Do You Know the True Financial Costs of Being Overweight?
None of us can see into the future. However, as the saying goes “forewarned is forearmed”. Since we know what health conditions are associated with being overweight, we can develop a sense of the future health costs of being overweight. The National Institute of Diabetes and Digestive and Kidney Diseases lists nine health problems linked to being overweight and obese. We’ll walk through each, one-by-one.
Throughout April 2019, we’re going to be examining the financial aspects of weight gain and weight loss. A lot of websites will talk about future health conditions related to weight loss, but not many translate this directly into dollars and cents. Over the next month, we’ll be looking at cost-effective weight loss programs and ways that you can lose weight for no cost, or even make money with some creative programs.
Thrifty Patient is focused on bringing you news related to how to save money in healthcare. To that end, we feel we should make a clear argument about the financial benefits to weight loss. Just keep in mind that Thrifty Patient doesn’t provide medical advice and you should always talk to your physician about any concerns you have regarding your weight.
How Can I Tell if I’m Overweight?
Unfortunately, knowing if you’re overweight isn’t as simple as just stepping on a scale and counting the pounds. You’ll want to understand what your BMI is. A great calculator / chart we’ve discovered is on the website Braceability. All you need is your height and weight and you can see if you’re underweight, optimal, overweight, or obese.
However, it gets a little more complicated if you’re very muscular, very tall, have a wide chest, or have other body dimensions that complicate the situation. As luck would have it, Braceability has you covered there too. Scroll down further in their article and it’ll give you instructions on how to determine your weight range.
Health Conditions & Costs Associated with Being Over-Weight via
The National Institute of Diabetes and Digestive and Kidney Diseases
1. Type II Diabetes – $13,700.00
Type 2 diabetes is a chronic disease. When you have type 2 diabetes your body stops responding properly to insulin. Insulin is a chemical released by your pancreas that functions like a key. This key allows muscle, fat, and a few other tissues to ‘suck up’ sugar from the blood and use it for energy. Without insulin our blood fills with sugar with leads to all sorts of problems.
Connection to Obesity: The connection between weight and the risk for diabetes is well-known and well-researched. Many reputable studies have pointed towards a connection between fat tissue, insulin resistance, and type 2 diabetes1.
The Cost of Type II Diabetes: As with many of the diseases we’ll be looking at, diabetes and the true health costs of being overweight goes far beyond any dollar amount. The CDC reports that diabetes was the 7th leading cause of death in the US in 2015 and that the average yearly medical expenditure was $13,7002.
2. High Blood Pressure – $2000.00
High Blood Pressure, also known as hypertension, is a serious conditions that can lead to many medical emergencies such as heart disease, strokes, aneurysms, and even death. It is another prime example of the health costs of being overweight. According to the CDC, 75 million (1 in 3!) American adults have high blood pressure!3 Treating high blood pressure is a multi-billion-dollar industry in the US. Being hypertensive also complicates other health issues. While new treatments are emerging all the time, it’s better to avoid the problem entirely, if you can, through lifestyle modification and weight loss.
Connection to Obesity: A classic study on cardiovascular health, The Framingham Heart study, came to the estimate that 26% of cases of hypertension in men and 28% in women could be connected to obesity. An explanation for this is that, the excess fat squashes our arteries and veins, so that heart has to work harder to push out the blood. Overtime this leads to chronic hypertension4. If you feel you’re obese and suffering from hypertension it’s so important that you speak with your physician.
The Cost of Hypertension: The CDC states that in 2011, the total cost of treating hypertension was $46 billion dollars between medications, health services, and missed days of work3. Estimates put the cost of care for hypertension at between $600 and $2000 annually per patient5.
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3. Heart Disease and Stroke – $200,000.00
Heart disease is a general term used to describe several different ailments. With hypertension we saw that the excess fat compressed arteries from the outside. Heart disease is the leading cause of death for men and women and about half of all Americans have a risk factor for heart disease, according to the CDC7. What are the CDC-listed heart disease risk factors? Diabetes, obesity, poor diet, physical inactivity, excess alcohol use. Feels like a common theme huh? Seriously, the stats on heart disease are frightening and it’s worth a read.
Connection to Obesity: Think of heart disease as the gunk inside of the arteries that can clog up the pipes. This leads to enough problems by itself, but when the gunk dislodges it can result in serious events like a stroke.
The Cost of Heart Disease & Strokes: The CDC estimates that heart disease results in over $200 billion each year. Estimating an exact cost for heart disease is complicated, because how the disease can progress is complex, and some therapies are more costly than others. Some findings in the state of NY in 1997 had the expense of heart disease at over $200,000 per individual8! If you’re the cost-conscious type, then both the financial and health implications of obesity-drive heart disease should scare you.
4. Certain Types of Cancer – $$$
Connection to Obesity: According to cancer.net, as your body puts on increased weight, it starts producing more of certain types of hormones. Cancer is not one of the health costs of being overweight that many people think of. In fact, it surprised this writer when first reading about the connection. Inflammation is also associated with increased weight gain. Research has shown that these changes are oncogenic. This means that they create environments where certain types of cancer can grow.
The Cost of Cancer: With cancer we’re not going to try and put a price on all the damage cancer does. Suffice to say, treatments are expensive and go far beyond any specific dollar amount. The mental, social, and physical price of cancer can’t be under-stated.
5. Sleep Apnea – $6,366.00
Sleep Apea. Unless you or a loved one suffers from it, few people think about it. As you’ll soon see, it’s a great example of the hidden health costs of being overweight. WebMD defines three types of sleep apnea: Obstructive, Central, and Complex10. Obstructive sleep apnea is associated with weight gain. About 29 million US adults are anticipated to have obstructive sleep apnea. With 23.5 million of the cases being undiagnosed11. Sleep apnea can impact sleep and result in all the negative side effects that reduced sleep can lead to.
Connection to Obesity: As fat builds up around the neck and on the chest, it compresses airways. If you read about the connection between weight and hypertension, you can think of sleep apnea as the airway version of that. This is an example of several truly hidden health costs of being overweight.
The Cost of Sleep Apnea: Sleep apnea might not seem like a serious issue, but the results of lack of sleep and lack of productivity cost the US economy about $6,366 per person11.
6. Osteoarthritis – $4,040.00
According to the arthritis foundation, Osteoarthritis is a degenerative joint disease. It most often affects the knees, hips, lower back and neck. Obesity isn’t the only cause of Osteoarthritis, but it is a cause that can’t be ignored. If you’ll suffer from any of the health costs of being overweight, there’s a good chance it’ll be Osteoarthritis.
Connection to Obesity: As increased weight bears down on the joints; the cartilage gets worn down by the extra pressure. In addition, researchers have found that obesity leads to a low-grade inflammatory state which also hastens the wearing-down of joints13.
The Cost of Osteoarthritis: Before we get into the cost of OA, it should be noted that we’re not going to try and tease apart OA costs caused by obesity from those caused by wear and tear. It’s very much a chick-and-egg type of question. Osteoarthritis costs the US $305 billion annually according to the CDC14. This amounts to extra medical costs of $2,117 per person with OA and complications costing $4,040 in less pay per adults14.
7. Fatty Liver Disease – $1,700.00
There are different types of liver diseases. Some of these are associate with alcoholism, but obesity is known to be linked to a different type of liver disease – known as Nonalcoholic Steatohepatitis or Fatty Liver Disease (NASH). The MAYO clinic estimates that over 80 million Americans have NASH15.
Connection to Obesity: When our liver cells store up too much fat, we run the risk of developing fatty liver disease. As our BMI increases, the fat in our blood and that accumulates in our liver increases. This directly leads to an increased risk NASH16.
The Cost of Fatty Liver Disease: According to research in 2016, the economic cost of NASH in the US is $103 Billion or $1,613 per patient17. At over a billion dollars annually, this is actually one of the smaller health costs of being overweight – at least financially. Still, I’d rather not have to suffer from NASH and I certainly don’t have the extra $1,700 to pay for treatment of a debilitating disease.
8. Kidney Disease – $2,633.00
Our kidneys act as filters for our blood. Wastes, toxins, and extra fluid gets filtered out and removed via our urine. Along with working as a filter, our kidneys also help us regulate our blood pressure, help us activate vitamin D, and help make red blood cells. When our kidneys can’t do these things as well due to damage, doctors call it chronic kidney disease or CKD.
According to the CDC, about 1 in 7 people have Chronic Kidney Disease (CKD), with the majority of the 30 million people who have it, not even realizing it. The CDC also lists it as the 9th leading cause of death in the US18. It’s not a naturally connection to think of kidney disease as one of the health costs of being overweight.
Connection to Obesity: Being overweight leads to CKD in a number of ways. In 2017, the Canadian Journal of Medicine identified how obese individuals end up overworking their kidneys19. As body weight increases, so too do metabolic demands and this results in more pressure in the kidneys. Think of this as a river that passes through a dam. As more rain falls the river swells and the pressure on the dam increases. Eventually that pressure could damage the dam if it goes on too long. This is another one of the hidden health costs of being overweight. Other ways to develop CKD are if you have high blood pressure, diabetes, or heart disease. Three other diseases closely connected to obesity.
The Cost of Kidney Disease: The yearly cost to Medicare to treat CKD $79 Billion. This amounts to $2,633.33 for each of the 30 million with CKD. Note that this cost doesn’t factor in how many of those people are on private insurance. Since Medicare tends to pay lower rates, we’re probably spending far more then $2633 per patient to treat kidney disease.
9. Pregnancy Problems – Complex Social and Financial Costs
This is one of the most complex complications to arise from obesity, since it involves the combined health of two individuals. Obesity can make it more difficult for you to conceivex. It can put you and the baby at risk of problems from high blood pressure like eclampsia or pre-eclampsia. It can also increase risk of gestational diabetes and sleep apnea.
A 2015 report from Reuters states that half of U.S. women are overweight during pregnancy. In 2010 (the most recent date we could find) about 9.8% of women between 15 and 44 years old we’re pregnant. That’s about 35.6% of women or 55,892,000 women. Half of that means 27.9 million women were overweight during their pregnancy.
Connection to Obesity: Carrying too much weight can result in the problems we’ve listed above, like having high blood sugar (gestational diabetes), high blood pressure (Eclampsia), and issues like sleep apnea. However, in addition to these issues it can also result in things like macrosomia, stillbirth, and premature birth.
The Cost of Pregnancy Issues: Nothing signifies the physical, mental, spiritual, social, and financial pillars of health better then this issue. When we talk about the health costs of being overweight, we don’t always just mean financial costs. The costs of obesity during pregnancy goes far beyond any price tag we can put on it. If you do look at just annual cost, researchers estimate it totally about 1.8 billion dollars without considering any of the long-term costs20,21.
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References:
1. Kahn, BB., Smith., U., Oct. 2016., ‘Adipose tissue regulates insulin sensitivity: role of adipogenesis, de novo lipogenesis and novel lipids’ https://onlinelibrary.wiley.com/doi/full/10.1111/joim.12540 Journal of Internal Medicine
6. Jadoon, Khalid., Tan, Garry., O’Sullivan, Saorise., ‘A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study’ American Society for Clinical Investigation 2017
13. King, Lauren., Anandacoomarasamy, Ananthila ‘Obesity & Osteoarthritis’ Aug 2013 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788203/ Indian Journal of Medical Research
17. ZM, Younossi., Dm Blissett., R, Blissett, M, Stepanova., Y, Younossi., A, Racila., S, Hunt., R, Beckerman., ‘The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe.’ https://www.ncbi.nlm.nih.gov/pubmed/27543837 US National Library of Medicine.
19. Kovesdy, Csabam Furth, Susan, Zoccali, Carmine., ‘Obesity and Kidney Disease’ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433675/ Canadian Journal of Kidney Health and Disease
21. Lenoir-Wijnkoop, Irene., Van Der Beek, Eline., Garssen, Johan., Nuijten, Mark., Uauy, Ricardo., May 2015., ‘Health economic modeling to assess short-term costs of maternal overweight, gestational diabetes, and related macrosomia – a pilot evaluation’ Frontiers in Pharmacology
