Obesity Update 2017 Policy insights Did you know? More than one in two adults and nearly one in six children are overweight or obese in OECD countries. Adult obesity rates are highest in the United States, Mexico, New Zealand and Hungary, while they are lowest in Japan and Korea. Obesity rates are projected to increase further by 2030, and Korea and Switzerland are the countries where obesity rates are projected to increase at a faster pace. Social inequalities in overweight and obesity are strong, especially among women. In about half of the eight countries for which data are available, less- educated women are two to three times more likely to be overweight than those with a higher level of education. In the last few years, some OECD countries have relied on fiscal policies to increase the price of potentially unhealthy products to encourage a healthier diet such as in Belgium, Chile, Finland, France, Hungary and Mexico. This Obesity Update focusses on communication policies designed to empower people to make healthier choices, which are increasingly used in OECD countries. New developments in communication policies include new easy-to- understand schemes of food labelling, mass media campaigns to increase public awareness, the use of social networks and new technologies for health promotion campaigns, and reinforced regulation of marketing of potentially unhealthy products, especially when directed to children. Comprehensive policy packages, including not only communication but also school-based interventions, interventions in primary care settings, and broader regulatory and fiscal policies, provide an affordable and cost-effective solution to tackle obesity. www.oecd.org/health/obesity-update.htm © OECD 2017 Obesity update - © OECD 2017 Obesity Update 2017: introduction Today, more than one in two adults and nearly one in six children are overweight or obese in the OECD area. The obesity epidemic has spread further in the past five years, although at a slower pace than before. Despite this, new projections show a continuing increase of obesity in all studied countries. Social disparities in obesity persist and have increased in some countries. A nearly tenfold variation in obesity and overweight rates can be seen across OECD countries. In the last few years, new policy strategies devised to fight obesity have emerged. ThisObesity Update focusses on a selection of those, specifically at communication policies aimed to tackle obesity, in particular by improving nutrient information displayed on food labels, using social and new media to sensitise the population, or by regulating the marketing of food products. Better communication helps empower people to make healthier choices. However, comprehensive policy packages, including not only communication but also broader regulatory and fiscal policies, are needed to tackle obesity effectively. 1 Obesity update - © OECD 2017 One in five adults is obese in OECD countries In 2015, across the OECD, 19.5% of the adult population was obese (Figure 1). This rate ranges from less than 6% in Korea and Japan to more than 30% in Hungary, New Zealand, Mexico and the United States. More than one in four adults is obese in Australia, Canada, Chile, South Africa and the United Kingdom. Overweight and obesity rates have grown rapidly in England, Mexico and the United States since the 1990s, while the increase has been slower in the other seven OECD countries for which trend data are available (Figure 2). Over the past decade, the prevalence rate of overweight and obesity has increased in Canada, France, Mexico, Switzerland and the United States, while it has stabilised in England, Italy, Korea and Spain. There is, however, no clear sign of retrenchment of the epidemic, in any country. Nearly one in six children is overweight or obese The share of children who are overweight or obese at age 15 ranges from 10% in Denmark to 31% in the United States (Figure 3). Despite policies put in place in OECD countries for a number of years, the number of 15-year-olds who report to be overweight or obese has steadily increased since 2000 in the majority of countries, according to the Health Behaviour in School-aged Children survey (Inchley et al., 2016). A more detailed analysis covering children aged 3 to 17 at several points in time shows relatively stable rates in France up to 2012, while trends have been somewhat upward again for both boys and girls in England since 2012, and since 2011 for boys in the United States (Figure 4). 2 Obesity update - © OECD 2017 One in five adults is obese Figure 1: Obesity among adults, 2015 or nearest year in OECD countries 3.7 Japan Women Self-reported data 5.3 Korea Measured data 9.8 Italy Men 10.3 Switzerland 12.0 Norway 12.3 Sweden 12.8 Netherlands 14.7 Austria 14.9 Denmark 15.3 France 16.3 Slovak Rep. 16.6 Portugal 16.7 Poland 16.7 Spain 17 Greece 17.8 Israel 18 Estonia 18.6 Belgium 19 Iceland 19.2 Slovenia 19.5 OECD 21 Czech Rep. 21.3 Latvia 22.3 Turkey 22.6 Luxembourg 23 Ireland 23.6 Germany Nearly one in six children 24.8 Finland 25.1 Chile is overweight or obese 25.8 Canada 26.9 United Kingdom 27.9 Australia 30 Hungary 30.7 New Zealand 32.4 Mexico 38.2 United States 5.0 India 5.7 Indonesia 7.0 China 17.3 Lithuania 19.6 Russian Fed. 20.8 Brazil 20.9 Colombia 24.4 Costa Rica 26.5 South Africa 40 30 20 10 0 0 10 20 30 40 % of population aged 15 years and over % of population aged 15 years and over Source: OECD (2017), OECD Health Statistics 2017 (Forthcoming in June 2017). www.oecd.org/health/health-data.htm Note: The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. 3 Obesity update - © OECD 2017 Figure 2: Rising overweight (including obesity) rates in adults aged 15-74 years 80% Mexico 70% United States 60% Hungary England Canada 50% Spain France 40% Italy Switzerland Rates of(including overweightobesity) 30% Korea 20% 1972 1976 1980 1984 1988 1992 1996 2000 2004 2008 2012 2016 Year Note: Overweight and obesity rates designate overweight and obesity prevalence rates. Age- and gender-adjusted rates of overweight (including obesity), using the 2005 OECD standard population. Measured height and weight in England, Hungary, Korea, Mexico and the United States; self-reported in other countries. Source: OECD analysis of national health survey data*. Figure 3: Self-reported overweight (including obesity) in children aged 15 years 2001-02 2013-14 35 30 31 25 24.5 20 21.5 % 18 15 17 17 17 16 16 16 16.5 16.5 15 15 15.5 15.5 15.5 15.5 14 14 14 13 12 12 12.5 12.5 12.5 12.5 12.5 10 12 10.5 9.5 5 0 * * Note: * Data for 2009-10. Child overweight is defined with IOTF age- and gender- specific BMI cut-offs. Source: Currie, C. et al. (2004); Inchley et al. (2016). 4 Obesity update - © OECD 2017 Figure 4: Obesity in children aged 3-17 years 25% 20% 15% 10% 5% Ratesof child obesity 0% 1990 1995 2000 2005 2010 2015 Year Boys, England Boys, France Boys, United States Girls, England Girls, France Girls, United States Note: Age- and gender-adjusted rates of obesity, using the 2005 OECD standard population. Definition of obesity based on the WHO BMI- for-age cut-offs. Measured height and weight in England and the United States; self-reported in France. Source: OECD analysis of national health survey data*. 5 Obesity update - © OECD 2017 Obesity rates are expected to increase further OECD projections show a steady increase in obesity rates until at least 2030 (Figure 5). Obesity levels are expected to be particularly high in the United States, Mexico and England, where 47%, 39% and 35% of the population respectively are projected to be obese in 2030. On the contrary, the increase is expected to be weaker in Italy and Korea, with obesity rates projected to be 13% and 9% in 2030, respectively. The level of obesity in France is projected to nearly match that of Spain, at 21% in 2030. Obesity rates are projected to increase at a faster pace in Korea and Switzerland where rates have been historically low. Figure 5: Projected rates of obesity 50% United States 45% 40% Mexico 35% England 30% Canada 25% Spain 20% France Rate of obesity Switzerland 15% Italy 10% Korea 5% 0% 1970 1980 1990 2000 2010 2020 2030 Year Note: Obesity defined as Body Mass Index (BMI) ≥30kg/m². OECD projections assume that BMI will continue to rise as a linear function of time. Source: OECD analysis of national health survey data*. 6 Obesity update - © OECD 2017 Inequalities in obesity and overweight are growing In the majority of countries, women are more obese most countries. However, in the United States, rates than men – however, in most OECD countries for have been increasing most rapidly among high- which data are available, male obesity has been educated people. growing more rapidly. Education and socio-economic background affect Less-educated women are two to three times obesity. Reciprocally, obesity damages labour market more likely to be overweight than those with a outcomes that, in turn, contribute to reinforcing higher level of education in about half of the eight existing social inequalities (Devaux and Sassi, 2015). countries for which data are available (Figure 6).