Fed by Broken Food System, Health Plummets as Costs Soar
As America's waistline expands, costs soar as health plummets
An over-weight individual is not necessarily more unhealthy than one who is slimmer, but the epidemic of obesity in the US and the dire health consequences of a 'fast food nation', supported by an industrial farm system are putting enormous strains on the lives of millions and helping to explode costs in an already inefficient health care system. The trend towards increased obesity occurs throughout the society, but is perhaps most troubling perhaps for the impact its having on school children.
"Today, two-thirds of U.S. adults and nearly one in three children struggle because they are overweight or have obesity," says the Campaign to Prevent Obesity, who recently released a new report tracking the relationship between the obesity epidemic and rising healthcare costs. "The effects of the nation’s obesity epidemic are immense: taxpayers, businesses, communities and individuals spend hundreds of billions of dollars each year due to obesity, including an estimated $168 billion in medical costs. Obesity is the reason that the current generation of youth is predicted to live a shorter life than their parents."
Asked to comment, John Hoffman, executive producer of The Weight of the Nation, a new four-part HBO documentary, says the most important thing to know is that this crisis is wholly preventable, but that the "consequences of not acting, boldly, systemically and decisively, are dire."
"We need to work together to make some big changes to the systems that govern the food we grow," says Hoffman in an interview with USA Today. "The economies that drive the food we manufacture; the policies that regulate what we market and serve, particularly to kids; the values we place on the overall quality of the schools to which we send our children; the design of our communities, parks and roads so they promote health; and the perspective of our health care system so that it's focused on preventing illness from happening, rather than just treating it once it develops."
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U.S. hospitals are ripping out wall-mounted toilets and replacing them with floor models to better support obese patients. The Federal Transit Administration wants buses to be tested for the impact of heavier riders on steering and braking. Cars are burning nearly a billion gallons of gasoline more a year than if passengers weighed what they did in 1960.
The nation's rising rate of obesity has been well-chronicled. But businesses, governments and individuals are only now coming to grips with the costs of those extra pounds, many of which are even greater than believed only a few years ago: The additional medical spending due to obesity is double previous estimates and exceeds even those of smoking, a new study shows.
Many of those costs have dollar signs in front of them, such as the higher health insurance premiums everyone pays to cover those extra medical costs. Other changes, often cost-neutral, are coming to the built environment in the form of wider seats in public places from sports stadiums to bus stops.
The startling economic costs of obesity, often borne by the non-obese, could become the epidemic's second-hand smoke. Only when scientists discovered that nonsmokers were developing lung cancer and other diseases from breathing smoke-filled air did policymakers get serious about fighting the habit, in particular by establishing nonsmoking zones. The costs that smoking added to Medicaid also spurred action. Now, as economists put a price tag on sky-high body mass indexes (BMIs), policymakers as well as the private sector are mobilizing to find solutions to the obesity epidemic.
"As committee chairmen, Cabinet secretaries, the head of Medicare and health officials see these really high costs, they are more interested in knowing, 'what policy knob can I turn to stop this hemorrhage?'" said Michael O'Grady of the National Opinion Research Center, co-author of a new report for the Campaign to End Obesity, which brings together representatives from business, academia and the public health community to work with policymakers on the issue.
The U.S. health care reform law of 2010 allows employers to charge obese workers 30 percent to 50 percent more for health insurance if they decline to participate in a qualified wellness program. The law also includes carrots and celery sticks, so to speak, to persuade Medicare and Medicaid enrollees to see a primary care physician about losing weight, and funds community demonstration programs for weight loss.
"The startling economic costs of obesity, often borne by the non-obese, could become the epidemic's second-hand smoke. Only when scientists discovered that nonsmokers were developing lung cancer and other diseases from breathing smoke-filled air did policymakers get serious about fighting the habit..."
Such measures do not sit well with all obese Americans. Advocacy groups formed to "end size discrimination" argue that it is possible to be healthy "at every size," taking issue with the findings that obesity necessarily comes with added medical costs.
The reason for denominating the costs of obesity in dollars is not to stigmatize plus-size Americans even further. Rather, the goal is to allow public health officials as well as employers to break out their calculators and see whether programs to prevent or reverse obesity are worth it.
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Q: What is it going to take to reverse the obesity epidemic?
A: The obesity epidemic is not a natural disaster that we can't do anything about. This national crisis is completely preventable.
We live in a world where there's an abundance of cheap calories, and we have foods high in sugar and fat at arm's reach at almost all times.
Big decisions made by the food industry, agriculture and government have a huge impact on the little decisions we make about what we reach for when we're hungry and how long we sit at our desks and in our cars.
Q: What was the most surprising thing you learned?
A: Over the course of human evolution, there has never been any reason to limit our food intake. In fact, it's the opposite. Because we need food to survive, we are genetically programmed to love it. There may be as many as 100 genes that favor food-seeking behavior. And we evolved a system to favor fat deposition as a buffer against times of scarcity. … But in a world full of burger joints, pizza parlors and vending machines, our biological imperative to store fat whenever we can may instead pose a threat to our survival.
Q: If you could wave a magic wand and make a change, what would it be?
A: Remove all sugared beverages from our diet. Our bodies are not adapted for that rush of liquid calories. It's clear they're driving a lot of obesity and a contributor to diabetes.
Q: What else did you learn?
A: Even after 10 years of maintaining a significant weight loss, the body doesn't readjust. Your brain still thinks you're in a state of deprivation, and it manipulates your body in ways you don't even notice: You're hungrier, less easily satisfied, and more frequently tempted by sweet and fatty foods; you are less inclined to exercise.
Losing weight and keeping it off requires a renovation of your entire life for the remainder of your life.
Q: What actions/policies would help the most?
A: We need to work together to make some big changes to the systems that govern the food we grow; the economies that drive the food we manufacture; the policies that regulate what we market and serve, particularly to kids; the values we place on the overall quality of the schools to which we send our children; the design of our communities, parks and roads so they promote health; and the perspective of our health care system so that it's focused on preventing illness from happening, rather than just treating it once it develops.
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