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Study: Obesity adds $190 billion in health costs



Question: Are obese people costing you money?




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updated 2 hours 41 minutes ago

U.S. hospitals are ripping out wall-mounted toilets and replacing them with floor models to better support obese patients. The Federal Transit Administration wants buses to be tested for the impact of heavier riders on steering and braking. Cars are burning nearly a billion gallons of gasoline more a year than if passengers weighed what they did in 1960.

The nation’s rising rate of obesity has been well-chronicled. But businesses, governments and individuals are only now coming to grips with the costs of those extra pounds, many of which are even greater than believed only a few years ago: The additional medical spending due to obesity is double previous estimates and exceeds even those of smoking, a new study shows.

Many of those costs have dollar signs in front of them, such as the higher health insurance premiums everyone pays to cover those extra medical costs. Other changes, often cost-neutral, are coming to the built environment in the form of wider seats in public places from sports stadiums to bus stops.

The startling economic costs of obesity, often borne by the non-obese, could become the epidemic's second-hand smoke. Only when scientists discovered that nonsmokers were developing lung cancer and other diseases from breathing smoke-filled air did policymakers get serious about fighting the habit, in particular by establishing nonsmoking zones. The costs that smoking added to Medicaid also spurred action. Now, as economists put a price tag on sky-high body mass indexes (BMIs), policymakers as well as the private sector are mobilizing to find solutions to the obesity epidemic.

"As committee chairmen, Cabinet secretaries, the head of Medicare and health officials see these really high costs, they are more interested in knowing, 'what policy knob can I turn to stop this hemorrhage?'" said Michael O’Grady of the National Opinion Research Center, co-author of a new report for the Campaign to End Obesity, which brings together representatives from business, academia and the public health community to work with policymakers on the issue.


The U.S. health care reform law of 2010 allows employers to charge obese workers 30 percent to 50 percent more for health insurance if they decline to participate in a qualified wellness program. The law also includes carrots and celery sticks, so to speak, to persuade Medicare and Medicaid enrollees to see a primary care physician about losing weight, and funds community demonstration programs for weight loss.

Such measures do not sit well with all obese Americans. Advocacy groups formed to "end size discrimination" argue that it is possible to be healthy "at every size," taking issue with the findings that obesity necessarily comes with added medical costs.

The reason for denominating the costs of obesity in dollars is not to stigmatize plus-size Americans even further. Rather, the goal is to allow public health officials as well as employers to break out their calculators and see whether programs to prevent or reverse obesity are worth it.


Because obesity raises the risk of a host of medical conditions, from heart disease to chronic pain, the obese are absent from work more often than people of healthy weight. The most obese men take 5.9 more sick days a year; the most obese women, 9.4 days more. Obesity-related absenteeism costs employersas much as $6.4 billion a year, health economists led by Eric Finkelstein of Duke University calculated.

Even when poor health doesn’t keep obese workers home, it can cut into productivity, as they grapple with pain or shortness of breath or other obstacles to working all-out. Such obesity-related “presenteeism,” said Finkelstein, is also expensive. The very obese lose one month of productive work per year, costing employers an average of $3,792 per very obese male worker and $3,037 per female. Total annual cost of presenteeism due to obesity: $30 billion.

Decreased productivity can reduce wages, as employers penalize less productive workers. Obesity hits workers' pocketbooks indirectly, too: Numerous studies have shown that the obese are less likely to be hired and promoted than their svelte peers are. Women in particular bear the brunt of that, earning about 11 percent less than women of healthy weight, health economist John Cawley of Cornell University found. At the average weekly U.S. wage of $669 in 2010, that's a $76 weekly obesity tax.

The medical costs of obesity have long been the focus of health economists. A just-published analysis finds that it raises those costs more than thought.

Obese men rack up an additional $1,152 a year in medical spending, especially for hospitalizations and prescription drugs, Cawley and Chad Meyerhoefer of Lehigh University reported in January in the Journal of Health Economics. Obese women account for an extra $3,613 a year. Using data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27) ages 20 to 64, among whom 28 percent were obese, the researchers found even higher costs among the uninsured: annual medical spending for an obese person was $3,271 compared with $512 for the non-obese.

Nationally, that comes to $190 billion a year in additional medical spending as a result of obesity, calculated Cawley, or 20.6 percent of U.S. health care expenditures.

That is double recent estimates, reflecting more precise methodology. The new analysis corrected for people’s tendency to low-ball their weight, for instance, and compared obesity with non-obesity (healthy weight and overweight) rather than just to healthy weight. Because the merely overweight do not incur many additional medical costs, grouping the overweight with the obese underestimates the costs of obesity.


 “Where healthcare costs really take off is in the morbidly obese.”

Those extra medical costs are partly born by the non-obese, in the form of higher taxes to support Medicaid and higher health insurance premiums. Obese women raise such “third party” expenditures $3,220 a year each; obese men, $967 a year, Cawley and Meyerhoefer found.

One recent surprise is the discovery that the costs of obesity exceed those of smoking. In a paper published in March, scientists at the Mayo Clinic toted up the exact medical costs of 30,529 Mayo employees, adult dependents, and retirees over several years.

“Smoking added about 20 percent a year to medical costs,” said Mayo’s James Naessens. “Obesity was similar, but morbid obesity increased those costs by 50 percent a year. There really is an economic justification for employers to offer programs to help the very obese lose weight.”

For years researchers suspected that the higher medical costs of obesity might be offset by the possibility that the obese would die young, and thus never rack up spending for nursing homes, Alzheimer’s care, and other pricey items.

That’s what happens to smokers. While they do incur higher medical costs than nonsmokers in any given year, their lifetime drain on public and private dollars is less because they die sooner. “Smokers die early enough that they save Social Security, private pensions, and Medicare” trillions of dollars, said Duke’s Finkelstein. “But mortality isn’t that much higher among the obese.”

Beta blockers for heart disease, diabetes drugs, and other treatments are keeping the obese alive longer, with the result that they incur astronomically high medical expenses in old age just like their slimmer peers.

Some costs of obesity reflect basic physics. It requires twice as much energy to move 250 pounds than 125 pounds. As a result, a vehicle burns more gasoline carrying heavier passengers than lighter ones.

“Growing obesity rates increase fuel consumption,” said engineer Sheldon Jacobson of the University of Illinois. How much? An additional 938 million gallons of gasoline each year due to overweight and obesity in the United States, or 0.8 percent, he calculated. That's $4 billion extra.

Not all the changes spurred by the prevalence of obesity come with a price tag. Train cars New Jersey Transit ordered from Bombardier have seats 2.2 inches wider than current cars, at 19.75 inches, said spokesman John Durso, giving everyone a more comfortable commute. (There will also be more seats per car because the new ones are double-deckers.)

The built environment generally is changing to accommodate larger Americans. New York’s commuter trains are considering new cars with seats able to hold 400 pounds. Blue Bird is widening the front doors on its school buses so wider kids can fit. And at both the new Yankee Stadium and Citi Field, home of the New York Mets, seats are wider than their predecessors by 1 to 2 inches.

The new performance testing proposed by transit officials for buses, assuming an average passenger weight of 175 instead of 150 pounds, arise from concerns that heavier passengers might pose a safety threat. If too much weight is behind the rear axle, a bus can lose steering. And every additional pound increases a moving vehicle’s momentum, requiring more force to stop and thereby putting greater demands on brakes. Manufacturers have told the FTA the proposal will require them to upgrade several components.

Hospitals, too, are adapting to larger patients. The University of Alabama at Birmingham's hospital, the nation's fourth largest, has widened doors, replaced wall-mounted toilets with floor models able to hold 250 pounds or more, and bought plus-size wheelchairs (twice the price of regulars) as well as mini-cranes to hoist obese patients out of bed.

The additional spending due to obesity doesn’t fall into a black hole, of course. It contributes to overall economic activity and thus to gross domestic product. But not all spending is created equal.

“Yes, a heart attack will generate economic activity, since the surgeon and hospital get paid, but not in a good way,” said Murray Ross, vice president of Kaiser Permanente’s Institute for Health Policy. “If we avoided that heart attack we could have put the money to better use, such as in education or investments in clean energy.” 

The books on obesity remain open. The latest entry: An obese man is 64 percent less likely to be arrested for a crime than a healthy man. Researchers have yet to run the numbers on what that might save.

Is anyone here concerned that our gov't is going to more closely watch and attempt to regulate the people they deem to be obese?

by on Apr. 30, 2012 at 9:27 AM
Replies (51-53):
by Silver Member on Apr. 30, 2012 at 9:24 PM

Something against Bfing or pointing out the flaws in your statements?

Bfing saves 13 billion? Prove it!

BFing is free and natural, why do we spend millions on it? Everything needs money to support it. You may think obese people need no support but do you also think Bfing mothers should get no financial money from the govt? Everything needs money to run. If you expect Obese people to self motivate then I expect new mothers to self motivate when BFing with absolutely no information or support. 

Quoting nb34:

Why do you have your panties in a bunch? I am real, you on the other hand seem to have something against breastfeeding. I am not preaching breastfeeding and no where did I say that we shouldn't have programs for obese people to help them loose weight. In fact instead of spending millions of dollars to make our hospitals comfortable for obese people we should spend that money, making obese people loose the extra weight and stay healthier. Now, breastfeeding saves an estimated $13 billion in health costs every year. Now I am not comparing the two, you are. I mentioned breastfeeding as an example of how we tend to not see the bigger picture when it comes to health and disease prevention and costs associated with it. Breastfeeding is the first step towards a healthy life style. If you choose the healthiest option over the most processed food out there (formula) for your child  you are taking the first step in insuring their health and well being. Now not everyone who breastfeeds will continue to make healthy choices, but those who choose breastfeeding over formula for health concerns are probably more likely to stick with healthier choices as they go along.

Besides, exercising and eating healthy is not something you need millions of dollars to invest in. We seem to be all for individuals responsibility, except  when it comes to obese people. All of a sudden every one should be willing to spend millions of dollars on them. I don't understand why the double standards? Walking is free, and eating healthy is actually cheaper in many places.

Quoting ButterMeUp:

Why exactly do you feel BF babies will save the country millions? I completely disagree. Is BFing healthy? Sure it is, but it's a stretch to say it is really going to save a lot of money.

BFing mothers by far get the best treatment out of all of us. BFing moms get mandatory pumping breaks, do you see fat people getting an extra 20-30 minutes every 2 hours to eat a snack? No. You can nurse where fat people cant eat. You can claim breast pumps on your taxes, can fat people claim a big mac? No! You can take a breast pump on a plane, can fat people take a McDonald's combo? No. You can plop your happy ass down in the middle of a target clothing area an nurse your child. I bet you if a fat person sat down there with a ham sandwich and refused to move, they would have been arrested for disorderly conduct. So before you go spouting off how things are not fair, get real.

Instead of preaching about BFing which in the long run will not stop your child from being as big as a house, how about you preach free exercise and nutrition classes for obese people. 

Quoting nb34:

No one says that is an absolute thing. Sadly you seem to not understand what I am getting at here. In general, breastfeeding is a much healthier option for a child than ff, that is a fact. Now are there sick breastfeeding babies, are there obese adults out there who were breastfed? Sure there are. I am not that stupid as you would like to suggest. I never suggested all breastfed babies are healthier or better. But I see the irony and hypocrisy in all these things, that you seem to be missing. The point is we cater to the needs of the people who don't take care of themselves, who let themselves get extremely unhealthy and cost our system millions upon millions of dollars each year, but somehow when it comes to accommodating mothers while they choose a healthy option ( that will be beneficial in the long run), we all scream about costs. Now, I don't expect this to change in our society. I know how the capitalist system works. It is all about instant financial gain. We don't think about future, or what may come, we only think about now and what we have to do at any given time to maximize profit and minimize costs. Now the hospitals put this money in to accommodate obese people, because they will profit from it, but overall we all have to pick up the tap, while we pay for our health premiums.

And how on earth did we get to crack and alcoholism?

Quoting ButterMeUp:


Quoting nb34:

I hope some one does something about the obesity pandemic in this country. I also think money is better spent in trying to get obese people to normal weight, rather than changing the size of everything. I was honestly shocked when I found out the oversized chairs in my Dr's office were not for two people, but for one obese person.

This is funny coming after the article on breastfeeding. We tend to punish nursing moms for doing the best they can to insure a healthy child and eventually save our society millions of dollars in health costs, yet we go out of our way to accommodate obese people who have such negative effects on our pockets.

 You do fully understand your child can be breastfeed and still end up the largest person on the face of the each right? BM is not some magical juice that some how makes your life perfect and excuses you from normal mental, physical, and emotional problems. I'm not sure why people tend to think BFing their child will make them perfect and just give them over all better lives, you're sadly mistaken. BM will not override effects of crack, large portions of big macs, alcoholism, ect.

Funny Pictures - Cat Gifs

by Andie on Apr. 30, 2012 at 9:36 PM
Quoting katzmeow726:

See my later answer . . . Great minds . . .
by Silver Member on May. 1, 2012 at 1:11 AM
1 mom liked this
Bummer. I know that normally works. I've recently struggled with weight gain myself. I know how frustrating it can be. Good luck at your doc appt.

Quoting Veni.Vidi.Vici.:

Yep. For four weeks I was on an 1800-2200 calorie diet with 60 grams of carbs or less. Most days an average of 38 grams. I gained 3 lbs. It wasn't muscle. I lost all of my weight on the glycemic index diet in the past. What's worse is i've lost energy, i've had insomnia and horrible headaches. I'm ggoing to an endocrinologiist in two weeks.

Quoting im23vaughn:

Quoting Veni.Vidi.Vici.:

Quoting TigOlBitties:

Didn't read it all and didn't have to because I deal with the obesity epidemic and the associated costs daily. It is insane!! I would never make fun of obese people but I do feel sorry for them...I can't help it. I try and help any/all of them that I can, but there are many that don't seem to even want help. It's like your quality of life could be sooo much better, but it is completely in your own hands.

For a lot of people losing weight is about a complete lifestyle change. Like I said previously, I've been there. I topped out at 240 lbs and lost 80lbs over the course of a year. I had managed to keep the weight off until a few months ago. Now I seem to be gaining for no reason, well except perhaps my age and genetics.

I have image issues, I struggle with self esteem and appearance. I'm aware. I don't try to fool other people into believing that big is beautiful. I also stopped working extra hard to try to prove myself to people who only see my appearance.

I want to be healthy for myself. The added pressure society places on people about their weight or appearance can be cruel and inadvertently sabotaging.

Have you tried limiting your carb intake? I know a few people who can't seem to lose weight unless they limit their carbs.

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