Obesity of Poles: a rising trend. How much does it cost? "We only see the top of the iceberg"
- In Poland, the problem of obesity affects about 30% of the population, with obesity and overweight affecting as much as 66% of our population. In addition, we are currently in a growing trend - says Prof. Marcin Czech
- Direct medical and non-medical costs associated with obesity are just the tip of the iceberg – 32% of all costs. The remaining 68% are indirect costs resulting from absenteeism, presenteeism and premature deaths, he explains.
- Although they constitute the vast majority, they also have less significance in decision-making in the system. Meanwhile, the costs of obesity-related absenteeism have increased fivefold in the last 10 years - he adds
The problem of obesity is huge, because 15% of citizens of developed countries may suffer from it. In Poland, it affects about 30% of the population, with obesity and overweight affecting as much as 66% of our population. In addition, we are currently in an upward trend - said prof. Marcin Czech , head of the Pharmacoeconomics Department and the Hospital Infection Control Team at the Institute of Mother and Child in Warsaw, during the conference "Patient with obesity disease".
- Obesity can be considered in the context of direct medical costs , which we can measure in the health care system, non-medical direct costs , e.g. transport costs, and indirect costs related to absenteeism, i.e. absence from work and presenteeism, i.e. reduced productivity. Indirect costs should also include premature deaths - the death of a patient during his productive life - the expert listed.
He explained that the total costs of overweight and obesity in Poland were estimated at USD 15.4 billion (2.6% of GDP) in 2019, including direct costs of USD 2.6 billion and premature deaths - USD 9.8 billion . Forecasts for 2060 already indicate the amount of USD 91.5 billion, i.e. almost 5% of GDP .
- When it comes to obesity-related diseases, their costs in 2025 are expected to be at the level of: type 2 diabetes - over PLN 941 million , hypertension - almost PLN 349 million , joint degeneration, mainly knee - PLN 146 million . High costs are also associated with dyslipidemia, sleep apnea, gallbladder diseases, fatty liver disease, or cancer - indicated Prof. Czech.
He added that direct medical and non-medical costs are only the tip of the iceberg – 32% of all costs. The remaining 68% are indirect costs resulting from absenteeism, presenteeism and premature deaths. Although they constitute the vast majority, they are also less important in decision-making in the system. Meanwhile, the costs of obesity-related absenteeism have increased five-fold in the last 10 years .
- It is worth taking a closer look at the situation of young people. The Institute of Mother and Child in Warsaw is examining the body weight of children and adolescents. The data resulting from these studies are alarming - we are one of the most obese societies in Europe. This means that when children and teenagers become adults, they may fall ill with obesity-related diseases . This will generate the aforementioned costs. At the same time, we are doing little to prevent this - the expert warned.
- How do we fight obesity in Poland? The value of reimbursement of benefits of the KOS-BAR program amounted to PLN 9 million in 2023, which, compared to the costs mentioned earlier, seems to be a very modest sum. The total cost of bariatric surgeries also remains relatively low, although it is growing very quickly. In 2017, the National Health Fund paid almost PLN 36 million for these procedures, while in 2023 it will be almost PLN 129 million - he noted.
- In the pharmacoeconomic dimension, another important aspect is not taken into account: mental disorders. A huge percentage of obese people suffer from depression, anxiety, and sleep disorders. The risk of a major depressive episode is 5 times higher in them than in people with a normal body weight . As many as 77% of obese patients also feel discriminated against in medical facilities - said Prof. Czech.
As he emphasized, mental disorders should be treated, but treatment often generates even greater obesity . This is about drug-induced metabolic syndrome caused by psychotropic drugs, mainly neuroleptics. Its most common symptoms are obesity, hyperglycemia, dyslipidemia, hypertension. Therefore, the risk of complications, hospitalization and absenteeism increases, and the costs of treatment also increase.
- Meanwhile, for the group of obese patients requiring psychiatric treatment, we do not have nationwide epidemiological or cost data. Therefore, we are unable to assess the scale of the challenge or its costs. We can only rely on expert estimates, which estimate that the increase in the costs of psychiatric treatment in this group is 30-50 percent - noted the expert.
Prof. Czech also commented on the rising costs of drugs used to treat obesity.
- The sales value of these drugs has grown from nearly PLN 19 million in 2019 to over PLN 238 million in 2023, which means that pharmaceutical companies are strongly focusing on the development of these preparations. In Europe, there are 15 drugs on the market for this indication, with different mechanisms of action. In North America, there are about 20 available, and in the Asia-Pacific region - 24 - he explained.
At the same time, as he said, there are currently over 500 such substances at various stages of development , including 2 pre-registration, 7 in phase III clinical trials, 43 in phase II clinical trials, 65 in phase I clinical trials, and 257 in the preclinical phase.
- This means that doctors and patients will have more effective tools in their hands to fight obesity. However, we should start with prevention: building social awareness, motivation, early interventions. It is necessary to build educational programs on healthy eating and physical activity that is attractive to children and young people, and to develop health education in schools - indicated Prof. Czech.
- I consider the fact that it is to be an optional subject to be one of the greatest failures of health policy in recent years. It will only deepen health inequalities - he added.
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