America's Girth Carries Hefty Price Tag

Obesity-related problems could consume 1 in 5 health-care dollars

THURSDAY, March 11, 2004 (HealthDayNews) -- Even as the U.S. government warns that Americans' poor diet and exercise habits will soon surpass tobacco as the leading preventable cause of death, new research puts a whopping price tag on the obesity epidemic.

By 2020, roughly one in five health-care dollars spent on people aged 50 to 69 years old could be for obesity-related medical problems. That's up 50 percent from 2000, according to a Rand Corp. report.

The nation's expanding waistline also will result in higher disability rates among middle-aged and older Americans, the authors predict.

"The continuing weight gain in America will erode health gains that were attained through better medical care," says study author Roland Sturm, a Rand Health senior economist.

The analysis appears in the March issue of Health Affairs.

The Rand report coincides with the release of new data underscoring the human toll of obesity. Poor diet and physical inactivity caused 400,000 deaths in 2000, the U.S. Centers for Disease Control and Prevention reported on Tuesday.

Only tobacco use caused more deaths -- 435,000 in 2000. Yet tobacco fatalities rose just 9 percent from 1990, while deaths caused by poor eating and a sedentary lifestyle jumped 33 percent over the same period.

That report appears in the March 10 issue of the Journal of the American Medical Association.

With obesity poised to surpass tobacco as the No. 1 preventable killer, Health and Human Services Secretary Tommy Thompson announced a new ad campaign aimed at encouraging Americans to take small steps to improve their health and reverse the obesity trend. He also announced a new effort by the National Institutes of Health to bolster obesity research.

"We're just too darn fat, ladies and gentleman, and we're going to do something about it," Thompson said at the news conference.

People who are overweight or obese are at greater risk of suffering from a number of costly and potentially deadly health conditions, including cardiovascular disease, hypertension, type 2 diabetes and osteoarthritis. Roughly 130 million adults are overweight or obese, costing an estimated $117 billion in medical expenses and lost productivity in 2000, according to the U.S. Surgeon General's 2001 report on obesity.

Tobacco remains the nation's No. 1 killer, responsible for 18.1 percent of all fatalities, followed by poor diet and exercise, causing 16.6 percent of deaths. Yet those numbers don't tell the whole story.

"That's the tip of the iceberg," Sturm cautions.

Using data from two national surveys, Rand researchers projected the effects of continuing weight increases through 2020 for Americans aged 50 to 69.

Obesity is defined as a ratio of weight and height known as body mass index (BMI). A BMI of 30 or higher is considered obese. That's at least 30 pounds overweight for a woman of average height and 35 to 40 pounds above ideal weight for man of average height.

Severely obese people -- those with a BMI of at least 35 -- are more than twice as likely as people of normal weight to be in fair or poor health, the study found. They suffer about twice as many chronic medical conditions as trimmer Americans.

They also pose the greatest financial challenge to the nation's health-care system. Severely obese Americans generate 60 percent higher health-care costs than normal weight individuals. Even moderately obese men and women boost health-care costs by 18 percent and 31 percent, respectively.

Considering the enormous challenge ahead, some health policy and nutrition experts say the government's response falls flat.

"It's pretty superficial, isn't it? It doesn't get to the root of the problem," Sturm insists.

Margo G. Wooten, nutrition policy director at the Center for Science in the Public Interest in Washington, D.C., concurs.

"The Bush administration should instead get junk food out of schools, ask Congress to require calorie labeling in fast-food and other chain restaurants, strengthen CDC's nutrition and physical activity division, and fully fund the CDC's VERB campaign, which promoted physical activity to youth," she said in a statement.

But Dr. Peter Vash, secretary of the American Obesity Association, doesn't dismiss the importance of encouraging Americans to take their health into their own hands. He says the government initiative represents a step in the right direction, agreeing that even seemingly simple actions, such as climbing the stairs, can make a difference.

"These people gain the weight very slowly and lose the weight very slowly," Vash observes. "The discipline, the drive, the dedication is what people don't want to be bothered with."

More information

Learn more about healthy eating from the American Dietetic Association, while you can get tips on reaching a healthy weight from the National Heart, Lung, and Blood Institute.

SOURCES: Roland Sturm, Ph.D., senior economist, Rand Corp., Santa Monica, Calif.; Peter Vash, M.D., M.P.H., executive medical director, Lindora Medical Clinics, Los Angeles, and secretary, American Obesity Association; Center for Science in the Public Interest statement; March 2004 Health Affairs; March 10, 2004, Journal of the American Medical Association
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