Estimating the mortality impact of overweight reduction scenarios in the Netherlands, 2024–2047

Background

Overweight and obesity are important drivers of the non-communicable disease (NCD) burden in the Netherlands, accounting for 3% of years of life lost (YLLs). Quantifying the specific health impact of reducing overweight prevalence is important for informing public health policy. This study estimates the Population Impact Fraction (PIF) for various overweight reduction scenarios.

Methods

Adult overweight and obesity projections, as well as several disease-specific mortality projections from the Dutch Public Health Foresight Study 2024 (PHFS) provided a baseline for 2024–2047. Overweight was categorized into normal weight (BMI < 25), overweight (BMI 25-30) and obesity (BMI ≥30). Intervention scenarios involved a fixed percentage reduction in the prevalence of overweight and obesity by shifting individuals down one category. A maximum feasible reduction (MFR) scenario assumed a maximum shift of one category per individual. PIFs were calculated and applied to mortality projections for 12 overweight-related diseases.

Results

All scenarios resulted in significant mortality reductions by 2047 compared to the baseline. The MFR scenario led to estimated decreases of 19% for cervical cancer (131 avoided deaths), 14% for diabetes (403 avoided deaths), and 12% for colorectal cancer (734 fewer avoided deaths). The 30% reduction scenario yielded more moderate mortality reductions: 5.7% for cervical cancer (32 avoided deaths), 4.3% for diabetes (121 avoided deaths), and 3.7% for colorectal cancer (220 avoided deaths). The impact varied across diseases, with the largest reduction observed for cervical cancer.

Conclusions

Reducing overweight prevalence in the Netherlands can lead to significant health gains. PIF modelling provides a clear link between reduction targets and potential health benefits. Future research should align these PIF estimates with specific interventions to further inform policy development.

Key messages

• Reducing overweight prevalence by 30% could prevent hundreds of deaths from diabetes and cancer annually in the Netherlands by 2047.

• Population Impact Fraction (PIF) modeling clarifies how overweight reduction targets translate into health gains, supporting evidence-based public health policy development.