November 14, 2023
Obesity is a major public health concern in Mexico and its prevalence has been increasing over the past several decades.1 Between 2000 and 2018, obesity in adults increased 42.2%,1,2 and obesity in children doubled between 1996 and 2016 (Figure 4.1).3 Most recent national survey data revealed that over one-third of adults were living with obesity and only 23.5% of the population were at a healthy weight.1,2 The main causes of mortality in the country are now linked to obesity, including cardiovascular diseases, type 2 diabetes, malignant tumors and liver diseases.1 In fact, in 2021, approximately 14 million adults in Mexico were living with type 2 diabetes, and almost half were undiagnosed. Undiagnosed diabetes puts people at serious risk for health complications like heart attack, stroke, blindness and amputation of lower limbs. Perhaps relatedly, Mexico is also in the top 10 countries for health expenditures related to diabetes.4
Source: World Obesity Federation: World Obesity Atlas 2023.
Employer Opportunity
Employers can provide screening programs that help people understand whether they currently have, or are at risk for, diabetes or prediabetes. This can help avoid serious health risks and allow people to get the care they need to manage their condition.
In recent years, the Mexican diet has evolved from mostly fresh and unprocessed foods to processed foods that are high in sugar, salt and fat.1 Approximately 23% of the Mexican population’s intake comes from these highly processed foods.1,5 Research has shown that sugar-sweetened beverages make up a significant portion of adult and children’s diets,1,6 although a tax on these drinks led to reduced consumption in the years after it was implemented.7 In October 2019, the Mexican parliament also approved a law that requires front of package labeling indicating whether the product is high in sugars, sodium, saturated fats, trans fats, and/or calories, among other information.8
Employer Opportunity
Employers can provide incentives for employees to choose healthier options in cafes and canteens by subsidizing those choices. They may want to consider creative ideas such as take-home options so that employees have access to healthy meals outside of work as well.9
The Cost and Impact of Overweight
The costs of being overweight are high, both to society and to employers. In Mexico, those with a BMI ≥ 25, have a life expectancy of 4.2 fewer years than those with a BMI in a healthy range.21 Overweight accounts for 8.9% of health expenditure [and] lowers labor market outputs by the equivalent of 2.4 million full-time workers per year.10
Table 4.1: Impact of Overweight
|
Health care impact of BMI ≥ 25kb/m2, US$ million |
Total economic impact of BMI ≥ 25kb/m2, US$ million |
Estimated GDP US$ billion |
Impact of BMI ≥ 25kb/m2 on GDP |
---|---|---|---|---|
2020 |
5,521 |
24,070 |
1,166 |
2.1% |
2025 |
6,707 |
30,194 |
1,326 |
2.3% |
2030 |
7,902 |
37,843 |
1,470 |
2.6% |
2035 |
9,184 |
47,879 |
1,634 |
2.9% |
Source: World Obesity Federation: World Obesity Atlas 2023.
Altogether, overweight decreases Mexico’s GDP by 5.3%, more than any other Organization for Economic Cooperation and Development (OECD) country.10 Furthermore, results from a 2018 study showed that respondents with obesity were more likely to report greater levels of presenteeism, work impairment, and health care visits than respondents with a normal weight.11 The projected economic impact of overweight, including productivity loss at work, from 2020 to 2035 is shown in Figure 4.2.
Source: World Obesity Federation: World Obesity Atlas 2023.
The Cost and Impact of Obesity
The national health budget makes up about 2% of the total federal health budget in Mexico. Funding for prevention and control of obesity and non-communicable diseases is less than 1% of that.1,12 Primary health care in the country has historically been weak and physicians are rarely trained in obesity management or nutrition.1 Treatment for obesity generally involves infrequent appointments with traditional recommendations related to diet and exercise.13,14 Research has shown that these types of interventions are unsuccessful, leading to weight loss of less than 1 kg/year.13
BMI screening, obesity treatment and diagnosis are not common in the primary care setting,12 and most Mexican adults with obesity are undiagnosed.13,15 A 2006 nationally representative survey revealed that only 20% of adults with obesity had been diagnosed (and only 8% had received treatment), and 47% of 2000 individuals surveyed in 2018 had a diagnosis.13,15
There is a limited budget to perform bariatric surgery in public institutions, and private insurers do not offer coverage.14,17 Employers say that lack of demand and coverage through the public health system are the top reasons they don’t provide weight management programs in Mexico.18 Additionally, similar to a few other countries discussed, a mindset that obesity is a lifestyle issue creates a gap and opportunity for employers. Bariatric surgery is becoming more common throughout the country; however, there is a need for reported follow-up guidelines and alignment with international standards.1
Employer Opportunity
Many employers are not sure whether their health plans in Mexico cover weight management programs. A gap analysis may be a helpful first step in determining what gaps in coverage exist. Once those gaps are identified, options for filling them include captives when applicable, negotiations with local health plans, and/or on-site services. However, employers must still be aware of what is available in Mexico and realistic about what can be provided.
Employers are aware of the challenges and needs related to quality services. When asked in a 2023 survey how they think employees would describe the quality of services to help manage their weight in Mexico, a third of employers responded good or very good. The most common employer offerings include stress management initiatives, digital weight management programs, healthy nutrition promotion and fitness incentives (via on-site facilities or gym membership subsidies).18
Employer Opportunity
Understand the evidence base for weight management programs and what works and what doesn’t. For example, intensive behavioral interventions can be provided electronically and are designed to lead to weight loss of 5% or more.9
Obesity Stigma and Mental Health Concerns
Stigma related to obesity in the country is significant: Business Group on Health’s Global Weight Management Survey found that 43% of employers view weight stigma as either extremely or very severe; however, only 7% have a strategy in place to address weight stigma (n=20).18
Also, research has shown that there may be a link between obesity and mental health conditions like depression, and a recent study shows this may be true in Mexico as well.19 A systematic review of 16 studies looking at the association between obesity and anxiety or depression on Mexican children and adolescents showed that those with higher BMIs were more likely to present with depression or depressive symptoms than those at a normal weight. This was more likely in females than in males.20
Employer Opportunity
Weight stigma and bias are associated with a host of negative consequences for people with obesity, including avoidance of physical activity, delaying of preventive care and increased risk of chronic conditions. Employers can address stigma by incorporating weight bias training into workplace trainings, asking employees about their experiences with bias during focus groups and ensuring that health and well-being materials are free from stigmatizing language and imagery.9
Employers should cross refer to mental health program offerings in their weight management education materials and vice versa. Make sure that vendors are aware of all obesity and mental health content available to employees.
Obesity in Mexico is a growing problem that will require a multitude of solutions. Changes will not happen overnight. However, employers can make strides with their workforces by understanding the landscape in country, prioritizing local needs and global priorities, and making targeted efforts to fill gaps and provide effective programs where possible.
Obesity and Overweight in Mexico
More Topics
Resource Diversity, Equity, Inclusion & Belonging (DEIB) Health Equity Plan Design & Administration- 1 | Barquera S, Rivera JA. Obesity in Mexico: rapid epidemiological transition and food industry interference in health policies. The Lancet. September 1 2020;8(9):P746-747.
- 2 | Barquera S, Hernández-Barrera L, Trejo-Valdivia B, Shamah T, Campos-Nonato I, Rivera-Dommarco J. Obesity in Mexico, prevalence and trends in adults. Ensanut 2018-19. salud publica mex. 2020;62(6):682-692.
- 3 | Gurría A. Launch of the Study: “The heavy burden of obesity: The economics of prevention”. Accessed November 10, 2022, https://www.oecd.org/about/secretary-general/heavy-burden-of-obesity-mexico-january-2020.htm
- 4 | International Diabetes Federation. 1 in 6 adults are now living with diabetes in Mexico. https://www.idf.org/index.php?option=com_attachments&task=download&id=2645:WDD2021_MEXICO_PR_Final. Accessed March 21, 2023.
- 5 | Marron-Ponce JA, Tolentino-Mayo L, Hernandez FM, Batis C. Trends in ultra-processed food purchases from 1984 to 2016 in Mexican households. Nutrients. 2019;11(1):45.
- 6 | Sánchez-Pimienta TG, Batis C, Lutter CK, J.A. R. Sugar-Sweetened Beverages Are the Main Sources of Added Sugar Intake in the Mexican Population. The Journal of Nutrition. 2016;146(9):1888S-1896S.
- 7 | Colchero MA, Rivera-Dommarco J, Popkin BM, Ng SW. In Mexico, Evidence Of Sustained Consumer Response Two Years After Implementing A Sugar-Sweetened Beverage Tax. Health Affairs 2017;36(3)
- 8 | Pan American Health Organization. Front-of-package labeling advances in the Americas. Accessed November 21, 2022. https://www.paho.org/en/news/29-9-2020-front-package-labeling-advances-americas
- 9 | Business Group on Health. An Employer's Practical Playbook for Treating Obesity. December 5, 2020. https://www.businessgrouphealth.org/resources/managing-overweight-and-obesity-full. Accessed December 12, 2022.
- 10 | OECD. The Heavy Burden of Obesity: The Economics of Prevention. https://www.oecd.org/mexico/Heavy-burden-of-obesity-Media-country-note-MEXICO.pdf. Accessed March 23, 2023.
- 11 | DiBonaventura MD, Meincke H, Lay AL, Fournier J, Bakker E, Ehrenreich A. Obesity in Mexico: prevalence, comorbidities, associations with patient outcomes, and treatment experiences. Diabetes Metab Syndr Obes. 2018;11:1-10.
- 12 | Barquera S, White M. Treating obesity seriously in Mexico: Realizing, much too late, action must be immediate. Obesity. 2018;26(10):1530-1531.
- 13 | Díaz‐Zavala RG, Candia‐Plata MDC, Martínez‐Contreras TJ, Esparza‐Romero J. Lifestyle intervention for obesity: a call to transform the clinical care delivery system in Mexico. Diabetes Metab Syndr Obes. 2019;12:1841-1859.
- 14 | Vázquez‐Velázquez, V., Laviada‐Molina H, García‐García E, Sandoval‐Diez E, Mancillas‐Adame L. Perceptions, Attitudes, and Barriers to Obesity Care in Mexico: Data From the ACTION‐IO Study. Obesity (Silver Spring). 2021;29(2):317-326.
- 15 | Pérez-Salgado D, Valdés Flores J, Janssen I, Ortiz-Hernández L. Diagnosis and treatment of obesity among Mexican adults. Obes Facts. 2012;5(6):937-46.
- 16 | Rivera-Dommarco JA, Colchero M, Fuentes ML, et al. La obesidad en México. Estado de la política pública y recomendaciones para su prevención y control. 2018.
- 17 | Herrera MF, Valencia A, Cohen R. Bariatric/Metabolic Surgery in Latin America. The American Journal of Gastroenterology. 2019;114(6):852-853.
- 18 | Business Group on Health. Global Weight Management Survey. April 7, 2023. https://www.businessgrouphealth.org/resources/global-weight-management-survey. Accessed June 20, 2023
- 19 | Plackett B. The vicious cycle of depression and obesity. Nature. 2022;608:S42-S43.
- 20 | Godina-Flores NL, Gutierrez-Gómez YY, García-Botello M, López-Cruz L, Moreno-García CF, Aceves-Martins M. Obesity and its association with mental health among Mexican children and adolescents: systematic review. Nutr Rev. 2022;Sep 26
- 21 | OECD. Mexico Policy Brief. https://www.oecd.org/health/Policy-Brief-Mexico-Health-EN.pdf. Accessed September 26, 2023
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