Obesity and healthcare costs

[Toro]

Here is one reason why America spends more on health care than any other nation in the world - we're too fat!

Two facts from the Wall Street Journal a few days ago:

The prevalence of obesity rose 37% between 1998 and 2006....Obese people spent 42% more than people of normal weight on medical costs in 2006.

This is consistent with what I said in a column on healthcare fallacies in the NY Times a couple years ago:

Americans are also more likely to be obese, leading to heart disease and other medical problems. Among Americans, 31 percent of men and 33 percent of women have a body mass index of at least 30, a definition of obesity, versus 17 percent of men and 19 percent of women in Canada. Japan, which has the longest life expectancy among major nations, has obesity rates of about 3 percent.

The causes of American obesity are not fully understood, but they involve lifestyle choices we make every day, as well as our system of food delivery. Research by the Harvard economists David Cutler, Ed Glaeser and Jesse Shapiro concludes that America’s growing obesity problem is largely attributable to our economy’s ability to supply high-calorie foods cheaply. Lower prices increase food consumption, sometimes beyond the point of optimal health.

FYI, here, from OECD data presented in the O'Neill study, are the percentages of the male population with a body-mass index of 30 or more (female obesity rates are similar):

Japan 2.8
France 9.8
Germany 14.4
Canada 17.0
U.K. 22.7
U.S. 31.1

The bottom line: Differences in healthcare costs and outcomes, either over time or across countries, depend on a lot more than the national system of health insurance.

Greg Mankiw's Blog: Obesity and Healthcare Costs

C'mon, America. Do you really need that stack of six pancakes with chocolate chips and whipping cream smothered in syrup first thing in the morning at IHOP?

 

[waltky]

Granny says, "Dat's right - Obama don't wanna be married to a fat mama...

US First Lady Promotes Anti-Obesity Initiative
February 09, 2011 : U.S. first lady Michelle Obama is celebrating the one-year anniversary of her "Let's Move" initiative, aimed at fighting the problem of childhood obesity.

Mrs. Obama was in New York City Wednesday on a two-day publicity tour, promoting the cause on two popular morning news and entertainment programs. The first lady said on ABC television program Live with Regis and Kelly the U.S. has come far on the obesity issue, but still has a long way to go.

Mrs. Obama also visited an NBC News program Today, where she said her healthy initiative is about "balancing" children's diets, a philosophy she says she promotes with her daughters: nine-year-old Sasha and 12-year-old Malia. She also put to rest rumors that her husband, President Barack Obama, is dying his graying hair. She said his hair has a lot of gray, and she joked that had he known he was going to be president he would have dyed his hair a decade ago.

The first lady travels to the southeastern state of Georgia later Wednesday to visit a school that has adopted her anti-obesity initiative. She also speaks at a local church. Mrs. Obama has gained wide backing for her program in the past year with Congress passing a $4.5 billion child nutrition bill. And last month, Wal-Mart pledged to reduce sugar, sodium and trans fats in thousands of its products to show its support for the program.

MORE

 

[The Hatter]

 

[Tank]

It is mostly blacks and Hispanics whom are obese

 

[JamesInFlorida]

Oh no we can't give our kids healthy options at school! How are they going to keep eating pizza, french fries, soda, and potato chips at lunch everyday! That's after they eat sugary cereals for breakfast. Hm why are all these kids getting diabetes and are so damn obese (driving up the cost for everyone else)? I wonder...

 

[old navy]

It is mostly blacks and Hispanics whom are obese

There are also a bunch of fat white dudes driving BMWs but you make a good point. Poverty in this country is not what one sees when thinking of living in poverty. Most American poor people have more than one TV, cell phones, cars, rent and utilities paid by social programs, and of course, plenty of food and sugery drinks. In principle, I don't agree with more taxes on soda or making food stamp purchases be healthy food choices only, but many poor people are obese because of the choices they make. This of course drives up the cost of health care in the U.S. due to diabetes, heart disease, kidney disease, and the list goes on. It is part of the cost of doing business in a free society.

 

[Douger]

Let me explain this to you dolts.

The fatcats that own the stock in BK, Coke, Dunkin' yernuts, Nacho Hell,McD,Pizza Rut, Proctor-Gamble and all of that other shit also own heavy stock in big pharma and hospitals.Hospitals and big pharma own tons of stock in those companies. They all pay your politicians a hefty sum annually ( pawned off as " lobbying")

Sorry to say it, but you're nothing more than cattle providing huge sums of money for fatcats.

MMMMMMMMMMM Genetically modified corn on the cob ! It's SOOOOOOOO sweet ! Pass the Parkay !
Idiots.

 

[editec]

Obesity does increase the need for HC, without doubt.

Of course the other reason why HC is so expensive here is because the cost is market driven like it is NOT in most nations.

1) American Samoa, 93.5% (of the population that is overweight)

It’s a staggering number. Many Pacific Island nations have had trouble with weight in modern times mostly because they have abandoned their traditional foods for cheap, easily attained processed foods from the West. Perhaps no other Pacific Island has had such access to these habits as American Samoa.

(2) Kiribati, 81.5%

Like American Samoa, Kiribati has been flooded with processed foods like Spam and mutton flaps (fatty sheep scraps), often sold at lower prices than native food.
(3) U.S.A., 66.7%

Well, the U.S.A. doesn’t top the list, but it’s close, and it falls behind only a small islands nation and one of its own unincorporated territories. The United States of Processed food, high fructose corn syrup and fast food has been high on this list over the last half century.
(4) Germany, 66.5%

The fattest country in Europe no doubt owes their portly woes to lots of beer, fatty foods and inactivity.
(5) Egypt, 66%

Obesity among Egyptian women is particularly high, often attributed to cultural taboos on women exercising or playing sports.
(6) Bosnia-Herzegovina, 62.9%

Once considered a problem only in high-income countries, obesity is dramatically on the rise in low- and middle-income countries like Bosnia-Herzegovina, where smoking, drinking and eating unhealthy foods spiked during the war that ravaged the country from 1992 to 1995.
(7) New Zealand, 62.7%

Obesity is a growing concern for New Zealand. While its native Maori have struggled with weight due to loss of traditional culture like other Pacific Islanders– they are mostly just a scapegoat. New Zealand’s entire population is getting fatter at a rapidly increased rate.
(8) Israel, 61.9%

In the past 30 years, the number of obese Israelis has tripled, evidence the country is truly part of the Western world.
(9) Croatia, 61.4%

Croatia, where cardiovascular disease is the leading cause of death, is also a victim of the globalization of the food market, which tends to suppress traditional diets as cheaper processed foods from the U.S. and Europe flood store shelves.
(10) United Kingdom, 61%

A recent survey ranked Brits among the bottom third of European nations in physical exercise, leading Health Secretary Andy Burnham to comment, “We’re really in danger of being known as the best in the world for watching sport, but one of the worst for getting out there and doing it for ourselves.”
—–
Source: Global Post

 

[Bern80]

Obesity does increase the need for HC, without doubt.

Of course the other reason why HC is so expensive here is because the cost is market driven like it is NOT in most nations.

.....and said market is being artificially inflated.

 

[Mad Scientist]

I lived in Japan and I can tell you, the Japanese walk everywhere! What takes 5 hours in a car takes only 1.5 hours on a train in Tokyo.

They have small refrigerators so they have to go food shopping everyday and that includes a walk to the local supermarket.

Their main dish isn't meat and potatoes, they eat a lot of vegetables and they eat smaller portions as well. Every time I visit Japan I usually see only 2 or 3 fat people.

 

[beennasuna]

About the only way i know of to get a fat democrat to lose weight is cut their food stamps.

 

[Bern80]

No question obesity is a problem in this country. I think it underscores however why our health care system needs to be free market based. People need to decide whether they prefer freedom or security. If this really is the land of the free and people want to be free than people need to understand that freedom comes with very high level of risk and personal accountability. A person is free to eat nothing but big macs and chain smoke for the rest of their lives, but such a choice requires that person bare the financial responsibility for that choice, including the financial and physical consequences.

If, on the other hand, people would rather have the government insure security from things like exhorbitant medical bills then government and ultimately me, now get a say in the choices you make, making you less free. Government's main means of paying for things is through taxes which come from you and me. So to prevent you from being wasteful with the money I was required to give to government, I and government are going to want to set some restrictions on the choices you can make. Where health care is concerned we will want to prevent you from making choices that will cause us to have to pay out money that we otherwise wouldn't have to, had you not decided to chain smoke and live on big macs.

The fundamental underlying principle is no one has the right to hold another involunatrily financially responsible for their poor choices. So for those of you that say we need to go to single payer or UHC or some form of government run health care, what you should be asking yourself is are you willing to sacrafice some choices? Are you willing to allow me to tell you how you have to live your life? Because I now have the moral authority to do so since you are essentially telling me I am financially responsible for your health care.

 

[boedicca]

Good topic. Obesity is the driver of much of the country's health care costs.

It would behoove us to consider why the country has become more obese.

Here's why: Big government dietary policies and agriculture programs which result in a much higher concentration of the typical American diet consisting of corn, wheat, rice, and soy. More of the American diet is comprised of convenience foods which are chockful of additives and refined ingredients. This food can be considered "predigested", and is converted into blood glucose at a much higher rate than Real Food.

The following link contains a phrase about how the Western Diet now causes us to "mainline glucose". (Long article - very good read)

http://www.nytimes.com/2007/01/28/magazine/28nutritionism.t.html?_r=1


Eat food. Not too much. Mostly plants.

That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy. I hate to give away the game right here at the beginning of a long essay, and I confess that I’m tempted to complicate matters in the interest of keeping things going for a few thousand more words. I’ll try to resist but will go ahead and add a couple more details to flesh out the advice. Like: A little meat won’t kill you, though it’s better approached as a side dish than as a main. And you’re much better off eating whole fresh foods than processed food products. That’s what I mean by the recommendation to eat “food.” Once, food was all you could eat, but today there are lots of other edible foodlike substances in the supermarket. These novel products of food science often come in packages festooned with health claims, which brings me to a related rule of thumb: if you’re concerned about your health, you should probably avoid food products that make health claims. Why? Because a health claim on a food product is a good indication that it’s not really food, and food is what you want to eat.

Uh-oh. Things are suddenly sounding a little more complicated, aren’t they? Sorry. But that’s how it goes as soon as you try to get to the bottom of the whole vexing question of food and health. Before long, a dense cloud bank of confusion moves in. Sooner or later, everything solid you thought you knew about the links between diet and health gets blown away in the gust of the latest study.

Last winter came the news that a low-fat diet, long believed to protect against breast cancer, may do no such thing — this from the monumental, federally financed Women’s Health Initiative, which has also found no link between a low-fat diet and rates of coronary disease. The year before we learned that dietary fiber might not, as we had been confidently told, help prevent colon cancer. Just last fall two prestigious studies on omega-3 fats published at the same time presented us with strikingly different conclusions. While the Institute of Medicine stated that “it is uncertain how much these omega-3s contribute to improving health” (and they might do the opposite if you get them from mercury-contaminated fish), a Harvard study declared that simply by eating a couple of servings of fish each week (or by downing enough fish oil), you could cut your risk of dying from a heart attack by more than a third — a stunningly hopeful piece of news. It’s no wonder that omega-3 fatty acids are poised to become the oat bran of 2007, as food scientists micro-encapsulate fish oil and algae oil and blast them into such formerly all-terrestrial foods as bread and tortillas, milk and yogurt and cheese, all of which will soon, you can be sure, sprout fishy new health claims. (Remember the rule?)

By now you’re probably registering the cognitive dissonance of the supermarket shopper or science-section reader, as well as some nostalgia for the simplicity and solidity of the first few sentences of this essay. Which I’m still prepared to defend against the shifting winds of nutritional science and food-industry marketing. But before I do that, it might be useful to figure out how we arrived at our present state of nutritional confusion and anxiety.

The story of how the most basic questions about what to eat ever got so complicated reveals a great deal about the institutional imperatives of the food industry, nutritional science and — ahem — journalism, three parties that stand to gain much from widespread confusion surrounding what is, after all, the most elemental question an omnivore confronts. Humans deciding what to eat without expert help — something they have been doing with notable success since coming down out of the trees — is seriously unprofitable if you’re a food company, distinctly risky if you’re a nutritionist and just plain boring if you’re a newspaper editor or journalist. (Or, for that matter, an eater. Who wants to hear, yet again, “Eat more fruits and vegetables”?) And so, like a large gray fog, a great Conspiracy of Confusion has gathered around the simplest questions of nutrition — much to the advantage of everybody involved. Except perhaps the ostensible beneficiary of all this nutritional expertise and advice: us, and our health and happiness as eaters. ....

 

[uscitizen]

Obwesity is just rright behind smoking as the leading preventable cause of death.
And yet they allow fat people to give off second hand fat in the restaurants and such.

 

[Harry Dresden]

Let me explain this to you dolts.

The fatcats that own the stock in BK, Coke, Dunkin' yernuts, Nacho Hell,McD,Pizza Rut, Proctor-Gamble and all of that other shit also own heavy stock in big pharma and hospitals.Hospitals and big pharma own tons of stock in those companies. They all pay your politicians a hefty sum annually ( pawned off as " lobbying")

Sorry to say it, but you're nothing more than cattle providing huge sums of money for fatcats.

MMMMMMMMMMM Genetically modified corn on the cob ! It's SOOOOOOOO sweet ! Pass the Parkay !
Idiots.

we are glad you left this Country asshole.....im sure your not getting to fat down there....you cant be making much picking up horse shit ......but then a loser like you is probably getting govt aide..... im sure Costa Rica was happy to be getting another X-American loser.....

 

[Toro]

Good topic. Obesity is the driver of much of the country's health care costs.

It would behoove us to consider why the country has become more obese.

Here's why: Big government dietary policies and agriculture programs which result in a much higher concentration of the typical American diet consisting of corn, wheat, rice, and soy. More of the American diet is comprised of convenience foods which are chockful of additives and refined ingredients. This food can be considered "predigested", and is converted into blood glucose at a much higher rate than Real Food.

Food companies are making bigger and bigger portions.

For example 20 years ago, two average slices of pizza contained approximately 500 calories. Today, the average slice of pizza is 850 calories. ...

It’s not just pizza either. Bagels are double the calories they used to be, from 140 calories for a 3″ bagel to today’s 5″-6″ bagel that carries a whopping 350 calories. The 8 oz. Coke bottle of yesteryear that contained 97 calories has been replaced by the 20 oz. Coke at 242 calories. Even our plates are bigger now. Twenty percent larger in fact. In 1990 the average plate size increased from 10 to 12 inches. If the plates are 20% larger, you would most likely be inclined to put 20% more food on that plate and eat it all. I know I did. Serve me a full plate of food I like and I’d clean it up. Not only that I may go back for more later when no one was paying attention to me.

Portion Sizes for Real People | Fit to the Finish

More

Portion Sizes: Then and Now

The simple fact is that food companies squeeze more profits out of each unit by making portion sizes bigger. They pour billions of dollars into marketing and testing to understand the innate triggers which cause people to want to eat. When you see this

It creates a deep-seated physiological stimulus to want it. You are hard-wired that way. In a population which is presented with such stimuli, more will be consumed. There isn't much worse for you than bacon, but there isn't much better tasting either! If its out of sight, its out of mind. But if stimuli can be created - marketing, cooking bacon while you're around - you are more likely to respond and consume and thus buy from the companies that are selling to you.

 

[uscitizen]

People need to be charged for health insurance by the pound.

 

[Big Black Dog]

I'd rather my tax dollars for health care costs go to a fat fucker with diabetes than a queer fucker with aids.

 

[Zander]

Obesity does increase the need for HC, without doubt.

Of course the other reason why HC is so expensive here is because the cost is market driven like it is NOT in most nations.

1) American Samoa, 93.5% (of the population that is overweight)

It’s a staggering number. Many Pacific Island nations have had trouble with weight in modern times mostly because they have abandoned their traditional foods for cheap, easily attained processed foods from the West. Perhaps no other Pacific Island has had such access to these habits as American Samoa.

(2) Kiribati, 81.5%

Like American Samoa, Kiribati has been flooded with processed foods like Spam and mutton flaps (fatty sheep scraps), often sold at lower prices than native food.
(3) U.S.A., 66.7%

Well, the U.S.A. doesn’t top the list, but it’s close, and it falls behind only a small islands nation and one of its own unincorporated territories. The United States of Processed food, high fructose corn syrup and fast food has been high on this list over the last half century.
(4) Germany, 66.5%

The fattest country in Europe no doubt owes their portly woes to lots of beer, fatty foods and inactivity.
(5) Egypt, 66%

Obesity among Egyptian women is particularly high, often attributed to cultural taboos on women exercising or playing sports.
(6) Bosnia-Herzegovina, 62.9%

Once considered a problem only in high-income countries, obesity is dramatically on the rise in low- and middle-income countries like Bosnia-Herzegovina, where smoking, drinking and eating unhealthy foods spiked during the war that ravaged the country from 1992 to 1995.
(7) New Zealand, 62.7%

Obesity is a growing concern for New Zealand. While its native Maori have struggled with weight due to loss of traditional culture like other Pacific Islanders– they are mostly just a scapegoat. New Zealand’s entire population is getting fatter at a rapidly increased rate.
(8) Israel, 61.9%

In the past 30 years, the number of obese Israelis has tripled, evidence the country is truly part of the Western world.
(9) Croatia, 61.4%

Croatia, where cardiovascular disease is the leading cause of death, is also a victim of the globalization of the food market, which tends to suppress traditional diets as cheaper processed foods from the U.S. and Europe flood store shelves.
(10) United Kingdom, 61%

A recent survey ranked Brits among the bottom third of European nations in physical exercise, leading Health Secretary Andy Burnham to comment, “We’re really in danger of being known as the best in the world for watching sport, but one of the worst for getting out there and doing it for ourselves.”
—–
Source: Global Post

Pricing for Healthcare in the USA is NOT Market Driven - It is the third party pay system that is inflating the costs. Procedures that are "not covered" by insurance have actually gone down in cost over the past 20 years. Consumers are forced to economize and the service providers have to find ways to cut costs to compete. By contrast procedures covered by insurance have tripled in cost (or more!) over the same period. When the procedure is being paid for by "someone else" (insurance companies) the prices go up and up and up. Why not? "someone else" is paying.

 

[Zander]

Good topic. Obesity is the driver of much of the country's health care costs.

It would behoove us to consider why the country has become more obese.

Here's why: Big government dietary policies and agriculture programs which result in a much higher concentration of the typical American diet consisting of corn, wheat, rice, and soy. More of the American diet is comprised of convenience foods which are chockful of additives and refined ingredients. This food can be considered "predigested", and is converted into blood glucose at a much higher rate than Real Food.

Food companies are making bigger and bigger portions.

For example 20 years ago, two average slices of pizza contained approximately 500 calories. Today, the average slice of pizza is 850 calories. ...

It’s not just pizza either. Bagels are double the calories they used to be, from 140 calories for a 3″ bagel to today’s 5″-6″ bagel that carries a whopping 350 calories. The 8 oz. Coke bottle of yesteryear that contained 97 calories has been replaced by the 20 oz. Coke at 242 calories. Even our plates are bigger now. Twenty percent larger in fact. In 1990 the average plate size increased from 10 to 12 inches. If the plates are 20% larger, you would most likely be inclined to put 20% more food on that plate and eat it all. I know I did. Serve me a full plate of food I like and I’d clean it up. Not only that I may go back for more later when no one was paying attention to me.

Portion Sizes for Real People | Fit to the Finish

More

Portion Sizes: Then and Now

The simple fact is that food companies squeeze more profits out of each unit by making portion sizes bigger. They pour billions of dollars into marketing and testing to understand the innate triggers which cause people to want to eat. When you see this

It creates a deep-seated physiological stimulus to want it. You are hard-wired that way. In a population which is presented with such stimuli, more will be consumed. There isn't much worse for you than bacon, but there isn't much better tasting either! If its out of sight, its out of mind. But if stimuli can be created - marketing, cooking bacon while you're around - you are more likely to respond and consume and thus buy from the companies that are selling to you.

We are getting fatter. But eating bacon is not making people fat. If we ate more bacon we'd actually lose weight. It is grains, bread, cereals, rice, sugar, and processed foods that we eat with the bacon that's killing us. That, and the awesome job that the food industry has done to convince people that they need to eat 3-6 meals a day - starting with a "healthy breakfast". That is such Pure bullshit. Do you think cavemen had access breakfast every morning? Let alone eat 6 meals a day? Hell no! Yet in spite of going sometimes weeks without food, the human brain grew at a phenomenal rate. All by eating lots of wild meat, fish, nuts and berries- sporadically at best. We benefit from missing a few meals now and then and feasting at other times. Once we started eating grains and "three square meals a day" our brains shrank and we started dieing of cancer. We became fat slobs. Connect the dots people , this shit ain't too hard to figure out. If you are fat you are eating too much grains, pasta, rice, and sugar! Don't even get me started on High Fructose Corn Syrup!!!! GRRRRRRR!!!

The truth is you can eat all you want and never get fat if you eat REAL food. Food that our hunter gatherer ancestors ate for millions of years. Odd thing is that once you start eating this way - your energy levels will go way up and your waistline way down. Eat pasta and cake and ice cream and all that shit - but just limit it to one day a week at most. You'll lose weight and improve your health.