Obesity Costs Take the Cake

A look at the expanding costs of obesity

January 10, 2011 / Author:  / Reviewed by: Joseph V. Madia, MD

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Are you at your optimum weight? If not, don't fret. Knowledge is power, and the more you know, the more you can do to make 2011 your Healthy Weight Year.

Obesity is defined as an an abnormally high and unhealthy proportion of body fat. The most reliable indicator of obesity is body mass index (BMI), which is the ratio of weight (in kilograms) to height (in meters) squared. A BMI greater than 30 is considered obese.

Obesity used to be a problem faced by only a few -- say, a portly relative or the chubby kid in class whose weight the school nurse discretely jotted down instead of announcing out loud when the class was weighed. But with obesity rates now reaching 30 percent or more in nine states, obesity is no longer someone else's problem. It's a national health crisis -- and a costly one, in terms of health and dollars.

Let's focus on the health expenditures, first.

Obesity and Depression

Obesity can lead to a score of health problems, many of which you are likely familiar with, including cardiovascular disease, diabetes and cancer. But did you know obesity appears to be linked to depression, and vice-versa?

Researchers at Leiden University Medical Center and GGZ Rivierduinen in the Netherlands found bidirectional associations between depression and obesity in a recent study, which indicated an obese person has a 55 percent increased risk of gradually developing depression. Of course, there are a number of emotional issues obese persons contend with every day -- such as bodily dissatisfaction and increased societal pressures -- but the root cause may in fact be biological: Obesity may be an inflammatory state, and inflammation is linked to risk of depression.

Conversely, depressed patients who are not obese are 58 times more likely to become obese, according to the study.

The authors write that weight gain tends to be a late consequence of depression, indicating care providers should monitor depressed patients' weight carefully, and overweight or obese patients should be monitored for depression.

Obesity and Cancer

Most everyone is aware of obesity's associated risks of heart disease and type 2 diabetes, but what about cancer? Experts have concluded cancers of the colon, breast (postmenopausal), endometrium (the lining of the uterus), kidney and esophagus are linked to obesity.

And now researchers from the the Albert Einstein Medical College of Medicine have found that obese women with pre-diabetes (hyperinsulinemia) and suffering from breast cancer are less likely to survive.

Obese women with operable breast cancer treated with adjuvant chemotherapy were less likely to survive their cancer, researchers observed in a specific subset of patients with estrogen receptor (ER)-positive/HER2-negative disease.

Joseph A. Sparano, M.D., professor of medicine and women's health at Albert Einstein and associate chairman of the department of oncology at Montefiore Medical Center in Bronx, N.Y., said this could be because obesity is linked to pre-diabetes, which may, in turn, cause estrogen-dependent tumors to grow.

Cost in Dollars

According to a study by researchers at RTI International, the Agency for Healthcare Research and Quality and the U.S. Centers for Disease Control and Prevention, obesity costs may be as high as $147 billion per year. From 1998 to 2006 alone, obesity prevalence has spiked by some 37 percent.

The study found, on average, an obese patient spends about $1,429 more per year in health care expenditures than an individual with a healthy weight. Obese Medicare recipients accounted for even more costs.

These bloated figures make obesity responsible for 9.1 percent of annual medical expenditures, compared with 6.5 percent in 1998.

It's Up to You

The good news is there's something you can do to combat these unnecessary health and monetary costs. Of course, the simple answer is to exercise more and eat fewer saturated fats, sugars and simple carbohydrates, and take in more whole grains, fruits and vegetables.

Perhaps most importantly: Once you've adapted to a regimen, stick to it! Losing weight is often easier than keeping it off.

A University of Colorado study found that exercise prevents the increase in the number of fat cells that occurs when weight is re-gained after it's lost. This finding challenges the conventional wisdom that the number of fat cells in our bodies are fixed and cannot be altered by dietary or lifestyle changes.

To celebrate Healthy Weight Week, why not adapt to a healthier lifestyle and make every week Healthy Weight Week?