BPA Exposure Linked to 127 Million Global Metabolic Disease Cases

Exposure to endocrine-disrupting bisphenol chemicals—including bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF)—was associated with more than 127 million cases of obesity, type 2 diabetes (T2D), and metabolic syndrome worldwide in 2024, according to research published in Science of the Total Environment.1

Researchers warned that despite declining BPA levels in many regions, rising exposure to BPS and BPF is driving a substantial and growing metabolic health impact.

72 Million Cases of Obesity Worldwide

Investigators analyzed biomonitoring data from National Health and Nutrition Examination Survey (NHANES), the European Human Biomonitoring Initiative, and regional datasets across 20 countries, applying meta-analytic relative risks for bisphenols and key metabolic outcomes. They found that global bisphenol-attributable disease increased from 68 million cases in 2000 to 127 million in 2024, reflecting an 87% increase. Asia carried 45% of the global burden, followed by North America (21%) and Europe (18%).

Obesity accounted for 72 million of the bisphenol-related cases, followed by 31 million cases of metabolic syndrome and 24 million cases of T2D.

BPA Exposure Declines Following Policy Changes

Across all regions, urinary BPA levels declined significantly following a mix of regulatory and voluntary restrictions. Between 2000 and 2024, BPA exposure decreased by 39% in Asia, 36% in Latin America, 32% in North America, and 29% in Europe. “These reductions coincide with progressive restrictions, including BPA bans in thermal paper and food packaging implemented across the European Union and voluntary phase-outs in North America,” the study authors noted.

However, exposure to BPS and BPF rose sharply at the same time, increasing the most in Asia by 51% and 46%, respectively. In North America, BPS exposure increased by 44%, and BPF increased between 33% and 41%. European BPS and BPF levels rose by 47% and 22% between 2015 and 2022 as BPA regulations became stricter.2

BPS and BPF exposure increased despite stricter BPA regulations. | Image credit: photka – stock.adobe.com

“This finding is consistent with biomonitoring reports from both Europe and the US, and supports the growing consensus that BPS and BPF are now prevalent BPA substitutes,” the authors said.1

According to the study, 76% of bisphenol-related metabolic disease cases in Europe are now attributable to BPS or BPF exposure. In North America, where there has been less uniform BPA regulation, about half of cases were attributed to BPA exposure and half to BPS or BPF exposure. Broken down by region, regression results showed clear variation in how exposure to endocrine-disrupting chemicals was associated with metabolic disease.

“The strongest associations were observed in North America, where historically high levels of BPA exposure remain a concern despite regulatory efforts to phase out its use in consumer products,” the authors said. “The magnitude of the association aligns with longitudinal NHANES data and mechanistic studies showing that North American populations are particularly vulnerable due to persistent legacy exposures and high metabolic disease prevalence.”

Economic Burden of Metabolic Disease in North America

The global economic burden of BPA-, BPS-, or BPF-attributable metabolic disease in 2024 was estimated to be $1.1 trillion.

With 26.7 million cases of bisphenol-attributable metabolic disease in 2024, North America generates some of the highest per capita costs globally. The continent’s total economic burden exceeded $250 billion, driven primarily by indirect losses such as absenteeism, productivity declines, and premature mortality, according to researchers. Direct medical expenses—hospitalizations, medication costs, and outpatient care—comprised approximately 30% of total expenditures.

Because obesity, diabetes, and metabolic syndrome carry long-term treatment and disability costs, the rise in bisphenol-associated metabolic disease may impose a growing financial strain on health systems and employers. The researchers suggest that reducing bisphenol exposure by 50% could prevent 49 million new cases and save $420 billion annually.

References

1. Jaskulak M, Zorena K. Quantifying the metabolic health burden of increased BPA/BPF/BPS endocrine-disrupting chemical exposure: a temporal and cross-country comparative analysis from 2000 to 2024. Sci Total Environ. Published online November 12, 2025. doi:10.1016/j.scitotenv.2025.180897
2. New EU regulation lowers BPA limit. ECA Academy. November 4, 2018. Accessed November 19, 2025. https://www.gmp-compliance.org/gmp-news/new-eu-regulation-lowers-bpa-limit