It has been nearly a decade since the OECD published its flagship report on obesity, Fit not Fat. During the intervening years, countries have put in place innovative and, in some cases, ambitious policies to turn the tide on the obesity epidemic.

An increasing number of people are overweight across the OECD, and this will curb GDP by an estimated 3.3% on average. Health problems linked to expanding waistlines are pushing up workplace absenteeism and lowering productivity as we consume more calories without exercising more. Rising levels of overweight are also damaging our health, wealth and wellbeing, lowering school performance for children, and increasing the risk of unemployment and shortening life expectancy for adults.

Despite policies and action plans put in place by countries at a global level, overweight continues to be a pressing public health issue and one of the key drivers of non-communicable diseases in OECD countries and beyond. This chapter brings together the main messages of this publication and describes the key policy implications from new OECD analyses on the health, social and economic burden of being overweight and its associated lifestyles, including poor diet, lack of physical activity and sedentary behaviour. The chapter presents trends and projections for up to 52 OECD (including accession and partner countries), Group of 20 (G20) and European Union (EU28) countries and makes a strong economic case for upscaling investment in policies that promote healthy lifestyles. The chapter concludes by presenting the expected effectiveness, impact on health expenditure and return of investment for ten such policies and analyses the potential implementation costs and approaches to mitigating such costs.

This chapter presents patterns and trends for overweight and obesity in OECD countries, OECD accession and selected partner countries, EU28 countries, and Group of 20 (G20) countries. Overall, obesity prevalence is increasing in all countries analysed and severe or morbid obesity is also on the rise. These patterns are examined in both adults and children, and separate analyses are performed to determine whether rates of overweight and obesity vary among different population groups, such as by sex and socio-economic status, including income and education. Lastly, this chapter covers various determinants of obesity, such as diet, physical activity, and sedentary behaviour, in order to elucidate targeted health policy strategies.

This chapter provides an overview of the burden of obesity on population health and the economy. Based on the results of the OECD Strategic Public Health Planning for non-communicable diseases (SPHeP-NCDs) model, it presents the impact of obesity on life expectancy, morbidity and mortality, and on health expenditure in 52 countries – including OECD, EU28 and Group of 20 (G20) member countries. It also explores the impact of obesity on the labour market and the wider economy. Linking to the OECD long-term economic model, the impact of obesity on gross domestic product (GDP) and tax rate is assessed.

This chapter investigates the relationship between childhood obesity and a variety of educational outcomes. A data analysis covering 32 countries explores the association between performance at school and obesity in children aged 11 to 15, and assesses the degree of inequality across countries. A longitudinal analysis investigates a potential causal relationship between childhood obesity and academic performance as well as education attainment in five countries. Finally, the chapter discusses the broader consequences of the relationship between obesity and educational outcomes, for individuals and the economy.

Overweight is a serious public health problem requiring a co-ordinated, multi-sectoral response. This chapter provides a broad overview of existing policy approaches, both national and international, aimed at improving diet and encouraging physical activity in OECD, EU28 and Group of 20 (G20) countries. Particular attention is paid to policies that are either innovative, or have a solid evidence base for their effectiveness, including policies that aim to influence lifestyle choices through information and education; policies that expand healthy choice options; policies designed to modify the costs of health-related choices, and policies aimed at regulating or restricting unhealthy options. Both the opportunities presented by the introduction of the selected policies, as well as the challenges associated with their implementation, are discussed.

This chapter presents results from modelling the implementation of ten policy actions including food labelling; menu labelling; mass media campaigns promoting physical activity; prescribing physical activity in primary care; mobile apps promoting healthy lifestyles; workplace wellness programmes; workplace sedentary behaviour programmes; school-based programmes; expanded public transport and statutory bans on advertising targeting children. In addition, the impact of three policy packages is shown, including a package of mostly existing, communication-based policies; a package of physical activity-based policies; as well as a mixed package of policies that are still relatively rarely implemented in OECD countries, but nevertheless show significant promise. Results are presented for 36 countries, including OECD countries in the European Region as well as Japan, Mexico, Canada, and Australia, together with other non-OECD EU28 member states and South Africa. A particularly innovative aspect of this analysis is its focus not only on health outcomes, but also on economic outcomes, including the policy impact on health spending, on the employment and productivity of workers, as well as on the gross domestic product (GDP) of countries.

Properly implemented, a reformulation policy can help achieve a win-win-win outcome for public health, the food industry and for consumers. This section briefly discusses the opportunities and challenges presented by the implementation of the set of actions needed to achieve food and beverage reformulation, while also presenting the health and economic outcomes based on a scenario of a 20% calorie reduction in foods high in sugar, salt, calories and saturated fats.

This chapter explores the impact that obesity policies can have on the food and drink industry. It presents the results of a literature review on six public health policies that directly affect the food industry: reformulation, portion size changes, food labelling, food taxes, advertising restrictions and healthy food subsidies. It considers both one-off implementation costs, as well as on-going changes in operations or sales.