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Tuesday, December 7, 2021

Monetary Costs of Obesity

The U.S. News reported this year that obesity is troublesome for Americans, and expensive: Obesity Costs the Average U.S. Adult Almost $1,900 per Year. This in the midst of COVID as some have allowed weight to increase and fitness to languish, see Comorbidity of Obesity (October 2021). The fact is, the American physique is large and getting larger, see What's in a Name (August 2020). 

But, $1,900 is a significant amount. For context, the mean American income in 2019 was "$51,916.27, and the median annual wage was $34,248.45," according to policy advice. That means the $1,900 is between 3.6% and 5.5% of income for the average, and thus definitionally more expensive for those whose income is lower. Obesity thus has a significant financial impact.

The U.S. News story notes that weight is not news. It acknowledges the variety of challenges that may come with increased weight such as contributions "to health conditions like arthritis, diabetes, heart disease, and certain cancers." The report details that increased medical costs are not dependent upon "significant weight gain." Instead, once one enters the "obese category," then healthcare costs may increase with "even incremental increases in weight." The increases are not insignificant. An individual whose body mass was sufficient to be labeled "obese" (BMI over 30) could expect to spend an additional $253 per year with "even a one-unit increase."

A "one-unit" increase is generally five to six additional pounds. The BMI chart for various heights and weights is here. You may locate your current BMI using your data, then consider how few pounds it would require to push you into the next column. If you are 30 or over, then this BMI process labels you "obese." Various prognostications then associate an increased risk of the conditions above as well as sleep apnea, arthritis, high cholesterol, infertility, and more. Included in this is "increased risk" from COVID-19, according to Truthaboutweight.com

The U.S. News author quotes one commentator who encourages this news about "one unit" and risks from "incremental increase" should be interpreted as positive news. That was an interesting take, and eye-catching. A "one-unit increase" costing an additional $253 annually should be seen as positive? 

This commentator contends that the inverse should be considered: "that (similarly) small improvements in weight could save health care dollars." She encourages a "glass half-full, half-empty" perspective to encourage us to each see the potential for cost savings through even moderate reduction in body mass. And, in keeping with the study findings reported, perhaps even small incremental decreases might impact our health and upon our annual healthcare expenditures. 

The impact overall is significant according to the study cited by U.S. News. "Adulthood obesity" is apparently responsible "for nearly $173 billion in annual medical expenses nationally," and the most significant age range is those in their 60s. That similarly hit home a bit. Like it or not, we are all getting a little older with each passing day. I have been troubled in recent years as more and more of my contemporaries have begun to suffer significant medical issues and health challenges. Aging is a tough path, but as they say, it beats the alternative. 

Proponents are quoted by U.S. News as urging regulation of nutrition in children. They contend that government regulation would be appropriate to enforce sound caloric consumption, activity, and thus resulting weight. They advocate more tax burden on us all  and provision of more healthy food through government programs like "the Food Stamp and Women, Infants and Children programs" and . . . School Lunch Program." 

A study released in 2020 concluded that efforts toward more focused school lunch menus last decade had a positive impact. The University of Washington School of Public Health concluded that the 2010 Healthy, Hunger-Free Kids Act "was associated with significant increases in consuming dark green vegetables, beans, peas and whole grains and decreases in consuming refined grains." Thus, improvement in the quality of foods consumed. The study found improvement in among those eating school lunches, most significantly among those in the "low" (30% increase in score) and "low to middle" (31% increase) income categories. Thus, there is the suggestion that diet can be adapted.  

The school lunch program is already a $10.4 billion annual expenditure, according to the USDA.  Women, Infants, and Children (WIC) was another $4.9. Some estimate that the total spend on federal food assistance programs approaches $70 billion annually. The U.S. News contention that increased taxpayer burden on such programs would lead to more healthy food consumption is therefore perhaps challenging. In fact, a detailed study in 2017 found that the food stamp program (SNAP) funds were significantly spent on soda and "disproportionately" on unhealthful foods." Lots of money is being spent, and constraints in a somewhat controlled environment like school lunches may alter consumption, but discretionary food spending is largely not focused on healthy foods.

Thus, we are led back to the age-old conclusion that diet, exercise, and health are largely personal decisions. Significant weight gain or loss may be important. The good news, however, is that small incremental weight loss can bring immediate benefit. A small weight loss of 5-7 pounds (one unit) can bring $253 per year in medical cost savings. A fifteen to twenty-pound loss becomes more significant, and so on. The conclusions of the report noted by U.S. News suggests that there is immediate and significant improvement from incremental weight loss. 

As we near 2022 and consider resolutions, perhaps there are worthy goals we might make regarding small adjustments to eating habits, unhealthful food consumption, exercise, and more?