The most significant threat to American healthcare

The estimated number of annual deaths attributable to obesity among U.S. adults is approximately 280,000 based on H.R.s from all subjects and 325,000 based on H.R.s from only nonsmokers and never-smokers. As the N.Y. Times recently reported, estimates of the medical cost of adult obesity in the United States (U.S.) range from $147 billion to nearly $210 billion per year. Most of the spending is generated from treating obesity-related diseases such as diabetes and cardiovascular disease, among others. And we continue to ignore the dangers largely.

Compared with those with average weight, adults with obesity in the United States experienced higher annual medical care costs by $2,505 or 100%, with prices increasing significantly with the class of obesity. Treating obesity and obesity-related conditions costs billions of dollars a year. By one estimate, the U.S. spent $190 billion on obesity-related health care expenses in 2005-double previous forecast. (1) The enormity of this economic burden and the enormous toll that excess weight takes on health and well-being are beginning to raise global political awareness that individuals, communities, states, nations, and international organizations must do more to stem the rising tide of obesity.

While people continue to rally against the high cost of prescription drugs, U.S. health care spending grew 9.7 percent in 2020, reaching $4.1 trillion or $12,530 per person. As a share of the nation’s Gross Domestic Product, health spending accounted for 19.7 percent. Prescription drugs only accounted for $.11 of every healthcare dollar spent.

Obesity indeed has many root causes, but research shows that the number one cause is overeating combined with the lack of exercise. The NIH is a little more specific, saying the #1 cause is “by overeating and moving too little…. Suppose you consume high energy, particularly fat and sugars, but do not burn off the energy through exercise and physical activity. In that case, the body will store much of the surplus energy as fat.

How are we responding to this epidemic? Having a website that allows obese people to tell their HCO not to weigh them because it “causes them stress.”

Obesity is not about choice or diversity or “prejudices”; it is very directly about health and mortality. While there is no place for “fat-shaming,” there is no place, either, for obesity-normalizing.

Washington Post

Medications, mental health, social deprivation, self-esteem, and genetics all play a role in our ability to control our weight, and judgment is never a constructive approach. But suggesting that being a size 30 is just as healthy as being a size 12 isn’t a body-positive message either – it’s an irresponsible form of denial.

And where is the healthcare industry in all this? Largely missing. To fight obesity, we need:

1ne: A national awareness campaign of the dangers of obesity, including the link between obesity and cancer.

2wo: Insurers should strongly suggest to obese customers that they seek nutritional counseling and offer them fitness wearable devices with financial incentives to lose weight.

3hree: All HCPs should be required to notify patients that they are obese and face a lengthy list of potential health problems.

4our: Insurers should pay for referrals to nutritional counseling.

5ive: Stop the fat-shaming but don’t normalize obesity.

6ix: Offer free mental health counseling for obese patients whose obesity may be caused by mental health issues.

The American healthcare system is too profitable for any provider to step forward and stand against obesity. That has to stop before we, as a nation, let healthcare costs continue to spiral out of control.