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.


"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.

Specializes in ED.
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.

Respectfully, I don't think obese people should get any preferential treatment, period. If they do, then let's pay for the addicts prevention plan as well. This includes smokers, drinkers etc. the inconsistency has to stop.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Respectfully, I don't think obese people should get any preferential treatment, period. If they do, then let's pay for the addicts prevention plan as well.
Many insurance companies already pay for measures for addicts such as Chantix, Zyban, gum, patches and smoking cessation programs for nicotine-dependent people.

Again, prevention is significantly cheaper than the treatment. If insurance companies were proactive and invested in preventive measures, they'd be spending a lot less money in the future on treatments related to obesity, smoking and other addictions.