The obesity debate

[lk70]

For those of you who get so very inflamed about how much "fat" people are costing us:

http://news.yahoo.com/s/ap/20080206/ap_on_he_me/obesity_cost;_ylt=AqgQLpPNk09r1ta7r8pffrWs0NUE

Fat people cheaper to treat, study says
By MARIA CHENG, AP Medical Writer

Preventing obesity and smoking can save lives, but it doesn't save money, researchers reported Monday. It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars.

"It was a small surprise," said Pieter van Baal, an economist at the Netherlands' National Institute for Public Health and the Environment, who led the study. "But it also makes sense. If you live longer, then you cost the health system more."

In a paper published online Monday in the Public Library of Science Medicine journal, Dutch researchers found that the health costs of thin and healthy people in adulthood are more expensive than those of either fat people or smokers.

Van Baal and colleagues created a model to simulate lifetime health costs for three groups of 1,000 people: the "healthy-living" group (thin and non-smoking), obese people, and smokers. The model relied on "cost of illness" data and disease prevalence in the Netherlands in 2003.

The researchers found that from age 20 to 56, obese people racked up the most expensive health costs. But because both the smokers and the obese people died sooner than the healthy group, it cost less to treat them in the long run.

On average, healthy people lived 84 years. Smokers lived about 77 years, and obese people lived about 80 years. Smokers and obese people tended to have more heart disease than the healthy people.

Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes, and healthy people had the most strokes. Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on.

The cost of care for obese people was $371,000, and for smokers, about $326,000.

The results counter the common perception that preventing obesity will save health systems worldwide millions of dollars.

"This throws a bucket of cold water onto the idea that obesity is going to cost trillions of dollars," said Patrick Basham, a professor of health politics at Johns Hopkins University who was unconnected to the study. He said that government projections about obesity costs are frequently based on guesswork, political agendas, and changing science.

"If we're going to worry about the future of obesity, we should stop worrying about its financial impact," he said.

Obesity experts said that fighting the epidemic is about more than just saving money.

"The benefits of obesity prevention may not be seen immediately in terms of cost savings in tomorrow's budget, but there are long-term gains," said Neville Rigby, spokesman for the International Association for the Study of Obesity. "These are often immeasurable when it comes to people living longer and healthier lives."

Van Baal described the paper as "a book-keeping exercise," and said that governments should recognize that successful smoking and obesity prevention programs mean that people will have a higher chance of dying of something more expensive later in life.

"Lung cancer is a cheap disease to treat because people don't survive very long," van Baal said. "But if they are old enough to get Alzheimer's one day, they may survive longer and cost more."

The study, paid for by the Dutch Ministry of Health, Welfare and Sports, did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs.

"We are not recommending that governments stop trying to prevent obesity," van Baal said. "But they should do it for the right reasons."

 

[RobAce]

Did I read this right?!?!!?
Let me read it again.........

But because both the smokers and the obese people died sooner than the healthy group, it cost less to treat them in the long run.

Calling Mr. Reaper.....Mr. Grim Reaper please pick up a white courtesy telephone.

They are actually saying its okay...you die sooner, less money to treat you?
AN INSTITUTE FOR PUBLIC HEALTH!?!?
I thought the goal was to advance lives and to make living longer better for people.
I can't wait to see the next report that will also prove that while war is expensive it saves a WHOLE LOTTA MONEY in healthcare later in life because soldiers die younger.

This has to be some kind of sick joke.........

The results counter the common perception that preventing obesity will save health systems worldwide millions of dollars.

Who cares about money...these are people LIVES! Something I thought the medical profession cared about.

"Lung cancer is a cheap disease to treat because people don't survive very long," van Baal said. "But if they are old enough to get Alzheimer's one day, they may survive longer and cost more."

Well gee Doc, sorry I beat that nasty ol cancer....perhaps if I got Alzheimer's sooner we wouldn't be having this conversation....or if we did I would not remember it...or the fact my foot is implanted in your ass.
I cant believe someone said that.
True, indeed. Reality, indeed. But I mean.....come on.
tact /tækt/[takt]
–noun
1. a keen sense of what to say or do to avoid giving offense; skill in dealing with difficult or delicate situations.

Me thinks the good Mr. van Baal needs to brush up on this.

"We are not recommending that governments stop trying to prevent obesity," van Baal said. "But they should do it for the right reasons."

Yeah....like SO PEOPLE CAN LIVE LONGER YOU POMPOUS JERK!

Funny how they mention smoking, since recent reports reveal that Obesity in the next few years will surpass smoking as the #1 avoidable cause of death.

(AP) News
New CDC study claims obesity will soon be more deadly than cigarette smoking - Centers for Disease Control and Prevention
March 15, 2004

America's weight problem is rapidly overtaking cigarette smoking as the leading cause of preventable deaths, federal health officials reported last week. Although tobacco is still the top cause of avoidable deaths, the widespread pattern of physical inactivity combined with unhealthful diets is poised to become No. 1 because of the resulting epidemic of obesity, officials said. "Obesity is catching up to tobacco as the leading cause of death in America. If this trend continues it will soon overtake tobacco," said Julie L. Gerberding, director of the federal Centers for Disease Control and Prevention, which conducted the study.

If current trends continue, obesity will become the leading cause by next year, with the toll surpassing 500,000 deaths annually, rivaling the number of annual deaths from cancer, the researchers found.

I still can not believe that a medical institute would say....Its okay, you die sooner...thus it costs less......healthy people cost more, maybe we all should do something and die sooner...would they be happy then?

My view of this can be summed up like this.....

*PPPPPPPPPPBBBBBBBBBTTTTTTTTTTTTTTTTTTT

Rob

 

[MrPartickler]

I'm beginning to wonder if the cheapest thing might be for us all to kill ourselves immediately....and that's also probably pretty damn good for the environment. Bonus!

Kidding aside, I think the point would be to compare costs of obesity to those for non-obese folks over the same period of time. From the article:

"The researchers found that from age 20 to 56, obese people racked up the most expensive health costs."

It's clear people are much more willing to spend money on prolonging life in general (e.g., living beyond age 56) than they are on treating preventable, self-inflicted maladies (e.g., lung cancer caused from smoking).

 

[Dussicar]

Wow...Number crunching capitalists on parade!

After reading that, I don't know what is worse, Scientists that wipe out certain species (or nearly so) for the sake of pointless research that really won't help us in the long run, or an amalgamation of "analysts" that put the dollar sign before the human.

Though, I have to admit, I liked what that Van Baal dude said about lung cancer and early death. It gives me one more excuse to not quit smoking.

 

[Redmage]

Calling Mr. Reaper.....Mr. Grim Reaper please pick up a white courtesy telephone.

They are actually saying its okay...you die sooner, less money to treat you?
AN INSTITUTE FOR PUBLIC HEALTH!?!?

Calm down, Rob (and all you other folks who are jumping on these scientists). They aren't saying it's preferable, or even OK for people to die young. They're just saying it's a fact. You can't blame them for reporting the facts.

People with serious weight problems and smokers die so young that their lifetime medical costs average out to be less than those for people with healthier habits that live longer. That doesn't mean that people shouldn't be encouraged to get down to a healthy weight. But it does mean that the social cost isn't an argument for that, as it has been thought to be.

That's all.

 

[SmileyTkls]

What? I've lost weight for nothing? Aww, man! I wish someone would've told me before the diet. Ah, well, I guess I'll just have to follow through since I started it, dang it.

 

[RobAce]

Calm down, Rob (and all you other folks who are jumping on these scientists). They aren't saying it's preferable, or even OK for people to die young. They're just saying it's a fact. You can't blame them for reporting the facts.

Like I said Redmage,

tact /tækt/[takt]
–noun
1. a keen sense of what to say or do to avoid giving offense; skill in dealing with difficult or delicate situations.

My main observation.

Rob

 

[Redmage]

Rob, this is a statement of fact:

"Lung cancer is a cheap disease to treat because people don't survive very long," van Baal said. "But if they are old enough to get Alzheimer's one day, they may survive longer and cost more."

Now, what's the nice, tactful way to say that without leaving out factual information?

You're interpreting it as saying "Hurry up and die, already! You cost too much!" But the scientists aren't making any value judgments about longer life. They're just trying to put out some information that policy makers need to know.

 

[LindyHopper]

I think one interesting wrinkle in this is the way that health care is paid for. In the United States, most people under 65 receive their medical coverage through an insurance company or similar organization, where they or their employer pay in a certain amount per unit time into the system to receive coverage. Once people turn 65, they become eligible for Medicare, and their health care tab is picked up by the U.S. government.

Medicare is horrifically expensive, largely because diseases of the elderly are the most expensive to treat. That's what's driving the finding published above. But consider the situation from the insurance company's point of view. They have to ensure the 20 to 56-year-olds, where obese people are the most expensive to treat, and thin, healthy people are cheaper. In fact, the thin, healthy folks are likely to pass the age-65 mark requiring a minimum of expensive care; and once they reach retirement age, the horrifically expensive rest-of-life care is the government's problem.

The obese people and smokers, in contrast, cost the insurance companies a lot of money during the age 20-56 range of their lives, but the insurance company doesn't receive the economic advantage of their shorter life expectancy, because they only cover people up to age 65. Instead, Medicare is the system that "wins" when people die earlier. It's a pretty raw deal for the insurance companies, unless they demand higher premiums to cover obese people and smokers.

I don't know how health care is paid for in the Netherlands, where this study was conducted. If citizens contribute X amount per person, the government "wins" with obese people and smokers, because their lifetime cost of care is lower. On the other hand, if citizens contribute X amount per person, per year, it would seem to me that the government breaks roughly even with all groups, because the longer-lived, healthy people have more years to pay into the system. In any case, the question of who pays is an important one when considering the cost of care.

Please note: in my post above, I was aiming for clarity, not for tact. I am not saying that death should be a money-saving cause for celebration, nor am I making any moral or value judgments on the systems and incentives I described. Please don't shoot your messenger.

 

[Icycle]

There was an interesting paper published recently that had similar finding relative to cyclist: Because cyclists tend to live longer than sendentary folks, they may actually cause more harm to the environment that good, because although they use less energy per year, they live a lot more years, and thus use more energy overall. And this was published by an avid cyclist and environmentalist!

The point is that though it may seem crude and gruesome to discuss all the downsides of long life, policy makers really do need research like this, so they can understand and account for the secondary effects of their policy changes.

For instance, if policy makers take actions to reduce obesity and smoking, this is likely to to increase health care costs, and thus the policy makers should take steps to increase funding for health care. Similarly, if policy makers take steps to increase rates of cycling, they should also take steps to further reduce the energy intensity of our overall lifestyles.

 

[milagros317]

Moreover, in the long run the best way to solve the Social Security funding problem would be to give out free cigarettes and donuts in all high schools. With lots of fat smokers dying before age 66, fewer people would collect and the fund would stay solvent forever. If your only objective is to save money (on health care or social security), then you want everybody to die young.

We call that reduction to absurdity in math proofs.

 

[Bugman]

JACKSON, Miss. — A state lawmaker wants to ban restaurants from serving food to obese customers — but please, don't be offended. He says he never even expected his plan to become law.

"I was trying to shed a little light on the number one problem in Mississippi," said Republican Rep. John Read of Gautier, who acknowledges that at 5-foot-11 and 230 pounds, he'd probably have a tough time under his own bill.

More than 30 percent of adults in Mississippi are considered it obese, according to a 2007 study by the Trust for America's Health, a research group that focuses on disease prevention.

The state House Public Health Committee chairman, Democrat Steve Holland of Plantersville, said he is going to "shred" the bill.

"It is too oppressive for government to require a restaurant owner to police another human being from their own indiscretions," Holland said Monday.

The bill had no specifics about how obesity would be defined, or how restaurants were supposed to determine if a customer was obese.

Al Stamps, who owns a restaurant in Jackson, said it is "absurd" for the state to consider telling him which customers he can't serve. He and his wife, Kim, do a bustling lunch business at Cool Al's, which serves big burgers — beef or veggie — and specialty foods like "Sassy Momma Sweet Potato Fries."

"There is a better way to deal with health issues than to impose those kind of regulations," Al Stamps said. "I'm sorry — you can't do it by treating adults like children and telling them what they can and cannot eat."

From Foxnews.com.

 

[RobAce]

Rob, this is a statement of fact:

"Lung cancer is a cheap disease to treat because people don't survive very long," van Baal said. "But if they are old enough to get Alzheimer's one day, they may survive longer and cost more."

Yes and so would this also......

"Lung Cancer patients generally do not live as long as those with other
diseases, though there are some treatments available. However if patients live long enough and develop Alzheimer's the length of time they live many be longer, but they do not have the quality of life they once had and costs skyrocket year after year for maintaining health."

TACT. Its not just a word anymore.

Now, what's the nice, tactful way to say that without leaving out factual information?

I think I just answered that.

You're interpreting it as saying "Hurry up and die, already! You cost too much!" But the scientists aren't making any value judgments about longer life. They're just trying to put out some information that policy makers need to know.

I wonder where I could get such an idea from....I mean how could I possibly have interpreted that from this article........

"But it also makes sense. If you live longer, then you cost the health system more."

governments should recognize that successful smoking and obesity prevention programs mean that people will have a higher chance of dying of something more expensive later in life.

"Lung cancer is a cheap disease to treat because people don't survive very long," van Baal said. "But if they are old enough to get Alzheimer's one day, they may survive longer and cost more."

"We are not recommending that governments stop trying to prevent obesity," van Baal said. "But they should do it for the right reasons."

Oh yeah...........Now I remember.
Seems like a reasonable assessment to me, and I dont think Im alone.

Rob

 

[Redmage]

"Lung Cancer patients generally do not live as long as those with other diseases, though there are some treatments available. However if patients live long enough and develop Alzheimer's the length of time they live many be longer, but they do not have the quality of life they once had and costs skyrocket year after year for maintaining health."

TACT. Its not just a word anymore.

Sorry, Rob, but I don't see that as one bit more tactful than the way it was said originally. It can still be understood to mean "It's better for society for people to die young" if you make the assumption that it's "better" to spend less money. If you don't make that assumption then the original wording is completely inoffensive.

 

[RobAce]

Sorry, Rob, but I don't see that as one bit more tactful than the way it was said originally. It can still be understood to mean "It's better for society for people to die young" if you make the assumption that it's "better" to spend less money. If you don't make that assumption then the original wording is completely inoffensive.

We will have to agree to disagree then, and perhaps a few others reading this thread might say which statement they would find less offensive or more tactful.

Kind of like at the hospital...
Do you want a doctor to say...

"She's dead, here's the paperwork"
OR
"She passed on, Im sorry...when you have some time there are some papers we need to get filled out. Again Im sorry for your loss."

Makes all the difference to me.

Rob

 

[resptimes]

Bring back super sized fries at McDonalds!!!!

 

[Iggy pop]

You could probably save a lot of money shutting down hospitals. If you get sick or in accident, you eithier recover or die.

Not the most humane thing to do, but it would probably save money.

 

[Redmage]

You could probably save a lot of money shutting down hospitals. If you get sick or in accident, you eithier recover or die.

Not the most humane thing to do, but it would probably save money.

And you'll notice that we leave hospitals open.

As I've said several times now, the authors of the study Rob cited are not proposing that we try to save money by letting smokers and obese patients die. They're saying that economic arguments for preventing smoking or obesity don't stand up to scrutiny. We may still want to do these things, but we'll have to find some reason other than "it would save money," because it won't.

 

[kis123]

Another research study......oh joy!

Everyone can debate the issues to death, but the bottom line comes to personal choice. Smokers choose to smoke with the surgeon general's label posted on the side of every pack they buy. Anyone with a tenth of a brain cell knows fast food is horrible for you. I stopped eating it about 10 years ago when the strangest thing happened. I used to go to McDonalds every morning to have my fruit parfait. I'm thinking I'm eating healthy and it beat the hell out of the steak, ham-n-cheese, and bacon bagels and biscuits they offer in the am.

One day I got curious and asked for the nutrition information on the parfait; 45 grams of sugar in the darn thing!!! I could eat two candy bars for breakfast and not make 45 grams of sugar!! I haven't eaten one since.

Obese people can read labels and make better choices to eat. I've done it even when I didn't want to. And if I ate the cake, pizza, or the horribly fat laden and unhealthy foods, I held myself (not the system) accountable.

I still believe that us fat folks get exploited on one end, and admonished and scorned on the other. But that's just life; you either let it consume you or you do what you need to do to feel bette about yourself. It's not society's job or anyone else's to make you feel better about yourself; stop expecting someone else to come along to do it for you (with all "you's" being hypothetical). Live life on your own terms, but be willing to accept responsibility for the terms you set.

Although if anyone can come up with cost efficient healthy eating, I'm all ears! Sometimes those who have little finances get stuck with what they can afford to eat. Those aren't the best choices in the world health-wise.

 

[Bugman]

Live life on your own terms, but be willing to accept responsibility for the terms you set.

 

[lk70]

Although if anyone can come up with cost efficient healthy eating, I'm all ears! Sometimes those who have little finances get stuck with what they can afford to eat. Those aren't the best choices in the world health-wise.

Man you are right about that! I buy a lot of my food from an organic co-op where I can actually work a few hours a week to get a discount.

 

[Icycle]

AAlthough if anyone can come up with cost efficient healthy eating, I'm all ears! Sometimes those who have little finances get stuck with what they can afford to eat. Those aren't the best choices in the world health-wise.

It is really unfortunate that in the United States, some of the cheapest food options are also amongst the most unhealthy. This is at least in part due to massive government subsidies to corn industry. Massive quantities of cheap corn get transformed by our industrial food system into a massive supply of edible foodlike substances. For example, high-fructose corn syrup derived from cheap subsidized corn is a very cheap, high calorie, low nutrition sweeter that is one of the primary ingredients of nearly all sodas, as well as a wide variety of other products.

Write to your Congressional delegation and tell them to end corn subsidies. Corn subsidies are a very big contributing factor to the unhealthy eating habits of Americans, as well as the growing epidemic of obesity and diabetes.

 

[kis123]

It is really unfortunate that in the United States, some of the cheapest food options are also amongst the most unhealthy. This is at least in part due to massive government subsidies to corn industry. Massive quantities of cheap corn get transformed by our industrial food system into a massive supply of edible foodlike substances. For example, high-fructose corn syrup derived from cheap subsidized corn is a very cheap, high calorie, low nutrition sweeter that is one of the primary ingredients of nearly all sodas, as well as a wide variety of other products.

Write to your Congressional delegation and tell them to end corn subsidies. Corn subsidies are a very big contributing factor to the unhealthy eating habits of Americans, as well as the growing epidemic of obesity and diabetes.

Wow! Talk about food for thought!

Never thought of it this way before; thanks for the info! I've been on my Conngresspeople and Senators about a couple of things going on locally. I'm sure they'll love me so much more when I come to them with this!

 

[Icycle]

Wow! Talk about food for thought!

Never thought of it this way before; thanks for the info! I've been on my Conngresspeople and Senators about a couple of things going on locally. I'm sure they'll love me so much more when I come to them with this!

If you are interested in learning more about how much corn we Americans all it, and some of the consequences of it, I recommend checking out The Omnivore's Dilemma by Michael Pollan.

Not only do American corn subsidies contribute to obesity and diabetes, but also to such diverse problems as global poverty (through depression of commodity grain prices), and antibiotic resistance (though industrial grain-fed beef production). Even E. coli O157:H7, a serious food-borne illness, can be traced to cattle raised on cheap, subsidized corn.

 

[kis123]

If you are interested in learning more about how much corn we Americans all it, and some of the consequences of it, I recommend checking out The Omnivore's Dilemma by Michael Pollan.

Not only do American corn subsidies contribute to obesity and diabetes, but also to such diverse problems as global poverty (through depression of commodity grain prices), and antibiotic resistance (though industrial grain-fed beef production). Even E. coli O157:H7, a serious food-borne illness, can be traced to cattle raised on cheap, subsidized corn.

Oh dude, now you're playing with my steak!!! That's enough reality for me in one day!!!

I always knew the traditional American diet sucked, but never really knew why. Although your infomration is true and relevant, it's also admittedly difficult to digest (pun intended). But it does explain why it's so difficult for many to maintain a resonably helathy weight in this country.

Thanks for the info; my present study schedule doesn't allow me much free time, but I do intend to further investigate.