or obese by 2030. In Malta, obesity is expected to generate an additional €5 million costs by 2022, on the assumption that the 2015 rate of obesity (25%), and the respective age and gender distributions are sustained between 2016 and 2022. Maintaining the level of obesity at this level is a daunting task, especially in light of the high rates of childhood obesity and the rising trend in adult obesity over the last decade. Childhood obesity poses a long-term problem, given that obesity in children tends to predict obesity in adults.
Thorough food labelling, fiscal-induced incentives (including tax credits for individuals pursuing a sports activity and grants subsidising the supply of healthy food products), and educational campaigns are examples of interventions which should entice sustained behavioural change among individuals, especially among children. Although a number of interventions have already been put into place by Government, their fruition is dependent on adequate and sufficient resources being devoted towards their implementation.