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Obesity Gets Part of Blame for Care Costs
Obesity Gets Part of Blame for Care Costs -- Posted by Gumbo on 10-30-04 06:39
Obesity Gets Part of Blame for Care Costs
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
spending."
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 as obese.
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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