Health policies and data

Obesity and the Economics of Prevention: Fit not Fat


 Executive Summary and Background NoteMedia Briefs | Country Facts  

Table of Contents | Contacts | Related Material | How to Obtain this Publication


ISBN: 978-92-64-06367-9 (print)

ISBN: 978-92-64084865 (PDF)


Publication date:
23 September 2010

265 pages, 5 tables, 50 graphs





Obesity has risen to the top of the public health policy agenda worldwide. Before 1980, rates were generally well below 10%. They have since doubled or tripled in many countries, and in almost half of the OECD, 50% or more of the population is overweight. A key risk factor for numerous chronic diseases, obesity is a major public health concern.

There is a popular perception that explanations for the obesity epidemic are simple and solutions within reach. But the data reveal a more complicated picture, one in which even finding objective evidence on the phenomenon is difficult. Policy makers, health professionals and academics all face challenges in understanding the epidemic and devising effective counter strategies.

This book contributes to evidence-based policy making by exploring multiple dimensions of the obesity problem. It examines the scale and characteristics of the epidemic, the respective roles and influence of market forces and governments, and the impact of interventions. It outlines an economic approach to the prevention of chronic diseases that provides novel insights relative to a more traditional public health approach.

The analysis was undertaken by the OECD, partly in collaboration with the World Health Organization. The main chapters are complemented by special contributions from health and obesity experts, including Marc Suhrcke, Tim Lobstein, Donald Kenkel and Francesco Branca.

“This book presents a valuable set of results and suggestions about the best preventive interventions to reduce the burden of obesity. It will aid any country concerned about this burden in defining public policies aimed at altering current trends.”
Julio Frenk, Dean, Harvard School of Public Health

Read the full statement

“The positive message of this book is that the obesity epidemic can be successfully addressed by
comprehensive strategies involving multiple interventions directed at individuals and populations.”
Ala Alwan, Assistant Director-General, World Health Organization

Read the full statement

“This innovative and well-researched book combines insights from a wide range of disciplines. It provides a clear exposition of the evidence that policy makers need to take action.”
Martin McKee, Professor of European Public Health, London School of Hygiene & Tropical Medicine

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logo_new_els‌For the latest trends and analyses on obesity, read the OECD Obesity Update 2014, released on May 27.


Executive Summary

Media Briefs









Underlying data and charts for all the graphics in the media briefs are also available in Excel


Country Facts











United States

United Kingdom




Table of Contents


Chapter 1. Introduction: Obesity and the Economics of Prevention

• Obesity: The extent of the problem

• Obesity, health and longevity

• The economic costs of obesity

• The implications for social welfare and the role of prevention

• What economic analyses can contribute

• The book’s main conclusions

• Overview of the remaining chapters

• Special Focus I. Promoting Health and Fighting Chronic Diseases: What Impact on the Economy? (by Marc Suhrcke)


Chapter 2. Obesity: Past and Projected Future Trends

• Obesity in the OECD and beyond

• Measuring obesity

• Historical trends in height, weight and obesity

• Cohort patterns in overweight and obesity

• Projections of obesity rates up to 2020


Chapter 3. The Social Dimensions of Obesity

• Obesity in different social groups

• Obesity in men and women

• Obesity at different ages

• Obesity and socio-economic condition

• Obesity in different racial and ethnic groups

• Does obesity affect employment, wages and productivity?

• Special Focus II. The Size and Risks of the International Epidemic of Child Obesity (by Tim Lobstein)


Chapter 4. How Does Obesity Spread?

• The determinants of health and disease

• The main driving forces behind the epidemic

• Market failures in lifestyle choices

• The social multiplier effect: Clustering of obesity within households, peer groups and social networks

• Special Focus III. Are Health Behaviors Driven by Information? (by Donald Kenkel)


Chapter 5. Tackling Obesity: The Roles of Governments and Markets

• What can governments do to improve the quality of our choices?

• Government policies on diet and physical activity in the OECD area

• Private sector responses: Are markets adjusting to the new challenges?

• Special Focus IV. Community Interventions for the Prevention of Obesity (by Francesco Branca) 


Chapter 6. The Impact of Interventions

• What interventions really work?

• Cost-effectiveness analysis: A generalised approach

• Effects of the interventions on obesity, health and life expectancy

• The costs and cost-effectiveness of interventions

• Strategies involving multiple interventions

• Distributional impacts of preventive interventions

• From modelling to policy: Key drivers of success

• Special Focus V. Regulation of Food Advertising to Children: the UK Experience (by Jonathan Porter)

• Special Focus VI. The Case for Self-Regulation in Food Advertising (by Stephan Loerke)


Chapter 7. Information, Incentives and Choice: A Viable Approach to Preventing Obesity

• Tackling the obesity problem

• Populations or individuals?

• Changing social norms .

• A multi-stakeholder approach

• How much individual choice?



Franco Sassi – Senior Health Economist and main author of the report


Michele Cecchini – Health Policy Analyst and co-author


Marion Devaux – Statistician and co-author


Related Material

OECD Health Working Papers


How to obtain this publication

Readers can access the full version of Obesity and the Economics of Prevention: Fit not Fat choosing from the following options:


Related Documents


Obesity Update

The Economics of Prevention

Health Publications

Health Policies

Third Lancet Series on Chronic Diseases