The cost of obesity in economic terms has been estimated to account for 2 to 7% of total healthcare costs1World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Technical Report Series no. 894. WHO, Geneva, 2000.. The combined direct and indirect costs to the USA have been re-assessed at US$123 billion in 20012Wolf AM, Manson JE, Colditz GA. The Economic Impact of Overweight, Obesity and Weight Loss. Ed Eckel R in Obesity. Lippincott, Williams and Wilkins, 2002.. This expenditure may overshadow the costs in smaller countries such as England where the Parliamentary National Audit Office assessed the cost at around £3 billion (adjusted to 2003 figures)3National Audit Office. Tackling Obesity. National Audit Office, London 2001. . In the Pacific islands, the economic consequences of non-communicable diseases, chiefly obesity and type 2 diabetes, have been dramatic, consuming US$1.95 million, almost 60% of the health budget of Tonga, and in Fiji absorbing US$13.6 million, 39% of the health budget4Dalton A and Crowley S. Economic Impact of NCD in the Pacific Islands in Obesity in the Pacific: Too Big to Ignore. Secretariat of the Pacific Community 2002..
The human cost can be measured in terms of years of disability, which can reduce the quality of life as well as lowering life expectancy. Higher body mass index has been shown to account for up to 16% of the global burden of disease, expressed as a percentage of disability-adjusted life years (DALYs)5World Health Organization. The World Health Report 2002. Reducing Risks, Promoting Healthy Life. IOTF research for the WHO Global Burden of Disease programme..