Tuesday, July 13, 2010

Fat chance of controlling costs

This Wall Street Journal article from a few weeks ago notes that Colorado is now the only state to have an obesity rate below 20%. If you want to watch the pattern of obesity spread over time, check out this post from April 2008.

About a year ago, I made suggestions about the primary causes of health care cost increases and included obesity as one of them.

Paradoxically, now that we have provided more universal access to care, we can expect costs to rise faster. Look here to see evidence of that in France.

Thus far, it has been politically unacceptable to address problems related to obesity. We even have trouble designing a Food Pyramid without the influence of lobbying groups.

Can that change? Unfortunately, cuts in local budgets often flow through in the form of reducing physical education time in schools.

But I remember being a boy and hearing from President Kennedy about the importance of physical fitness. It made a big impression. Would it be possible for today's presidents and governors and mayors to do the same?


Anonymous said...

We're going to have to start treating obesity like smoking in the public realm. The health costs of obesity no doubt exceed those of smoking by now, although I have no data to support that.
Just think of all the measures applied to reduce the smoking rate over the past 30+ years, and let's apply them to the causes of obesity - starting with fast food and sodas.

nonlocal MD

Cetus said...

Lenore Skenazy started a fun parenting movement called "Free Range Kids" a few years back:


It's worth a look. Turning the problem of kids not being allowed outside due to hyper-vigilant parents with outsized fears wildly disproportionate with the risk data into a health issue... let's just say "No" to that, shall we? And let nature take its course.

Melissa said...

we also have to take into consideration the state of the school systems' lunch programs. Daily nachos and cheese fries do not a balanced meal make.

76 Degrees in San Diego said...

Would you advocate Body Mass Index based insurance premiums? If so, would this be considered "discriminatory" by the American Disability Act?

Anonymous said...

I pursued data to support my thought that obesity is now a greater health cost problem than smoking. The primary author of a study comparing the two is quoted below:

"In 2008, the quality-adjusted life years lost due to obesity is slightly higher than the quality-adjusted life years lost due to smoking,"
"While smoking has bigger impact on mortality, smokers die at a much younger age. For an obese person, although they [are at an increased risk to] die, they die at an older age," often with high medical bills for chronic medications and expensive treatments.
(Jia, H. and Lubetkin EI, American Journal of Preventive Health, January 2010.)

Of interest, similar findings were reported in Australia, where the government was criticized for having acted strongly against tobacco but failing to tackle obesity adequately.

Paul's referenced post in 2009 was prophetic in including obesity as a suggested cause of rising health care costs:

"Perhaps this suggests that a common organism underlies our problems, homo sapiens and its curious ability to live longer and expect more."

nonlocal MD

catsandmusic said...

When President Obama tried to deliver an address to schoolchildren last fall, just as many past presidents have done--you mentioned the Kennedy physical fitness speech from our youth--the irrational outcry that greeted Obama was so disrespectful and insulting that I am still sickened thinking of it. I don't know why the media gave credence to the fringe wingnuts who raised the hue and cry, but they did. So, remembering this episode, I don't think that Obama will be addressing the nation's children again, as much as it would be welcomed by most people. However, the First Lady has made this issue one of her main initiatives, and I think she is doing a great job.

stop smoking help said...

I agree with the smoking analogy. Smoking is the most preventable cause of disease worldwide. Obesity will soon be spoken in those terms if current trends continue.

Unfortunately, it will have to get worse before it can get better before the conversation about discrimination becomes tiresome and people begin to realize it's a matter of health AND "yes", money. (Just like smoking.)

But with programs like NFL Play 60 and tv programming like The Biggest Loser, this should become a public conversation sooner than later.