Epidemiology and Costs
On average the population of the western world has been putting on weight since World War II. While the USA show a BMI above 27kg /m2 among 30 - 40% of their population, Europe records a BMI of over 30kg /m2 in 10 - 25% (depending on country). Currently no specific data concerning the prevalence (number of occurrences) of adiposity in Switzerland are available. Cautious, probably conservative estimates for Switzerland are shown in Table 5. In all likelihood, the actual numbers won’t differ much from those of neighbouring countries (e.g. Germany).
As studies and international comparisons show, adiposity mainly occurs at a young age, between 25 and 55 years of age, with progressively increasing tendencies. In Germany for example (Schneider 1996), the percentage of females with a BMI greater than 30 increased from 16.5% in 1985 to 19.3% (17.2% in males) in 1990. It is especially alarming that the number of children and teenagers suffering from adiposity is growing.
In Europe a distinct east-west decline is evident. For women of the 40-60 age group with a BMI above 30, Russia records top values of 44% (men 14%), while Eastern Europe and the Adriatic countries show 30% for females, and for males 18% and 16% respectively. The most favourable numbers are recorded in the northern European countries (Denmark, Sweden, Norway, Finland, and Iceland) with 10% in males and 15% in females. The values for western European countries (France, Belgium, Germany, Netherlands, and Great Britain) are between these values: 16 % for females, 13 % for males.
| BMI ( kg/m2 ) | Prevalence (5) | In Mil. |
|---|---|---|
| 25-30 | 25 (-40) % | 1.75 |
| 30-40 | 5 (-16) % | 0.35 |
| >40 | 0.5 (-1) % | 0.035 |
| Tab. 5: Estimated prevalence of adiposity in Switzerland (Numbers in brackets denote Germany) |
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The therapy costs for secondary diseases caused by adiposity are at a level that they affect the economy as a whole. In the US, annual spending has been calculated at 68.8 billion dollars (Martin et al. 1987). Just recently calculations have shown 3 – 4 billion Swiss Franks in costs for Switzerland, caused by health insurance benefits as well as sick leave compensations. This is equivalent to 8% of the total costs incurred by the compulsory health care system, and the tendency is growing. In Great Britain the growth rate for patients with a BMI above 30 is approx. 3% every 5 years..
Thus adiposity is a major health problem for the western industrial states, causing astronomical costs. Studies in the US and Germany have shown that surgical treatment of adiposity proves to be more cost efficient in the long run than conservative treatments.