Obesity; The "Second Hand Smoke" of Modern American Society

It’s no surprise when we hear on the news that America has an obesity problem. Nurses are acutely aware that more of our patients are so obese that it is beyond our ability to help them with rolling over in bed and mobility. I work in a GI setting where we do EGD’s and Colonoscopies and I see the problems severe obesity causes for anesthesia such as airway issues. That is what spurred me to look into how obesity affects the cost of healthcare. In three articles, I will explore the basic question of cost, the second will look at the added risks for rural patients, and the final article will address childhood obesity. Nurses General Nursing Article

Our country's rising trend over the past few decades of eating processed food and dining at fast food restaurants has added to the obesity problem according to the article, "Obesity is bankrupting America, disease costs soar," by J.D. Heyes. Convenience and lower cost of these high calorie foods can be appealing to some consumers.

Obesity is addressed in the 2010 healthcare reform law, allowing employers to charge more to their overweight employees for health insurance. In fact, they can charge 30 to 50 percent more to employees who refuse to participate in a weight loss and health/ wellness programs. Additionally, in the article, "Obesity Now Costs Americans More In Health Care Spending Than Smoking," by Rick Unger tells us that Obamacare "funds community programs designed to help people take off the extra pounds." Medicare and Medicaid receive incentives to help recipients get into a weight loss program.

There is growing concern among Federal and state officials over the growing amount of federally funded health care towards treating obesity. Lucas Jackson states in his article, "How the Obesity Epidemic Drains Medicare and Medicaid," that one third of Americans are obese. The annual cost of obesity is estimated to be 305.1 billion dollars according to an analysis by the George Washington University. That number includes not only direct medical care, but indirect as well such as worker productivity loss and disability issues. Some officials believe that funding to treat and prevent obesity should be a private sector rather than federally funded.

It remains to be seen whether pumping so much money into federally funded weight loss programs actually will decrease our nation's obesity problem while the temptations on every street corner remain.

Some of the risks of obesity are; diabetes, heart disease, some cancers, and osteoarthritis. It's the "second hand smoke" of our generation in American society (Heyes). A BMI of 30 percent or higher is considered obese, while 40 or higher is morbidly obese. Since 1960, the percent of obese people has tripled to 34 percent and morbidly obese has increased by six times. Those with a BMI of 25-29 or "overweight" has stayed pretty much the same.

In the article, "Economic Costs," they estimate the cost of obesity related health care in 2005 to be $190 billion (This number is different than the above mentioned one, but they are estimates from different sources). Indirectly, there are costs such as higher life insurance premiums and more in worker's compensation for obese employees over those who are not. Also, the days employees are not at work are a cost to the employer due to short term absences and long term disability. The article also mentions the word, "presenteeism" which means that these obese employees may not work at full potential. It is estimated that the obesity related health care costs will increase by $66 Billion by the year 2030 if obesity in America continues to grow at today's current rate.

Breaking that down a bit, for each obese individual, the cost (in 2006) was an added $1429 per individual, a 42 percent hike over the average weight person. "Economic Costs," reports that " In middle-aged men, treatment of five common obesity related conditions . . . resulted in roughly $9,000 to $17,000 higher costs compared to normal weight adults".

There are several ways America's growing waistline has affected shrinking wallets - through increased insurance premiums and higher energy costs. Yes, one billion dollars of additional gasoline is used due to the extra strain on cars because of obese drivers and obese passengers (Unger).

Obesity has taken the top spot from smoking as the highest costing health risk. As Unger tells us, "smokers die early enough that they save Social Security, private pensions, and Medicare trillions of dollars," but obese people live just about as long as those who maintain a normal weight.

Caring for the severely obese poses problems for the patient themselves as well as healthcare workers. Hopefully, as smoking has decreased, obesity will one day too. Please share your insight into this issue and I look forward to sharing my next article that will look into how obese patients who live in rural areas face additional health care problems.

References

"Economic Costs." N.d. Obesity Prevention Source. 25 January, 2015. Web.

Heyes, J.D. "Obesity is Bankrupting America, Disease Costs Soar." Sunday 6 May, 2012. Natural News. 26 January, 2015. Web.

Jackson, Lucas. "How the Obesity Epidemic Drains Medicare and Medicaid." 15 December, 2014. The Fiscal Times. 26 January, 2015. Web.

"The Healthcare Costs of Obesity." N.d. State of Obesity. 25 January, 2015. Web.

Unger, Rick. "Obesity Now Costs Americans More In Health Care Spending Than Smoking." 30 April, 2012. Forbes. 26 January, 2015. Web.

2) children eating better (real nutritious food in school lunch programs,

That's been the trend the last 8 or so years (think Michelle Obama). I was a school nurse during that time for 5 years. I sat in the cafeteria with a diabetic student and watched the kids toss most of their "healthy" food in the garbage. It was sad how much food is wasted.

You can't legislate this issue. No food police.

Locally, we have lots of places to bike, hike, etc. Not everyone takes advantage of that though.

I'm not sure what the answer is but I know it isn't an edict from on high . . . :no:

This is easier said than done for kids who grow up in less advantaged households. I grew up in a financially stressed household. My parents frequently paid the rent late, utilities were occasionally disconnected, and at times there was only $20 left for groceries.

What types of foods do people purchase with $20 that must be stretched for two weeks to feed a family of three until the next paycheck arrives? Processed carbs will ensure the family is fed for those two weeks. Kraft boxed macaroni & cheese was $0.50 per box and served as meatless dinners. Top Ramen noodles were 10 for $1.00. A 10-pound sack of potatoes was $2.00 and a 5-pound bag of white rice was $1.50. Sources of protein included hot dogs ($0.99 per 10-pack), eggs ($0.99 per dozen) and bologna cold cuts ($0.99 per 16 slices).

Society shames families for buying processed junk foods. However, produce and lean meats are somewhat pricey outside the major agricultural states. On the other hand, simple carbs and processed foods are dirt cheap due to subsidies. Somethings gotta give...

You just described my childhood diet. The only difference is that we would have a little extra sometimes and could get a Chef Boyardee pizza kit. Mmmmm....

We drank water or tea (southern, y'all), got eggs and milk from my grandfather's farm, and had a vegetable garden. We picked beans and corn in the summer and canned tomatoes. My parents were too proud to go on government assistance.

They also smoked three packs a day, each, back in the seventies when it was cheap, because it was less expensive than therapy and helped them deal with the stress of living just above subsistence level. We had electricity, so we were in high cotton.

We had to stretch $30-60 a week to feed a family of four. We usually fed at least three at a time. My brother and I would be "not hungry" sometimes so both my parents could eat. My mom weighed 90lbs and my dad weighed 180 at 6'1". By the time I was twelve and we were a little more financially secure, all the bad eating had taken it's toll.

I was fat like the michelin man, my brother's weight yo-yo'd, my mom weighed 180 pounds, and my dad was 250 lbs.

It's hard to break survival habits.

Seems like much allowance and sympathy for obese people here, but cigarette smokers are still the scapegoat for society... oh the irony. Obese people should be beaten upon just like smokers, alcoholics, drug addicts. Or perhaps, no one should be beaten upon? Tax each individual according to their sins? Smokers need a reprieve though, they have been taxed unfairly long enough, and no, I'm not a smoker...

You can live without smoking, drinking and drugs. You must eat to live. There is no irony here. Smoking, drugs, and alcohol are all addictive choices people make because they decided they wanted to look cool, numb the pain, or just feel good. The were not forced to start doing it, they will not die if they stop "cold turkey" (well, severe alcoholics and some drug users could). You can't just quit eating.

Food is an addiction for many. Poor eating choices occur for many reason, education, poverty, laziness or just not caring. Lack of exercise is a huge contributor for children/young adults. There are also metabolic issues that come in to play for some (but not all).

Yes healthier choices need to be made, people need to exercise more. We are getting fatter as a nation, but comparing obese people to other addictions is not the same.

And yes, I am obese (morbidly at that).

Now me being a morbidly obese nurse telling people to eat better and exercise more, that is irony.

Specializes in Geriatrics, Home Health.

Natural News? The Fiscal Times? Really?

Problems contributing to obesity:

1. Food: fast food and junk food are cheaper. Fresh produce is more expensive per calorie. Most people don't grow their own produce anymore, so they don't have it as easily available. Our culture worships junk food. Cooking shows don't feature simply prepared fruits and veggies on a plate, they feature complicated and fattening recipes.

2. Exercise: Many areas do not have sidewalks for walking and jogging, or if they do they are not always safe to walk alone in. People are more crowded together in cities which leads to less safety being alone outside. Kids don't play outside anymore because instead of the usual dangers like falling and scraping your knee you risk things like being kidnapped by a drug dealer or being catcalled by a predator. People have gone from having active jobs where they do manual labor to sedentary jobs in offices. Manual labor keeps you in shape but does not pay well and is not respected. Exercise has become something limited to the gym and not a daily outdoors practice.

And then, with obese people, instead of saying "feel good about yourself but work on getting in shape". We insult them and humiliate them and shame them. You may be obese and that is not healthy, but it does not mean you're less valuable as a person and deserve to be humiliated and shamed. You can lose the weight but it does not need to be an obsession or make you live your life miserably.

Natural News? The Fiscal Times? Really?

Yeah, Natural News is not a good resource for true medical information. :rolleyes:

Never heard of The Fiscal Times.

Problems contributing to obesity:

1. Food: fast food and junk food are cheaper. Fresh produce is more expensive per calorie. Most people don't grow their own produce anymore, so they don't have it as easily available. Our culture worships junk food. Cooking shows don't feature simply prepared fruits and veggies on a plate, they feature complicated and fattening recipes.

2. Exercise: Many areas do not have sidewalks for walking and jogging, or if they do they are not always safe to walk alone in. People are more crowded together in cities which leads to less safety being alone outside. Kids don't play outside anymore because instead of the usual dangers like falling and scraping your knee you risk things like being kidnapped by a drug dealer or being catcalled by a predator. People have gone from having active jobs where they do manual labor to sedentary jobs in offices. Manual labor keeps you in shape but does not pay well and is not respected. Exercise has become something limited to the gym and not a daily outdoors practice.

And then, with obese people, instead of saying "feel good about yourself but work on getting in shape". We insult them and humiliate them and shame them. You may be obese and that is not healthy, but it does not mean you're less valuable as a person and deserve to be humiliated and shamed. You can lose the weight but it does not need to be an obsession or make you live your life miserably.

Crime rates are about as low as they've ever been. Such a fallacy about modern safety that's repeated over and over.

Specializes in ED.
Crime rates are about as low as they've ever been. Such a fallacy about modern safety that's repeated over and over.

I have to agree with you. Crime rates influencing exercise? It's more like, TV influencing paranoia. True the creepers are out there, like they've always been, but sensationalism is to blame when a guy is scared to chat with the neighborhood children for fear of some accusation.

I've also noticed, at least in my area, a lack of parental discipline. A child starts crying or screaming because he/she can't have the box of Oreos, and the parent, trying to soothe the child or avoid public stares, caves and creates an unhealthy pattern. I'm not generalizing this behavior but saying that it could be one of many factors.

And I agree with Joanna. Organic foods/non-processed foods can be up to triple the price of convenient, cheaper alternatives. It can be a financial struggle for those trying to live a healthier lifestyle.

Specializes in Family Practice, Med-Surg.

Obesity...Second Hand Smoke

My husband is morbidly obese at age 64 and has blown off any attempts to lose weight. He used eating to stuff his feelings. We eat pretty healthy at our house, except I can't control his portion sizes (enormous) or the fact that he would rather eat fast food for lunch rather than the food I have in the house.

i always felt my husband would drop dead of a heart attack before retirement because of his lifestyle. He fooled me. Over the last several months he developed symptoms of increasing fatigue, loss of appetite, mild jaundice, and weight loss. Just about 2 months ago, he gained 20 pounds back, three weeks ago, he showed me his legs that were massively swollen. I was unable to see he had massive ascites as well because it was camouflaged by his normally massive gut.

In the last 3 weeks after tons of labs, ultrasound, CT's, MRI, a paracentesis, massive diuretic therapy, a hospitalization for 2 days last week, he is hospitalized again. His diagnosis? Cirrhosis, liver cancer, renal failure. A gastroenterologist told me that NASH (non alcoholic steatohepatitis) is the fastest growing cause of liver cancer. My husband is not a drinker, nor has he ever done drugs. Will he live to see retirement? My husband is very ill, not sure how long he will live, the work up is not even done.

Our family is blown away by the fact that my husband had cirrhosis and liver cancer, now complicated by renal failure due to morbid obesity. And no diabetes anywhere in sight.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Our family is blown away by the fact that my husband had cirrhosis and liver cancer, now complicated by renal failure due to morbid obesity. And no diabetes anywhere in sight.
Thank you for sharing your very personal story. I am so very sorry about your husband's health situation and will keep your family in my thoughts.
Obesity...Second Hand Smoke

My husband is morbidly obese at age 64 and has blown off any attempts to lose weight. He used eating to stuff his feelings. We eat pretty healthy at our house, except I can't control his portion sizes (enormous) or the fact that he would rather eat fast food for lunch rather than the food I have in the house.

i always felt my husband would drop dead of a heart attack before retirement because of his lifestyle. He fooled me. Over the last several months he developed symptoms of increasing fatigue, loss of appetite, mild jaundice, and weight loss. Just about 2 months ago, he gained 20 pounds back, three weeks ago, he showed me his legs that were massively swollen. I was unable to see he had massive ascites as well because it was camouflaged by his normally massive gut.

In the last 3 weeks after tons of labs, ultrasound, CT's, MRI, a paracentesis, massive diuretic therapy, a hospitalization for 2 days last week, he is hospitalized again. His diagnosis? Cirrhosis, liver cancer, renal failure. A gastroenterologist told me that NASH (non alcoholic steatohepatitis) is the fastest growing cause of liver cancer. My husband is not a drinker, nor has he ever done drugs. Will he live to see retirement? My husband is very ill, not sure how long he will live, the work up is not even done.

Our family is blown away by the fact that my husband had cirrhosis and liver cancer, now complicated by renal failure due to morbid obesity. And no diabetes anywhere in sight.

It must be as hard to watch as anything that someone does that destroys their life. I'm sorry.