Weighing the scales
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|
Analysing the scales
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.
Understanding the direct and indirect costs of obesity
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.
The effects of obesity on mental health and wellbeing
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.
The problem will not diminish any time soon
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.
The need for active interventions
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.