Professor Annie S. AndersonProfessor Annie S. AndersonCentre for Public Health Nutrition ResearchCentre for Public Health Nutrition ResearchCentre for Research into Cancer Prevention and ScreeningNinewells Medical School,Ninewells Medical School,University of DundeeUniversity of Dundeeemail: a.s.anderson@dundee.ac.ukemail: a.s.anderson@dundee.ac.uk

The cost of diet related diseases in Scotland?

Who knows?..........Who knows?..........

Reflections and thoughts……..Reflections and thoughts……..

The healthy/unhealthy landscape influenced The healthy/unhealthy landscape influenced by diet and ways of life……………….by diet and ways of life……………….

Medical Complications of ObesityMedical Complications of Obesity

Phlebitisvenous stasis

Coronary heart disease

Pulmonary diseaseabnormal functionobstructive sleep apneahypoventilation syndrome

Gall bladder disease

Gout

Diabetes

Osteoarthritis

Nonalcoholic fatty liver diseasesteatosissteatohepatitiscirrhosis

HypertensionDyslipidemia

Cataracts

Skin

Pancreatitis

Idiopathic intracranial hypertension

Cancerbreast, uterus, ovary, kidneycolon, oesophagus, pancreas, gall bladder

Gynecologic abnormalitiesabnormal menses/ infertilitypolycystic ovarian syndromeNumerous pregnancy comps.

Stroke

Most people with any long term condition have Most people with any long term condition have multiple (diet related) conditions in Scotlandmultiple (diet related) conditions in Scotland

People living in more deprived areas in Scotland People living in more deprived areas in Scotland develop multimorbidity 10 years before those living in develop multimorbidity 10 years before those living in

the most affluent areasthe most affluent areas

Scottish Women aged Scottish Women aged 50 to 74 50 to 74

70% are overweight or obese70% are overweight or obese

76% do not eat 5 a day76% do not eat 5 a day

58% do not meet physical activity 58% do not meet physical activity guidelinesguidelines

35% regularly drink over 35% regularly drink over 14 units 14 units per weekper week

Scottish Health Survey, 2013

The cost of obesity to Scottish The cost of obesity to Scottish societysociety

We estimate that the total cost to Scottish society of obesity in 2007/8 was in excess of £457 million and it is likely that this is an underestimate. Much of this cost is avoidable...

(Published 2010)

The cost of obesity The cost of obesity to the NHS (2007/2008)to the NHS (2007/2008)

> £175 million > £175 million (direct costs)(direct costs)IncludesIncludes• £ 4.5 m associated with drug cost£ 4.5 m associated with drug cost• £48 m obesity related diabetes£48 m obesity related diabetes• £38 m hypertension£38 m hypertension

Add the costs of being Add the costs of being overweight…overweight… may be half again may be half again ADD £137 mADD £137 m

TOTAL NHS COSTS for OW and obesity TOTAL NHS COSTS for OW and obesity ££312m312m

NHS CostsNHS Costs

Accounts for around 2% of total Accounts for around 2% of total healthcare costshealthcare costs

Obese individuals had medical costs 30% Obese individuals had medical costs 30% higher than those with normal wthigher than those with normal wt

Around 23% of spending on all drugs is Around 23% of spending on all drugs is attributable to overweight and obesity. attributable to overweight and obesity.

The cost of obesity The cost of obesity to Society(2007/2008)to Society(2007/2008)

Impact on employment Impact on employment • obesity 25% less likely to be in employmentobesity 25% less likely to be in employment• overall attainment less for womenoverall attainment less for women

Production levelsProduction levels

Incapacity benefits est £195 mIncapacity benefits est £195 m

Premature death est £87 mPremature death est £87 m

Infra- structure planningInfra- structure planning• Hospital costsHospital costs

TOTAL society COSTS for obesity TOTAL society COSTS for obesity ££282m282m

RCP (2013) Action on Obesity

What are the total costs?What are the total costs?

? £457 m (estimates of direct and indirect)? £457 m (estimates of direct and indirect)

£0.6b to £1.4b£0.6b to £1.4b

Future estimates (Scotland)Future estimates (Scotland)

10-15 years behind US (2003 S = 1991 US), 41% predicted to be obese by 2030

Estimated UK costs of £1.9 to 2 billion /year by 2030