HEART HEALTH

The High Cost of Obesity

How the obesity trend will
impact more than the American
healthcare system in ten years

“Ten years from now, nearly half of U.S. adults will be obese if current trends continue.” Those were the findings in a study published in the New England Journal of Medicine by researchers from the Harvard T.H. Chan School of Public Health. The team stated that by 2030, 48.9% of adults nationwide will be obese. Obesity affects low-income adults, minorities, and women at higher numbers. It is also one of the three major controllable risk factors in the development of heart disease. “Unfortunately, for myself and my colleagues, we see this trend increasing at an alarming rate,” commented Dr. Heather Stahura, a board-certified cardiologist at Capital Cardiology Associates.

What is obesity?

Harvard researchers shared in their December 2019 findings that they used body-mass index (BMI) data collected from the Behavioral Risk Factor Surveillance System Survey (1993–1994 and 1999–2016) and the National Health and Nutrition Examination Survey. These were large studies of over 6.2 million adults (18 and over) from all 50 states. There has been a controversy within the medical community on the relevancy of BMI. Body mass index is a measure of body fat based on height and weight that applies to adult men and women. There is an online calculator from the National Heart, Lung, and Blood Institue where you enter your height (in feet and inches) along with your weight to compute your BMI. For example, a man who is 6 feet 0 inches, weighing 220 pounds would have a BMI of 29.8. Dr. Stahura points out that this calculation is where the problem begins.

“Obesity means different things to different people. If you want to look at hard endpoints, you will look at BMI. A BMI between 18-25 is considered normal. Over 25 is overweight. Anyone above 30 would be obese. The problem with BMI is that you cannot always say that someone with a BMI of 29.8 is overweight,” explained Dr. Stahura. In this example, the person with a BMI of 29.8 is me, a 42-year old male who ran almost 30 miles in the month of January. “You have to consider the whole person. BMI because it calculates your height to weight, there are outliers. If you are very tall, you may look like you have a higher BMI but be quite healthy. Five pounds of muscle weighs the same as fat. I would say muscle weight is healthier than fat. I think it matters more where you are carrying visceral fat – it’s worse around the stomach than your legs and rear.” This discrepancy, looking at the hard data without considering the patient body composition, is one area where the Harvard study came under fire. The team reported that 1 in 4 adults are projected to have severe obesity by 2030 (BMI above 35), and the prevalence will be higher than 25% in 25 states. The locations of these obese states/areas were the second area of controversy.

Why do some areas of the country struggle with body weight?

Lead study author, Zach Ward, addressed how the obesity prevalence is lower in some states than in others. “Obesity is rising in every state in the United States. And, some states are going to be at a very high level. We find that severe obesity is growing very rapidly in about 25 states.” Three of the states with the highest levels of obesity are Alabama, Arkansas, and Mississippi. “This is a hot button topic,” replied Dr. Stahura. “Unfortunately, a lot of Southern states suffer from a lower socioeconomic status. These states have to conserve their funds, making resources stretch further.” The Harvard team acknowledged that awareness was critical in combatting the obesity crisis. “It’s really hard to lose weight; it’s really hard to treat obesity. Prevention has to be a the forefront to combat this growing epidemic,” noted Ward.

The cost of obesity

There is long-standing research measuring the effect of obesity on the American healthcare system. The medical costs of obesity in the United Staes were estimated to be around $147 billion in 2008, according to the Centers for Disease Control and Prevention (CDC). There are also concerns that this health epidemic will impact all aspects of the American economy. Obesity imposes costs in the form of lost productivity and foregone economic growth as a result of lost workdays, lower productivity at work, mortality, and permanent disability. “One of the reasons we did this study was to help state policymakers,” said Ward. “And there’s a lot that they can do. One of the most effective and cost-saving interventions is limiting the intake of sugar-sweetened beverages. Some states are implementing a sugar-sweetened beverage tax. Which we find in some areas would actually save more money than it costs to implement.”

Read more on "Health in All Policies"

Do smoking and soda bans work? “There is an interest in your government, believe it or not, in having you live a healthy lifestyle,” declares Dr. Robert Benton, Clinical Research Director at Capital Cardiology Associates. “The costs of health care are huge in this country. We could save so much if people ate a healthy diet and exercised. Why not let people know that? Why not remind people of that? Not to the point of being onerous but allowing you to make your own decisions, giving you the information to be confident with your lifestyle choices.”

One of the key points stressed by every government health agency, medical professional, and healthcare expert is the need of at least 30 minutes of moderate physical activity every day to combat obesity, heart disease, and other health issues. A healthy diet that emphasizes eating whole grains, fruits, vegetables, lean protein, low-fat and fat-free dairy products, and drinking water is also recommended. “There is a notion of being ‘fit but fat.’ When I talk with my patients, I encourage any activity or exercise, just moving more, even if the scale isn’t reflecting the change they want, as long as they are getting out and moving, that’s a success,” added Dr. Stahura. Having a healthy diet pattern and regular physical activity is also important for long term health benefits and prevention of chronic diseases such as Type 2 diabetes and heart disease, both long-term by-products of obesity and a sedentary lifestyle with poor health choices.

Written by Michael Arce, Marketing Coordinator
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.