Abstract
Background: Obesity and type 2 diabetes (T2DM) are increasing in Saudi Arabia (SA). These risk factors increase the likelihood of non-alcoholic fatty liver disease (NAFLD), which in turn increases risks for advanced liver disease, such as non-alcoholic steatohepatitis, cirrhosis and cancer. The goal of this study was to quantify the health and economic burden of obesity-attributable T2DM and liver disease in SA. Methods: We developed a microsimulation of the SA population to quantify the future incidence and direct health care costs of obesity-attributable T2DM and liver disease, including liver cancer. Model inputs included population demographics, body mass index, incidence, mortality and direct health care costs of T2DM and liver disease and relative risks of each condition as a function of BMI category. Model outputs included age- and sex-disaggregated incidence of obesity-attributable T2DM and liver disease and their direct health care costs for SA's working-age population (20-59 years) between 2020 and 2040. Results: Using available data, the increase in the next 20 years will be: 1 976 593 [± 1834] new cases of T2DM, 285 346 [± 874] new cases of liver disease, and 2101 [± 150] new cases of liver cancer that are attributable to obesity, amongst working-age people, between 2020 and 2040. The direct health care costs of these obesity-attributable diseases are predicted to be approximately 117.8 billion USD by 2040. Conclusions: The increase in obesity-associated T2D and liver disease suggests that obesity interventions could meaningfully reduce the future health and economic burden of T2DM, liver disease and liver cancer in SA.