Morbidities associated with obesity are also associated with high medical costs for care.
Obesity is a global epidemic according to World Health Organization
reports. There are more than 1 billion overweight (BMI 25–29.9) adults,
and at least 300 million of them are obese (BMI > 30) compared with 850
million who are chronically underweight (malnutrition and hunger). The United
States ranks number one in the world in rates of overweight and obese
individuals per capita, estimated in 2004 at 64.5% of the population; Mexico
(62.3%), the United Kingdom (61%) and Australia (58.4%) follow close behind.
The lowest percentages are recorded in Japan (25.8%) and Korea (30.6%).
|
Saad Shebrain |
Brant K.
Oelschlager |
Researchers from Johns Hopkins Bloomberg School of Public Health
addressed the prevalence of obesity and found the U.S. obesity rate has
increased at an alarming rate over the past three decades, according to results
of a recent study. The researchers expect that by 2030, 86% of U.S. adults will
be overweight or obese, with related health care spending projected to be as
much as $956.9 billion. They concluded that without a change in people’s
eating habits or exercise habits, the figures will continue climbing to a
public crisis.
From an economic standpoint, obesity is costly for both individuals and
society, with its associated major health problems leading to substantial
economic consequences for the U.S. health care system. This includes both
direct and indirect costs. Direct medical costs may include preventive,
diagnostic, and treatment services related to obesity; indirect costs relate to
morbidity and mortality costs.
These economic costs related to obesity hit on multiple levels, starting
from the base of pyramid — the overweight or obese person him/herself,
his/her employment, the family — to the community, to the city level, to
the state level, the national level, and the global international level. All
these levels have a common pathway of economic destruction with shifting the
resources from being used for human welfare like education, health care of
manageable diseases and building the infrastructures in community in need.
At an individual level, obese people are subjected to a well-known major
health problems related to obesity including, but not limited to, hypertension,
osteoarthritis, dyslipidemia, type 2 diabetes, coronary heart disease, stroke,
gallbladder disease, sleep apnea and respiratory problems, and some cancers
(endometrial, breast, and colon). These morbidities are associated with very
high medical costs for treatment of these problems or their complications.
Unfortunately, almost all obese people have a combination of more than one of
these health issues.
Obesity and obesity-related conditions result in $62.7 billion in
doctors’ visits and $39.3 billion in lost workdays each year. Type 2
diabetes, for example, has the highest contribution with an estimated $98
billion per year in health care costs because of its links with other health
issues such as coronary artery diseases, renal diseases, hyperlipidemia and
stroke.
The effect of obesity is not limited to health problems only, but it
encompasses all aspects of these individuals’ daily living activities at
home and travel. An example of this is the reflection of obesity on fuel
consumption. In the 1990s, Americans’ average weight increased by 10 lb,
which meant that airlines spent $275 million on fuel costs in one year to
account for that average increase in weight. This made some airlines require
obese people or people who may take up more than one seat to buy an adequate
number of seats on the flight.
More recently, researchers found that nearly 1 billion additional
gallons of fuel are consumed annually in the United States as a result of
average passenger weight increases since 1960. They concluded that 0.7% of the
fuel consumed by passenger vehicles annually can be attributed to the rising
prevalence of obesity since 1960. Although this fraction seems to be small, it
can be translated into a large amount of money loss when one considers the
increasing cost of gasoline.
At the level of employment, a recent study by Hertz et al showed that
obesity has essentially the same effect as 20 years of aging on employees’
ability to work. Obese employees are less productive because they cannot work
as many hours because of physical limitations or health problems. They also
have lower wages. Researchers with Stanford University found that obese people
earn, on average, $3.41 per hour less than their peers, translated into about
$7,000 in lost income a year. However, they found no significant difference
when comparing the wages, retirement and life insurance benefits of obese and
non-obese workers whose employers did not provide health insurance. Results of
another study has shown that the annual additional cost for a worker who is
obese can reach $2,500. Taking the frequency of obesity into account, as well
as the overall gender makeup of the workforce, the researchers argue that for a
firm with 1,000 employees, obesity would cost about $285,000 a year.
On a national and state level, medical expenses for overweight and
obesity accounted for 9.1% of total U.S. medical expenditures in 1998 and may
have reached as high as $78.5 billion ($92.6 billion in 2002 dollars).
Finkelstein et al conducted a more recent study to predict annual state-level
estimates of total Medicare and Medicaid obesity attributable medical
expenditures and found the state-level estimates range from $87 million to $7.7
billion. Obesity-attributable Medicare and Medicaid estimates range from $15
million to $1.7 billion and from $23 million to $3.5 billion, respectively.
This range depends on the state. For example, in Washington state, the
estimated adult obesity-attributable expenditure was $1.3 billion, while the
obesity- attributable Medicaid and Medicare expenditures were $365 million and
$236 million, respectively.
In summary, the economic effects of obesity are severely damaging.
Obesity is a major burden on both developed and developing countries with its
damaging effect through health care costs and lost productivity. Without
well-planned programs to combat the factors responsible for this major public
problem, human health is in danger and the global epidemic crisis will become
worse. In other words, any action by both federal and state governments alone,
without individual participation, is likely to fail.
For more information:
- Economic impact of obesity. 2007.
http://www.obesityinamerica.org/economicimpact.html.
- Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending
attributable to overweight and obesity: how much, and who’s paying?
Health Aff. 2003;219-226.
- Finkelstein EA, Fiebelkorn IC, Wang G. State-level estimates of
annual medical expenditures attributable to obesity. Obes Res.
2004;12:18-24.
- Fisher M. Airlines should calculate prices by the pound. November
18, 2004.
http://www.washingtonpost.com/wp-dyn/articles/A58886-2004Nov17.html.
- Jacobson SH, McLay LA. The economic impact of obesity on automobile
fuel consumption. Engineering Economist. 2006.
- James W, Jackson-Leach R, Mhurchu CN, et al. Overweight and obesity
(high body mass index). In Comparative quantification of health risks: global
and regional burden of disease attributable to selected risk factors. WHO.
2003;497-596.
- Loureiro ML. Obesity: economic dimensions of a ‘super
size´ problem. Choices. 2004;1-5.
- Wolf AM, Colditz GA. Current estimates of the economic cost of
obesity in the United States. Obes Res.1998;6:97-106.
- Wolf, A. What is the economic case for treating obesity? Obes Res.
1998;6:2S-7S.