Quantifying the fiscal benefits of obesity prevalence reduction in China

Abstract

With obesity becoming increasingly prevalent in China, its impact extends beyond health losses to wider public finance pressures. This study assessed the fiscal implications of reducing obesity prevalence from the government perspective and explored the potential fiscal benefits of obesity control. An age-stratified prevalence-based fiscal simulation model was constructed in Microsoft Excel®. The analysis considered four government-related fiscal dimensions associated with obesity: tax revenue, disability-related pension costs, retirement pension payments, and healthcare expenditure. Outcomes were estimated under two scenarios, namely the observed obesity prevalence and a prevalence reduction scenario, and the fiscal effect was derived from the difference between them. Parameter inputs were identified through a targeted literature review and supplemented with published statistical sources and yearbooks. Costs were adjusted to the 2024 level using the consumer price index. A one-way sensitivity analysis was conducted to verify the robustness of the results. The model estimated that reducing obesity prevalence by 1 percentage point would improve government finances by ¥30.37 billion overall. This net effect was driven by higher tax revenue, including ¥15.99 billion in direct tax and ¥3.12 billion in indirect tax, together with lower public spending on disability pensions and healthcare, generating savings of ¥5.08 billion and ¥6.70 billion, respectively. Retirement pension payments were projected to increase by ¥0.24 billion. Scenario projections further indicated that, if the obesity growth slowdown targeted under China’s Weight Management Year program is achieved, the net fiscal gain in 2026 would be ¥4.06 billion. The one-way sensitivity analysis showed that the results were most sensitive to the marginal effect of obesity on income. Obesity affects not only health system spending but also broader government revenues and expenditures. Even a modest reduction in prevalence could produce measurable fiscal gains in China. Strengthening obesity prevention and control may therefore provide value not only for population health but also for public finance sustainability.