Due to increases in body weight and medical complications, insurance companies may be confronted with increasing claims which will impact their profitability. To mitigate this cost, insurance companies may have to increase the premium so as to commensurate with this rising claim cost. This increase in price will impact on the healthy population.
Health insurance premium has doubled in the past 10 years, but it is unclear how much of this premium is sufficient to cover the financial burden of the obesity pandemic. The evaluation of existing and developing new health coverages related to obesity-related conditions is an important consideration for the profitability of the health insurance providers.14
March 4 of every year is considered as “World Obesity Day”. This is to increase awareness on obesity, its health issues and economic concerns. Every country is aware of this issue, but not many governments have implemented successful policies to curb this increasing number of overweight populations in the past or recent years. Nevertheless, many countries are constantly working on this and have implemented certain prevention programmes to curb the unhealthy trend.
Some of the cost-effective interventions to prevent obesity are imposing higher taxes on sugar-sweetened beverages (SSBs), nutrition labelling, advertising bans on unhealthy food, and school-based interventions, etc. WHO has expressed its concern on increasing intake of free sugars, particularly in the form of SSBs which may increase the prevalence of obesity. In 2016, the WHO recommended the “implementation of an effective tax on SSBs” as one of several key measures to address childhood obesity.15 Asia, the Philippines and Thailand have already imposed sugar taxes. In Singapore in order to curb the nation’s sugar intake, by the end of 2023, the city’s food and beverage outlets will be required to indicate which of their drinks are high in sugar through the use of a government-developed grading system. The measures will build on regulations that are soon to come into effect.16
Current evidence indicates that consumers perceive nutrition labels to be useful and that labelling has a significant impact on food selection. There is limited evidence on its impact on BMI and obesity prevalence, but nutrition labelling is considered a cost-effective intervention in many settings.17
Unhealthy food and beverage advertisements may affect children’s eating habits and be associated with increased childhood obesity. In 2010, the WHO released recommendations urging member states to restrict the marketing of unhealthy foods and beverages to children. Since 2011 several countries, mostly developed nations, have tightened their regulations on the marketing of unhealthy foods and beverages to children and have banned unhealthy food and beverage television advertisements during children’s peak viewing times.18
School-based interventions include several activities intended to create environments and cultures that support children eating healthier foods and being more active, such as nutrition education classes, improvements in the nutritional quality of school food, physical education, and activities that promote movement and exercise.
In Singapore, the Health Promotion Board (HPB) has introduced programmes such as the Healthier Choice Symbol (HCS) and Healthier Dining Programme (HDP) to increase the availability of healthier options, as well as campaigns such as the Eat, Drink, Shop Healthy Challenge to incentivise healthier purchases.
In partnership with the Ministry of Education, HPB has implemented healthy meals programmes in all mainstream schools and 80% of preschools, to inculcate healthy eating habits from young.19
For seniors, Active Ageing Programmes (AAPs) are made available at over 600 locations island-wide where the elderly can participate in group exercises and health workshops. There are more than 350 parks and gardens, 200 km of covered link-ways, and 440 km of cycling paths and park connectors in the small Singapore island, and there are plans to further enhance the living environment to support a more physically active nation.20
In China, experts from various disciplines such as public health, clinical medicine, nutritionists, and health policymakers grouped together to provide a collective consensus on obesity prevention and treatment in May 2022. The main aim is to come up with a guide to prevent and control rising obesity, promote the participation of the whole society, and contribute to Healthy China 2030 national development goals.21
In the Kingdom of Saudi Arabia, taxation of sugary beverages by the General Authority for zakat (GAZT) have also been implemented with a tax rate of 50% for soft drinks and a tax rate of 100% for energy drinks. Another prominent initiative was the implementation of Rashaqah (fitness), a joint programme between the Ministry of Health and the Ministry of Education, which addresses the provision of healthy canteen food, structured regular exercise sessions and screening for overweight and obesity among students.22
Role of insurance in controlling obesity
In Asia, some insurance companies introduced financial incentives (for example: cash payments or reduced premiums) for better weight management during their renewal process for overweight policyholders in order to motivate insured lives to keep their weight in check and adopt healthier lifestyle. However, this was not always successful.
Currently, few of the companies have products which use claim-based pricing, which is a fairer pricing approach where the premiums are adjusted based on the claims history.
Insurance companies should continue to experiment on innovative approaches to educate the public on obesity and its long-term health benefits and incentivise healthier living to attract healthier policyholders. Further, reducing the prevalence of obesity is one of the most profitable investments which life and health insurance industry can make.
Obesity is a growing concern across the globe. Curtailing the current trend of obesity is everyone’s responsibility. It is recognised that stigma is a common experience for people with obesity, with an impact on a person’s physical and mental health. This leads to social isolation, depression, and anxiety which complicates the metabolic disorder and other medical complexities associated with obesity. People with obesity experience poorer medical care because of stigma and judgemental attitudes held, and often expressed, by various healthcare professionals. Surveys in Asian countries suggest that such opinions are common among clinicians and the general public, and that people with obesity are reluctant to engage their doctors in a discussion about their weight.23
Apart from government health promotion boards and the WHO, doctors, healthcare facilities, and health insurance companies can be the primary sources where awareness of obesity can be promoted. This includes advertising the benefits of low body weight, healthy food choices and adverse effects of consuming fast food, sugary drinks, etc. In addition, clinicians are well positioned to advocate for public health policies that promote healthy habits and help prevent obesity through exercise, antenatal, infant, and child nutrition programmes, and education. They can be the role model for healthy lifestyles. And as members of the broader community, they can bring their knowledge and standing to advocate for healthy changes that reach people well beyond the walls of the clinic.
Life and health insurance, with our broad claims data, can contribute by providing mortality and morbidity statistics to the local government health authorities and policymakers which in turn helps them develop health awareness campaigns for the public. Insurance companies with their broader reach can be an effective influence on the weight control behaviours of the insured public. They can promote themselves through sponsoring multiple health prevention programmes which certainly have a positive impact on society.
Ultimately, it is the responsibility of individuals who are overweight to take greater ownership of their bodyweight and understand the complications associated with it. People can take actions to maintain healthy bodyweight through healthy lifestyle, and discipline which can reap lifelong benefits.