Consider this: the world has just been through one of the worst economic crises since the Great Depression, yet Australia seems to have come through it swimmingly — at least for the moment.

How did we do it? The government gave us money to help us consume.

Synonyms for “consume” in Roget’s thesaurus include: “eat”, “drink”, “get through”, “devour”, “put away”, “munch through”, “chomp through”, “guzzle”.1 With not a tinge of irony, the Australian Government Senate report, Weighing it up: obesity in Australia2 (and most other obesity reports), advises us to take stock of ourselves, not to be such pigs, to stop overeating, leave the SUV (sport utility vehicle) at home and walk, or ride a bicycle — in other words, to stop consuming!

Is this schizophrenic government policy? No, it’s sensible, post-Keynesian economics, currently being applied around the world. But how sensible is a system that puts vast amounts of money into treating a problem that it puts vast amounts of money into creating?

Obesity depends on overconsumption — of food, drink and effort-saving technology; hence, the fatter the population, the fatter the economy. A spoof “pitch” on a recent ABC television program on advertising cleverly illustrates this. Asked to develop a campaign to reduce prejudice against obesity, the competing agency came up with an advertisement praising fat people for their overconsumption for being heroes in the battle to reverse the 2008–2009 global financial crisis. The catch phrase of this spoof, “Australia: our success depends on your excess”, sums up the modern conundrum.

Reporting in the journal Health Affairs,3 researchers calculated that obese individuals in the United States pay US$1400 per year more for their health (or lack thereof) than their lean counterparts. This adds an extra $47 billion per year to the US budget, or about 10% of all health spending, which, ironically, all goes to the measure of economic health, or gross domestic product (GDP). People with diabetes spend US$4100 more per year on medical care in their first year of detection than people without diabetes, and each incurs an extra $158 of medical expenses each year, which is also added to GDP.4

Currently, these physically sick but economically valuable people make up 7% of all Australians. However, there are another 15% with prediabetes, lining up to contribute to the nation’s coffers.5 Such a vital economic segment of the population could easily be doubled within a generation, with money to consume more fatty foods, use gas-guzzling cars rather than walk or cycle, and watch televised activity rather than actively participating. If the economy remains sluggish, smoking, and alcohol and drug use, which currently add about 9% to GDP directly, and a similar amount from dealing with the consequences, could be increased overnight with a further government bailout.

While health experts decry these costs as evidence of health system failure, economists rub their hands together to the tinkle of money that is keeping the GDP in the black. Politicians, of course, are the meat in the sandwich.

Without labouring the point (ie, the economic benefits of fast food, obesity surgery, weight-loss programs, etc), it should be obvious that there is now a disconnection between the modern system of economic growth and human health. This is not to suggest that this has always been the case. There is no doubt that economic growth has been the greatest single contributor in history to improving human health.6 But even the early architects of economic growth — Mill, Keynes and others — foresaw a time when growth would pass its use-by date, when the returns on further investment would start to decrease and then become negative. As pointed out by one commentator: “after maturity, continued growth is either obesity or cancer”.7

In his Principles of political economy, written in 1848, John Stuart Mill states:

In health terms, it seems this time may have arrived. Data from Sweden over the past 200 years show an initial close relationship between health and economic growth, but then in recent years, a reversed relation in which faster growth implies less progress in improving health.9 Diminishing returns in health, as reflected by increases in obesity, disability-adjusted life-years, and health costs (although not yet by decreases in longevity), have also been linked with climate change,10 making an alternative to our current growth fetish even more crucial.

For most people, of course (including those in the health professions), this is all too hard, along with its correlates in water shortages, species extinction, freakish weather events, and global warming. So, we tend to ignore it, hoping it will go away. But without considering the macroeconomic system’s dynamic influence on human health, and the fact that economic growth has largely finished its work in developed countries and we now need to pay greater attention to reducing inequity,11 obesity and its related chronic diseases will continue their onward march to becoming the only human epidemic to approach affecting 100% of the population. Let’s hope economists, health scientists and politicians can agree on similar goals before that happens.