A new study from the department of public health at Sweden’s Karolinska Institute, discussed on Dr. Arya Sharma’s blog, and published in the journal Obesity, shows that men who are obese at age 18 are 30 percent less likely to be upwardly mobile and 30 percent more likely to be downwardly mobile than men with a normal body weight.

The researchers measured social mobility by determining whether the obese men in the study achieved a higher or lower socioeconomic status than their fathers.

The Swedish study is the largest of its kind, following 1,578,694 men with the goal to determining “the relationship between Body Mass Index (BMI) and social mobility between generations.” As Sharma points out, the findings were independent of childhood socioeconomic index, IQ or education, “suggesting that societal factors (e.g. bias and discrimination) may be responsible.”

Sharma, a physician who is also the scientific director of the Canadian Obesity Network, goes on to link downward social mobility to loss of income and lower socioeconomic status. He also writes that many of the obese patients he sees in his clinic are on short-term or long-term disability, unemployed or not working to their full potential. He argues that this may be obesity’s greatest cost to society—one that far exceeds the burden it puts on the health care system.

What kind of economic figures do we actually have?

A seminal study in the Canadian Medical Association Journal in 1999 put the direct cost of obesity to the health care system in 1997 (including cost of hospital care, physician services, drugs, health research, etc.) at $1.8 billion per year. Another Canadian study, in 2004, that accounted for indirect costs, such as lost economic activity due to short-term and long-term disability, put the total figure at $4.3 to 5.3 billion annually.

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