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

[Brenda F. Johnson]

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.

[Libby1987]

I guarantee that if people stopped eating processed foods and ridiculous amounts of sugar - even cold turkey - they will not die.

So, yes, I see the irony the PP spoke of.

I grew up in a poor family with limited food choices as well, however I CHOOSE now what I buy. Just like a smoker CHOSE to start smoking. "Back in the day", it was the cultural norm to eat these kinds of diets due to finances, or familiarity, but so was smoking.

Both are incredibly hard habits to break and its a shame that smokers are crusified while obese people ate coddled. Why can't we be supportive of both? I say this as a smoker and someone who has a BMI of 30 (read: obese).

I think there is abundant fatism where the individual is entirely blamed, there just aren't as many non obese to crucify them. Where the recognition is not made of refined sugar and processed non food as opportunistically addictive designed by focus research groups. Where many either don't recognize or fail to understand the gripping power of the insulin cycle spun out of control and fat as an organ perpetuating the whole thing.

I say this as a grateful non smoker with a BMI of 21.

I wish everyone would read Gary Taubes' "Why We Get Fat" and Malcom Gladwell's "The Tipping Point". And watch Dr Attia's TedTalk video.

[TheCommuter, BSN, RN]

And watch Dr Attia's TedTalk video.

I love Dr. Attia's viewpoints on nutrition and have been reading his blog for the past year.

Anyhow, he was overweight in spite of a healthy diet and extremely vigorous exercise, and found that the only sustainable technique that helped him lose weight was a high-fat ketogenic diet that virtually eliminated CHO. Meanwhile, his wife had biochemistry that enabled her to eat bags of cookies and processed junk all day and maintain a 110-pound weight all her adult life.

All of the people in his family are overweight and die young. All of the people in his wife's family are thin and live long lives, even with crappy diets. It is interesting.

[subee, MSN, CRNA]

When i was young and couldn't afford kids, I didn't have them. Some believe that if you love kids, you have a lot. Others, like myself, flip that adage around and only have the kids we can take care of. But I guess that's an education thing....sigh.

[Roy Hanson]

nonsense! Obeseity & 2nd handsmoke (have not heard that term fora LONG time). Obeseity is self indulgence, you are your own worst enemy. Oh but that couch and the McD burger with double cheese looks soo rude and good. but the trick is, to get off the couch and go for a walk at least once a week. Get the point?

As for smoke..Up here you have to go across the street (100') to enjoy a smoke. Why? Becasue smokers are rude & stand by the door way to get their fix.

[Nurse SMS, MSN, RN]

Thank you for sharing your very personal story. I work as a bariatric educator for a bariatric surgeon's office. Every patient who has surgery has a liver biopsy done and all who have even mild steatosis get referred to a liver specialist due to this increasing trend.

You and your family are in my prayers.

[Nurse SMS, MSN, RN]

I guarantee that if people stopped eating processed foods and ridiculous amounts of sugar - even cold turkey - they will not die.

So, yes, I see the irony the PP spoke of.

I grew up in a poor family with limited food choices as well, however I CHOOSE now what I buy. Just like a smoker CHOSE to start smoking. "Back in the day", it was the cultural norm to eat these kinds of diets due to finances, or familiarity, but so was smoking.

Both are incredibly hard habits to break and its a shame that smokers are crusified while obese people ate coddled. Why can't we be supportive of both? I say this as a smoker and someone who has a BMI of 30 (read: obese).

The obese are CODDLED? I'd like to see exactly where! The obese are the last legal discrimination in this country and are openly disdained, insulted and torn down everywhere they go. I am amazed anyone would say otherwise.

[marialsnd]

Another issue, at least with my BCBS health insurance policy is that they won't cover "obesity related" charges. I went for my annual physical and because it was coded wrong, they didn't cover any of the visit because it was obesity related. Insurance will cover dietitians and medications for all the diseases caused by obesity (at least in part), such as diabetes and high blood pressure, but will not pay for those same services for people trying to lose weight to prevent developing those diseases. Wouldn't it be cheaper in the long run for insurance companies to pay for prevention? Our local hospital has a medical weight loss program which includes both dietitians and personal trainers but the downside is that insurance won't cover the cost of it, even in part, because I don't have any of those diseases. However my mother who has several obesity related diseases was able to get the majority of the program paid for. It's a terrible catch-22 to be in; trying to lose weight to prevent disease, but health insurance won't help cover the cost while at the same time charging more for their policies.

[TheCommuter, BSN, RN]

When i was young and couldn't afford kids, I didn't have them. Some believe that if you love kids, you have a lot. Others, like myself, flip that adage around and only have the kids we can take care of. But I guess that's an education thing....sigh.

And in many cases, parents of young children slip into poverty due to long-term structural unemployment, death, divorce, and other reasons. They had their finances in order when they brought these children into the world, but peoples' financial statuses can change in an instant.

Obeseity is self indulgence, you are your own worst enemy. Oh but that couch and the McD burger with double cheese looks soo rude and good. but the trick is, to get off the couch and go for a walk at least once a week. Get the point?

Don't be fooled. Not all obese people are sitting on the couch gobbling on double cheeseburgers, pizzas and junk foods. It's not prudent to make sweeping statements about a wide swath of people in society.

[holisticallyminded]

I'm a former nutritionist turned nurse. It isn't just fast/junk food that is causing this problem. The problem is that the field of nutrition (based in biochemistry and not fully understood without such knowledge) has become political fodder for government organizations wanting to push particular foods/ideas down our throats (literally). What am I talking about? You know that nutrition course you took for nursing prerequisite? Politics. Even the basic chemistry used is not enough to understand the way nutrition works.

Myth Number One, the lie going on for almost two full decades now is that dietary fat makes you fat. Nope, nada, CAN'T do that. It is and has always been starch/sugar/carbohydrates. And with the million and one "health professionals" recommending "whole grains" and a diet of "complex carbohydrates" (that mainly come from starch), people can't figure it out. Swapping out puffy white starches and sugars for "whole grain" versions are not going to cut it. They all break down into the same glucose molecules in the end. Sure, you can get them through the system faster (fiber) but you'll still break most of them down because they're SO EASY to break down, even with the fiber. And you don't need even HALF of what you're eating of them.

I always tell people when they remark on how I am able to keep my weight down in my 40s, "Well, if you had any idea of how much fat I eat!" Blood lipids? Fabulous. All of my vital stats are great. NO HEALTH ISSUES. My younger siblings? Not so great. So no, it isn't just genetics. If you want to get rid of the obesity epidemic, you'll have to pay the real cost of food, tell people the truth about their food, recognize that nutrition professionals are just as propagandized to about how health studies work as any other health care worker (the main reason I left the field), stop talking to doctors about nutrition (because they have NO IDEA; they don't have the background) and start doing some research yourself.

You have been duped long enough and I've only brought up ONE issue. If I tried, I could go on all.........day.........long.

Main rules (with REAL science behind them): avoid sugar, limit starch, if you're sensitive to a food stay away from it (and find out what you're sensitive to), stop eating food out of BPA lined cans and bottles or out of shrink-wrapped plastic whenever possible, buy organic (that's poison-free, GMO-free food with lots of soil organisms that you NEED), don't wash the dirt completely off of your organic produce (root vegies, etc), eat cultured and fermented foods whenever possible (daily), grass-fed free range meat/dairy/eggs OR NOT AT ALL, I personally would not eat as much seafood as recommended if you want to avoid some really huge toxins that are totally unavoidable otherwise (yep, it's a bummer), eat coconut oil, grass-fed butter and olive oil but fats from grass-fed meats are also good. An avocado a day would benefit anyone, nuts make the best snack ever (forget about all of those calories they have- that's another topic entirely). Throw away all of those soy/canola/corn oils but cold pressed nut oils are fine. Grain in serious moderation, depending on sensitivity. And remember, you don't have to eat any particular food. That's right, you can live without it. There is no 100% rule for all.

I'm sorry that I can't explain all of this but it would be enormous.

[Roy Hanson]

we enjoyed the wording of poor mouths. You can find food and drink cheaper. Generiic, no name. Most on welfare/social assistence are uneducated on labeling of foods. One does not NEED to buy brand name foods, for ego.

There is a law in France enacted this month, forcing grocery stores and restaurants to give end of day food, or due date food to food banks. Too bad it cant be voluntary. Be interesting if it migrates here. I noted one of our major grocerty stores is selling, imperfect veggies..crooked carrots, slightly bruised apples.

[joanna73, BSN, RN]

nonsense! Obeseity & 2nd handsmoke (have not heard that term fora LONG time). Obeseity is self indulgence, you are your own worst enemy. Oh but that couch and the McD burger with double cheese looks soo rude and good. but the trick is, to get off the couch and go for a walk at least once a week. Get the point?

As previous posters have mentioned, obesity is caused by various factors. Not everyone is gorging themselves on fast food, as the stereotypes suggest.

Metabolism is heavily determined by genetics. I range within 10 pounds of my ideal body weight. Big deal, right? Do you realize how disciplined I have to be to maintain this? It's very, very easy for me to gain weight, no matter what I eat.

Carbohydrates are not my friend. If I don't check myself, my weight could/ would easily skyrocket, even with exercise. Why? My body does not metabolize fats, carbs or extra calories. It just sits there.

My point is, before making assumptions, please understand that for many people, they fight a daily battle with food. They are not all just sitting around, eating all day and doing nothing about it.

[NadineGarcia]

I think one consideration that has been overlooked is how we classify obesity. I am 5'5" and weigh 245. I am classified in the same obesity category as an individual who is bedbound due to extreme obesity. We need better classification to separate those whose BMIs are under 50 from those who are truly "morbidly obese". I'm a home care nurse who is pregnant and runs around a lot, to medically classify me in exactly the same weight category as a 400 pound individual who cannot dress independently leaves a lot of room for discrimination of those who are less "morbid" in their obesity.

We all need to work to stay healthy in this society, and teaching our patients and families healthy eating and moderate exercise is the first step. When my diabetic patients are told to restrict carbs, but never taught what equals a carb or how to eat... they will never be compliant with their diet simply from lack of understanding. And we need to be sure that food stamps have enough to cover healthy food. Maybe each new food stamp user should have sessions with a dietician to learn how and what to eat...