Aug 27 2012

How much does obesity cost American society?

The costs of obesity are personal, but also societal.

Economists love trying to figure out how to quantify such things.

The most widely used estimate for the United States is from Cawley and Meyerhoefer’s 2012 article in the Journal of Health Economics: $190 billion annually for health care and lost productivity (their 2010 working paper may be easier to access at the National Bureau of Economic Research site).

Now the Campaign to End Obesity has published its own analysis of these costs.

  • $44.7 billion, for inpatient services.
  • $45.2 billion, for non-inpatient services.
  • $69.3 billion, for pharmaceutical services.
  • $146.6 billion, across all services.

As the Campaign puts it:

the total economic cost of overweight and obesity in the United States and Canada caused by medical costs, excess mortality and disability is approximately $300 billion per year. The portion of this total due to overweight is approximately $80 billion, and approximately $220 billion is due to obesity. The portion of the total in the United States is approximately 90 percent of the total for the United States and Canada.

I don’t know what to make of such estimates.  They are always based on assumptions that may or may not be valid. 

One thing is clear: obesity is expensive, personally, economically, and politically.

That’s why it’s a good idea to support public health initiatives to make it easier for people to maintain a healthy weight.

Providing healthier food in schools, getting junk food out of schools, soda taxes, soda caps, and restrictions on marketing to kids are the kinds of ideas that are worth supporting.  

Now. 

Comments

I’m sure the HAES evangelists will have lots to say about this, but it’s really, really unfortunate that obesity is shorthand for all of the lifestyle diseases that are really the source of the cost. I say let’s have public health policies that support *health* and let weight take care of itself.

Don’t mistake this as support for obesity, but these numbers are a bit misleading. You can’t ignore that obesity leads to people dying earlier. Earlier deaths means, among other things, less money spent on healthcare for the elderly and a more solvent social security system.

It’s like Bastiat’s “Broken Window Fallacy.” You see the cost of medication that a person buys today due to an obesity-related disease, but you forget that this person would have otherwise needed some other type of medical care later on in life. You add the cost of the obesity-related medication, but then never subtract the amount he would have spent if he weren’t obese. This leads to numbers that seem more meaningful than they actually are.

For a more specific example, imagine a person who eats poorly, doesn’t exercise, and becomes obese. She gets diabetes and heart disease at age 30, takes medications to treat those problems, but eventually dies of a heart attack at age 43. It’s not honest to count the cost of her medications and health care while ignoring the fact that, were she to instead live a healthy life and make it to 100 years-old, she would have still needed lots of healthcare and drawn on Social Security for more than 30 years. Does the cost of one scenario outweigh the other? I’ve yet to see any research that really tries to answer this.

Every public health issue doesn’t have to become an economic issue to be relevant.

  • A Stanley
  • August 27, 2012
  • 1:32 pm

If the ‘obesity problem’ was one day solved by someone inventing some magic pill to make people eat the ‘correct’ amount, an awful lot of diet experts and gurus would be out of a job. Weightwatchers and all the other groups like it would go out of business, and all the diet bloggers would have to sit twiddling their thumbs all evening wondering what to do.

  • Howard
  • August 27, 2012
  • 3:06 pm

The “Obesity Epidemic” was *caused* by Big Pharma’s co-opting of government to give us really bad dietary advice. The Campaign to End Obesity is cut from the same cloth, and the solution is *not* to apply more of the cause.

The solution is to get rid of the “healthy [whole] grains,” sugar, and vegetable oils, and eat REAL FOOD that our 18th and 19th century ancestors would recognize.

Hint: If it requires a nutrition label, it is probably not REAL FOOD.

  • Jen Oslund
  • August 27, 2012
  • 4:24 pm

phew….I feel a bit more justified in the extra money I spent at the grocery store today to get fresh, local, organic foods….I will have to pass this article along to my husband to explain that it really is a good investment…

  • Cathy Richards
  • August 27, 2012
  • 4:36 pm

Doesn’t look like they calculated the costs to businesses and public sector for sick days, loss of productivity, loss of key capacity employees, mobility challenges, and (dare I risk typing this out loud?) perhaps even public relations.

Oh, and cost of fuel for airplanes, cars, and busses carrying extra weight. Cost of injured health care workers from caring for heaviers patients, cost of new equipment for hospitals, cost to funeral parlours to build larger capacity crematoriums. Etc.

The capitalistic, terrified-of-regulations society begins to look less financially wise.

  • Cathy Richards
  • August 27, 2012
  • 5:02 pm

@Howard, the “if it has a label” rule doesn’t always work. A very short list of things that have labels that are good for us: milk, frozen peas, tomato sauce, bread. And things that don’t: bulk candy, deli meats from a deli, donuts from a donut shop.

Even the ingredient rule doesn’t work: chocolate milk vs. granulated sugar.

This general idea is very important to grasp! But then, why is it still so rare for the food movement to understand how the farm bill contributes to cheap (pauper, not king) corn and soybeans, hfcs & transfats? “Corn is the biggest farm bill loser” and, except for the dairy crisis which is killing off our family farms, soybeans is next biggest.

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I think the government needs to do something and bring in some new technology and solve this obesity problem because else wasting $146.6 billion is just ridiculous.

  • Anthro
  • August 28, 2012
  • 9:59 am

What’s the best way to “support” the ideas and strategies that you mention?

As many of the comments reflect, few people approach these issues scientifically or read your blog in its entirety, let alone your books.

Until we do more to educate people and somehow convince them that real science does not lie (although many who interpret it DO), the majority will continue to advance their own brand of “intuition”, or worse, in the face of the facts.

Note: Cathy, you are, of course, exempt from my criticism.

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  • Cathy Richards
  • August 28, 2012
  • 1:58 pm

Thanks Anthro :)

  • Suzanne
  • August 29, 2012
  • 10:57 am

@Cathy Richards – I would disagree with every item on your list as “good for us” – with a possible exception of tomato sauce – and that’s only if there are no added sugars or fillers.

And as far as the Deli Meat – Applegate Farms deli meats are an excellent source of saturated fat and protein and part of my healthy diet. They employ humane animal welfare standards including no antibiotics and GMO grains.

  • that_girl
  • August 29, 2012
  • 11:45 am

@ Suzanne … do you have something against frozen peas? or milk?

Cheap pretend food cheapens life.

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  • Addi Faerber
  • September 2, 2012
  • 6:58 am

What sorts of diseases are prevented through obesity? Should we include the prevention of these diseases in the estimate of the burden of disease? For example, obesity is associated with more diabetes and heart problems, and obesity is negatively associated with malnutrition and vitamin deficiency.

  • Suzanne
  • September 4, 2012
  • 10:36 am

@that_girl – I don’t consume milk or frozen peas. Too high in sugars. There are other foods that provide similar benefits without the sugar.

  • Keith
  • September 29, 2012
  • 5:22 am

Thanks in favor of sharing such a pleasant opinion, paragraph is pleasant, thats why i have read it fully

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