April 30, 2012

Study Shows Financial Impact of Obesity

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The impacts of obesity on a person’s physical and mental state have caused concern on national scale. However, a Cornell study published in January addresses another potential side effect of obesity: obese individuals also tend to suffer financially.

According to the study –– which was conducted by Prof. John Cawley, policy analysis and management, and Prof. Chad Meyerhoefer, economics,  Lehigh University –– obese individuals pay $2,741 more annually for medical care than do people of a healthy weight.

Nationally, the condition accounts for $190.2 billion per year in medical costs, a figure that amounts to more than 21 percent of all national health care expenses, Cawley said. This estimate is considerably larger than those from previous studies. which Cawley, the study’s lead author, attributed the discrepancy to the unique approach of his research.

“For years, [many] studies just measured the correlation of medical care costs of obesity by just comparing them from someone who is obese with someone who is a healthy weight. Then, they interpreted that entire difference as due to the obesity,” Cawley said. “That’s not necessarily very accurate, though, because I might be obese and have high health care costs because I injured my back and I go to the doctor a lot. Those other studies interpreted that as a cost of obesity.”

Additionally, the study has raised questions about the definition of obesity.

According to Jennifer Austin, a health communications specialist at Gannett Health Services, the National Institute of Health defines an individual as obese if his or her Body Mass Index is 30 or higher.

The BMI is measured by calculating the ratio of an individual’s weight to his or her height.

However, in reality, the line between “healthy” and “obese” is not as clear, according to Dr. Alexandra Hall, a clinician at Gannett.

“In the past, we felt that weight was just a simple equation: energy in versus energy out.  Now, we are learning that the system is much more complex,” Hall said in an email.

Cawley also argues that other factors –– including the fact that many patients tend to under-report their weight –– may have affected the results of the study. To make his study more accurate, Cawley said he aimed to isolate the “causal effect of obesity,” or the hereditary component of weight that is encoded in people’s genes, he said.

“Before we’re born, we’re endowed with genes that may predispose us to being heavier or not,” Cawley said. “By using the heritable component of obesity, we’re able to measure what the causal effect is of obesity on these outcomes. When we do that, we get considerably larger estimates than previous studies.”

However, this higher cost of healthcare does not just affect obese individuals. Cawley said the economic effects could be felt by the patient’s coworkers, who pay the same premium, as well as by employers.

According to Cawley, the 2010 Patient Protection and Affordable Care Act –– President Obama’s healthcare bill –– enables employers to charge 30 percent higher premiums to employees who refuse to participate in initiatives designed to promote healthy lifestyles.

“Increasingly, employers have been looking for ways to improve their employees’ health, with things like workplace programs to encourage people to quit smoking or lose weight and be more physically active,” Cawley said. “These are seen as sort of win-win opportunities where the employer can lower healthcare costs and the employee can achieve their health goals.”

Taxpayers are also affected by this cost increase due to public health insurance programs, such as Medicare and Medicaid. This was be a factor that encouraged the national government to actively try to counter the obesity epidemic, according to Cawley.

“Now, there’s a rationale for government intervention to reduce obesity because all taxpayers are paying part of this bill,” Cawley said. “There’s rationale for things like menu labeling laws, better school cafeterias and better physical education programs for schoolchildren.”

In addition to the economic risks, health specialists at Gannett also argue that the physical and emotional effects of obesity should inspire people to pursue a healthier lifestyle.

“Obese individuals are statistically more likely to experience health risks such as diabetes, high blood pressure, and stroke, all of which can be worrisome,” Austin said in an e-mail. “Perhaps more worrisome, however, are the feelings of inadequacy or depression people who are perceived as being overweight sometimes experience as a result of cultural bias and media distortion.”

According to Cawley, the study has laid the groundwork for evaluating schools and businesses around the country in order to determine if employers, administrators and other officials are combating obesity in the most effective way.

“There is now this widespread awareness that obesity is a problem, but what we need to do is build up the evidence basis for what works,” Cawley said. “The more we know what works, the better we can know where to spend our resources.”

Original Author: Lauren Avery