An economy of scales: A selective review of obesity's economic causes, consequences, and solutions

J Health Econ. 2015 Sep:43:244-68. doi: 10.1016/j.jhealeco.2015.03.001. Epub 2015 Aug 14.


This paper reviews the economic research on obesity, covering topics such as the measurement of, and trends in, obesity, the economic causes of obesity (e.g. the monetary price and time cost of food, food assistance programs, income, education, macroeconomic conditions, and peer effects), and the economic consequences of obesity (e.g. lower wages, a lower probability of employment, and higher medical care costs). It also examines the extent to which obesity imposes negative externalities, and economic interventions that could potentially internalize such externalities, such as food taxes, subsidies for school-based physical activity programs, and financial rewards for weight loss. It discusses other economic rationales for government intervention with respect to obesity, such as imperfect information, time inconsistent preferences, and irrational behavior. It concludes by proposing a research agenda for the field. Overall, the evidence suggests that there is no single dominant economic cause of obesity; a wide variety of factors may contribute a modest amount to the risk. There is consistent evidence regarding the economic consequences of obesity, which are lower wages and higher medical care costs that impose negative externalities through health insurance. Studies of economic approaches to preventing obesity, such as menu labeling, taxes on energy-dense foods, and financial rewards for weight loss find only modest effects on weight and thus a range of policies may be necessary to have a substantial effect on the prevalence of obesity.

Keywords: Diet; Nutrition; Obesity; Physical activity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Chronic Disease / economics*
  • Chronic Disease / epidemiology
  • Cross-Cultural Comparison
  • Employment / economics
  • Employment / trends
  • Fast Foods / adverse effects
  • Fast Foods / economics*
  • Fast Foods / supply & distribution
  • Food Assistance / economics*
  • Food Assistance / standards
  • Food Assistance / trends
  • Food Supply / economics*
  • Health Care Costs / trends
  • Health Education / economics
  • Health Education / trends
  • Humans
  • Insurance, Health / economics
  • National Health Programs / economics
  • National Health Programs / trends
  • Obesity / complications
  • Obesity / economics*
  • Obesity / epidemiology
  • Prevalence
  • Residence Characteristics
  • Salaries and Fringe Benefits / economics
  • Salaries and Fringe Benefits / trends
  • Social Discrimination / economics
  • United States / epidemiology
  • Weight Reduction Programs / economics
  • Weight Reduction Programs / legislation & jurisprudence