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Category Life Insurance

Obesity – Health risks far too real to ignore!

21 February 2013 Nicholas van der Nest, Divisional Director: Risk Products, Liberty
Nicholas van der Nest, Divisional Director: Risk Products, Liberty

Nicholas van der Nest, Divisional Director: Risk Products, Liberty

Obesity is becoming an increasing health concern in many parts of the world. In some parts of the world obesity has already replaced malnutrition and infectious diseases, such as HIV/AIDS and tuberculosis, as the primary cause of poor health. According to


In South Africa 61% of adults are obese. This is according to research released in October 2012 by GlaxoSmithKline. Far worse is that 78% of obese people consider themselves healthy according to the survey!

The Body Mass Index (BMI) or Quetelet index, is a measure for human build, taking into account height and weight. It is a way of classifying people as normal weight, overweight or obese. Although some scientists believe that it is an inaccurate measure of obesity related risks, a recent study has found that it works as well as other body measurements and better than some to predict certain health problems.


An individual’s BMI is calculated as:

BMI = weight (in kg) / height2 (in metres)

The World Health Organization (WHO) defines being overweight or obese as having “abnormal or excessive fat accumulation that may impair health”. The WHO uses the BMI to classify a person based on their build, as follows:




What causes a person to become overweight or obese?

Becoming overweight or obese is most commonly as a result of eating more calories than needed and/or undertaking too little physical activity to match calorie intake. However, it is acknowledged that the problem is much more complex than just excessive calorie intake and there are several other possible causes that may contribute to a person becoming overweight or obese. These include:

• A genetic predisposition to obesity
• Socio-economic factors
• Cultural background
• Psychological problems such as depression
• Endocrine disorders such as an underactive thyroid

What are the risks associated with obesity?

Obesity has been classified as a chronic condition and there are a large number of medical problems associated with being obese. We know that, compared to a healthy weight male, an obese male is:
• 5 times more likely to develop type 2 diabetes
• 3 times more likely to develop cancer of the colon
• more than 2.5 times more likely to develop high blood pressure (which is a major risk factor for heart disease and stroke).

On the other hand an obese female, compared to a healthy weight female is:
•almost 13 times more likely to develop type 2 diabetes

• more than 4 times more likely to develop high blood pressure
• more than 3 times more likely to have a heart attack

Besides the above, depression is often a side effect of obesity (as the disorder is stigmatised).

Being overweight can lead to body image issues, unhappiness and eating disorders related to drastic and radical attempts to reduce weight.

Finally, other medical problems associated with obesity include osteoarthritis, sleep problems and digestive disorders.

Does obesity increase the risk of premature death?

The relative risk of death increases significantly at BMI levels above 30. It is also more significant in men than women.

A study of more than one million adults, over a period of 14 years, showed that the lowest levels of mortality occur at BMI levels between 22 and 25. In the overweight range (BMI between 25 and 30), the relative risk shows a slow increase but the risk starts to escalate sharply in the obese range (BMI above 30).


What treatment is available to treat obesity?

The primary method of treatment is to reduce calorie intake and increase physical activity. Pharmaceutical treatment is available that can be used in addition to a weight loss programme. In some cases weight loss surgery, including gastric bypass surgery, may also be considered in some obese people. In general however this will not be a substitute for a healthy diet and exercise.

What is the impact of obesity on the life insurance industry?

Obesity is one of the top 3 medical conditions presented on insurance application forms nowadays. The rising prevalence of obesity cannot be disregarded as there is sound clinical evidence to demonstrate a reliable relationship between BMI and mortality and morbidity risks in the insurance industry.

In the current competitively priced South African market, the underwriters and actuaries are subjected to increasing pressure for more lenient ratings for overweight and obese applicants. The current range of increased BMI rateable at standard rates is relatively wide. However, insurers can no longer deny the effects of this growing epidemic as it will soon be the number one cause of preventable death. To survive as an industry we need to formulate a sustainable risk management solution which is likely to include revisions to the way we rate obesity.

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