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Obesity Gets Part of Blame for Care Costs Early Intervention Is Key to
Controlling Rising Health Spending, Study Author Says
By Ceci ConNoLinkListy Washington Post Staff Writer
Wednesday, October 20, 2004; Page A03
More than a quarter of the phenomenal growth in health care
spending over the past 15 years is attributable to obesity, Emory
University researchers reported yesterday.
With 60 percent of the U.S. population deemed overweight or
obese, study author Kenneth Thorpe said the only way to control
soaring medical costs is to begin targeting prevention efforts and treatment
on the most costly weight-related illnesses, such as diabetes, high cholesterol
and heart disease.
"We've got to find ways to get the rates of obesity stabilized or falling,"
he said in an interview. "We need to find effective interventions to deal
with this on multiple levels -- the schools, at home, in the workplace --
because clearly this is a major driver in terms of growth in health care
From 1987 to 2001, medical bills for obese people constituted 27 percent
of the growth in overall health care spending, he found. The jump in spending
was attributable to both a rise in the number of obese Americans and higher
costs for treating those patients.
Treating obese patients was 37 percent more expensive than medical
care for normal-weight people, Thorpe and colleagues wrote in the journal
Health Affairs. Put another way, obesity accounted for an extra $301 per
person in medical spending over the 15-year study period.
"The actual numbers are probably higher," Thorpe said, because his
team relied on people who self-reported their weight and height.
Obesity is determined by body mass index or BMI (a formula in which
a person's weight in kilograms is divided by the square of his or her height
in meters). A score higher than 30 is deemed obese; 25-30 is considered
overweight. By those standards, a six-foot man weighing 225 pounds is categorized
Federal officials have estimated that treating obesity-related
illnesses costs about $93 billion a year, but Thorpe is the first
to examine the impact on the overall growth in health spending. The Emory
team based its analysis on inflation-adjusted federal data on medical spending
and health status.
"These numbers show that the prevailing approach for dealing with obesity,
which is to blame people who have the problem and hope the situation will
disappear, is a fantasy," said Kelly Brownell, director of the Yale Center
for Eating and Weight Disorders. "Something dramatic needs to be done to
change the environment in order to prevent this problem from occurring in
the first place."
Before 1980, obesity in the United States remained fairly stable, at
about 15 percent of the population. In the following two decades, however,
the problem reached epidemic proportions, fueled primarily by a more sedentary
lifestyle, processed foods and extra-large portions.
Brownell advocates creation of a $1.5 billion "Nutrition Superfund"
raised by imposing a 1-cent federal tax on each can or bottle of soda. The
money could be used for a massive advertising and education program, especially
aimed at children, he said.
"Once you are obese, it is very hard to treat, so prevention makes
sense," he said. "And when you focus on children, you get away from the
libertarian arguments that adults are just doing this to themselves."
The financial toll is pronounced in people with diabetes, high cholesterol
or heart disease, researchers said. Forty-one percent of the rise
in spending on heart disease was obesity-related.
The data come as insurers and some government agencies have begun adopting
broader reimbursement policies for treating weight-related illnesses. The
federal Medicare program announced in July it would begin considering requests
to cover weight-loss therapies, and three months later Blue Cross and Blue
Shield of North Carolina said it will provide special services to more than
1 million members with weight problems.
Earlier this month, a panel of the National Academy of Sciences called
for numerous changes, including mandatory exercise for all schoolchildren,
nutrition standards for school cafeteria food and new limits on the marketing
of junk food to children.
A spokeswoman for the Centers for Disease Control and Prevention said
its budget for nutrition, physical activity and obesity for fiscal year 2004
is $45 million, up from $34 million the previous year.
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