Obesity and Health Care Costs

Last year the Congressional Budget Office (CBO) released a report about the rising costs in health care, including the reasons. Media headline’s based on this report included “CBO – Obesity will Decimate Future Health Costs and Care” and “Obesity’s Punch to the Gut”.

You know, sometimes I feel like a tinfoil hat conspiracy theorist, but I’m pretty sure it’s not me –  The CBO report stated clearly that obesity was NOT a major cause for rising healthcare costs. So what in fat hell happened here?

CBO- Obesity will decimate future health costs and care

This article included a quote from the CBO report: “per capita spending on health care for adults would rise by 65 percent—from $4,550 in 2007 to $7,500 in 2020.”

The quote is accurate, but they cut off the last part of the quote which reverses the meaning.  The actual CBO report says:  ” per capita spending on health care for adults would rise by 65 percent – from $4,550 in 2007 to $7500 in 2020largely as a result of the continuation of underlying trends in health care that have led to rapidly increasing spending for all adults regardless of weight.” (emphasis mine) I have a hard time believing that this was accidental as that would require me to defend the idea that a professional journalist cannot tell when a sentence ends.

“Obesity’s Punch to the Gut”

The Boston Globe ran this headline and also used numbers from the report that seemed large out of context to paint a picture of obesity as the culprit for healthcare costs, thereby grossly misrepresenting the conclusions of the report.  It almost seems like they had decided what it the article was going to say before they read the report. Maybe they just didn’t want to give up this witty, witty headline. (sarcasm meter 10 out of 10)

McKinsey Global Institute (MGI) published a report called  “Accounting for the Cost of Health Care in the United States,”  Using a comparative analysis of the US with Germany, Japan, Italy, Spain, France, and the United Kingdom they found, among other things, that Americans are indeed fatter, but that we are not significantly sicker. We do spend a lot of health care ” $650 billion above expected, even when adjusting for the relative wealth of the US economy.”  So, was obesity the culprit?

Can we attribute this additional spending to the fact that the US population is less healthy overall than people in other developed countries?  Our analysis suggests that the answer is largely no. In fact, disease prevalence in the United States is slightly lower than in peer OECD countries despite an increase in the burden of chronic disease and growth in risk factors such as obesity.

Adam Carroll put information from that report into a very illustrative graph (obesity -which is not a disease- and diseases correlated with obesity are included in the blue section).

Also let’s remember that “costs of obesity” are not the same as costs of obesity hysteria and that many of the costs of diets are included in this figure, but that’s a topic for another blog.

If you are interested in where our healthcare spending goes, I highly recommend reading the report.  For now, remember that we know that no weight loss intervention ever studied has been proven to effectively get obese people into the “normal” BMI range longterm, we now know that getting them into the normal BMI range isn’t going to have a discernible impact on healthcare costs because fat people aren’t having a discernible impact on healthcare costs.  We know that obesity isn’t the reason for the huge rise in healthcare costs, we cannot even find a causal relationship between health and weight despite a mountain of attempts, and many studies tell us that healthy habits create similar health outcomes in bodies of a wide variety of sizes.

Yet outlets that call themselves “news” continue to lie to us saying that diets work if you try hard enough, that obesity is causing an insurmountable rise in healthcare costs, that we have to get people to lose weight or we’re all going to go broke paying for their healthcare, and that extra weight causes health problems.  Is it because they are getting ad dollars from people selling weight loss? Is it because people like to read about how fat people are the cause of all the world’s problems? Do they really believe what they write?  Are they substituting everybody knows” for actual facts? Are professional journalists really incapable of discerning between the middle and end of a sentence? I don’t know and that’s not what’s most important to me right now.

What’s important to me is that we can choose to stop buying these lies wholesale. We can stop shopping for our information at Merde Mart right now.  We are responsible for verifying our news. Often is doesn’t even take a huge effort, these lies are debunked by a simple reading of the CBO report.  We also need to consider that other people are being lied to and buying the lies.  This may include doctors, teachers, healthcare providers, your mother, and plenty of people who comment on this blog.  We are responsible for making sure that we get good information and unfortunately, that is not always simple or quick. We live in a 24 hour news cycle that produces some highly suspect news. I suggest that you verify your information because, whether accidentally or on purpose, the media is lying to us.

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I do HAES and SA activism, speaking and writing full time, and I don’t believe in putting corporate ads on my blog and making my readers a commodity. So if you find value in my work, want to support it, and you can afford it, please consider a paid subscription (it’s like a fan club, you get bonus stuff, discounts, and you’re always the first to know about projects) or a one-time contribution.  The regular e-mail subscription (available at the top right hand side of this page) is still completely free. If you’re curious about this, you might want to check out this post.  Thanks for reading! ~Ragen

26 thoughts on “Obesity and Health Care Costs

  1. These reports crack me the hell up. (I’ll add here that my sense of humor is best described as “gallows.”) One of my best friends ever outweighs me by at least 100 pounds, is perhaps half as active, drinks more frequently than I do, and has a “worse” diet. In an average year, she’ll barely go over her medical deductible, and the only prescriptions she’s got are for glasses and birth control. I, OTOH, am vegetarian save a tendency to eat fish a couple of times a month. I work out up to six days a week, and I have maybe two alcoholic drinks in a heavy month. I consistently clean out my medical deductible in January (though I may have made it to February a couple of years ago), and the number of prescriptions I take has gotten me silent, “You’re kidding,” stares from nurses taking my medical history.

    In short, yeah, people need to stop cherrypicking and look at the real reasons behind medical costs.

    (Oh, Ragen, I had a thought earlier: how much of the culture of self-hatred do you think exists as a divide and conquer measure? This can be applied to any social minority–or invisible majority–but right now, I’m thinking of it in terms of body policing in America (because it’s the only country I can draw from). As long as x% of American women are taught to hate themselves and be wary and suspicious, or even envious, of women with “better” bodies, then the group remains not just a minority, but a divided minority. Call me cynical, but I can’t help but think that these divisions are enhanced in the media in order to keep people controlled.)

    Ignore me if I make no sense. Stupid insomnia. Maybe I’ll sleep tomorrow night.

  2. I’ve worked on the business side of health care for my entire adult life, and i will tell you this with some degree of confidence…it is not obesity that decimates health costs, it’s age. Whether we like it or not, the longer we live, the more it’s gonna cost to take care of us. And what should we do about that?

  3. People are starting to wise up all over the place–look at the various #Occupy movements, National Bank Transfer Day, and some of the results from Tuesday’s elections. I am starting to feel hopeful (after years of despair!) that people will begin to wake up to the lies and manipulations of the corporate media.

    Next we have to re-educate the average person about all the issues that have been manipulated–and the mindsets about obesity and health are soooo deeply ingrained. But now is the time for shifting the implacable–so that’s what I’m going to keep trying to do!!

  4. This is why I don’t read the Globe (my local paper) anymore. Also, people of the English-speaking world, can we please stop misusing the word decimate? It means “to kill or eliminate one in every ten,” or, more colloquially, to kill or destroy a great (but nonspecific) number of something. It is a verb that requires a population as its object. You cannot kill one in every ten healthcare spendings. That’s not even a thing.

    …Not to be deliberately missing the point, or anything, but I have nothing to add to what others have said so eloquently.

    1. The Boston Globe almost went out of business a few years ago because they’re owned by the NY Times who was losing massive amounts of The Almighty Dollar.

      How do you make money off of a newspaper? Ads, lay-offs, and more readers. More advertising is easy. Lay-offs, well, the first place they cut is the science writers, because who cares about science, right? Just buy your stories from the AP! The majority of my local paper’s stories (Providence Journal) is bought from AP. How do you get more readers? Sensentionalized headlines. Bam… no one cares about statistics… let’s just say fatties kill the world. That’s WAY more interesting.

    2. It wasn’t just you – I was thinking the same thing. Except I also had the thought of “if obesity is decimating the cost, that means the cost is GOING DOWN because of obesity … how is that a bad thing?” when I saw it.

  5. I don’t believe the current mindset about fatness and health are deeply ingrained at all, what they are connected to is as was suggested by both Ragen and Susan when she spoke about divide and conquer.

    People are on board with fat hate because they want to be. When I say this, people think I’m saying people are bad, no, its good people behaving very badly, it happens. Look what many of us did to ourselves under the influence.

    That is the problem with ideas about education and “persuasion”, as was said, people who know and love fat people, people who know better step over that knowledge telling and being eager to have those lies confirmed to go with fat hate, we are not up against the unwary or the unwilling, that is the heart of the problem. The media is giving the people what they want.

    Its going to be more of a power struggle, I think. We have to fight those we love and in general good reasonable rational people who are choosing to misbehave because they want to.

    In the end its going to come down to them no longer feeling they have the power or that it takes too much effort to impose on us.

    1. People who have been brainwashed can’t do anything because they want to, and when I say attitudes are deeply ingrained, I’m talking about brainwashing. People have been brainwashed–by the media, the corporate health-care establishment, the pharmaceutical industry, the food industry, etc., etc. When you hear something from your doctor, your neighbor, your local newspaper, the network news, and NPR, you start to believe it. The medias is “giving people what they want” only because the media has told people what they want.

      But no more!! People are coming awake. Now is the time to educate people, because they’re becoming more able to listen. It isn’t easy, because in order to believe something different, one must first admit that the original belief was wrong–and people hate being wrong! But it can happen. It will happen. Average people are reclaiming their voices and their power, and this issue is only one of many that is ripe for adjustment.

  6. Just a thought–we can change this reporting.

    Reporters are individuals, and so are newspaper and magazine editors (their bosses) and editors in chief (the editors’ bosses).

    As I’ve commented before, there are a lot of untrained writers doing health reporting. However, at major newspapers, like the Boston Globe, the person who wrote this may have actually had some health-reporting training, and very likely has worked and sacrificed like hell to get and keep his or her job. Having a serious factual falsehood pointed out in their work is something that every journalist I personally know would take very seriously–you mostly have to really care about being a journalist these days to be one. Their editors HAVE to take it seriously because they lose credibility (read, “readership, which equals money”) if it comes out in another media outlet that they have published inaccuracies, especially in health topics, which people use to make personal health decisions.

    If you see an article that you know is untrue in an article, you can potentially change the writer and editors’ thinking and publishing policies or even get a printed retraction if you send a letter that has these qualities:

    1. It’s timely–as soon as possible after the article was published. Within one day, preferably, or a week at most in outlets with a 24-hour news cycle, or within the publishing cycle–one month for monthlies, say, everywhere else.

    2. It’s calm, respectful, and has good grammar and no typos. Newspapers get a ton of letters from truly crazy people, so anything that comes off ragey or stupid will simply get tossed without a reading, fair or not.

    3. It quotes specific lines in the article that were wrong and says exactly, factually, why they were wrong–preferably quoting the source material that was misrepresented or a very large study that contradicts the statement and then noting exactly what the logical fallacy is.

    4. At the *end,* it contains a personal story about why this falsehood affects you personally.

    5. It’s short. Anything more than a page or two long will also get tossed or just skimmed.

    6. End with, “I look forward to hearing your response” and your e-mail or physical address–if you get anything back, you want it in writing.

    If you don’t get anything back, look for another media outlet or writer whose work you respect, or who might just be hungry for a scandal, and tell them the facts that are egregiously off or just plain made up and that you got no response when you pointed it out. They can make the kind of trouble that most people can’t.

  7. You know who are really making healthcare costs go up? Could it, perhaps , be the ones who profit most from it? Doctors make their money off of illness! Pharmaceutical companies make money off of illness! Now, keep going to the doctor, get more pills because the last two used together give you yet another condition. The whole obesity think seems to work the same way….”fix”it so you will remain a steady customer. When my sister was offering one of her kidneys for her husband ( I know, right?!)before the doc had a chance to start on her weight, she told him,basically, yeah, I’m no supermodel, my sisters who do look slim and “healthy”, I wouldn’t give their body parts to Dr. Frankenstein.” Doc just laughed. Don’t get me started on how “obese” pregnant women are treated. High risk my fat ass!

    1. Ugh! My mom took statins (which upset her stomach) and an inhaler for COPD, which raised her blood pressure, which medication made her have dizzy spells. I said, “Why live in misery when no one in our family ever died early from high cholesterol or blood pressure? Just keep the ones that directly improve your quality of life.” She’s only taking the inhaler now.

      Fortunately, I haven’t had trouble being fat and pregnant. The only time it came up was when the OB said, “Larger women tend not to gain as much weight, but let’s shoot for around 20lbs.”

  8. I’ve said it before and no doubt I’ll be saying it again many, many times until people get the point: When you start seeing any group of people purely in terms of how much they cost the taxpayer, you’re heading away from seeing them as people – and that’s an incredibly dangerous direction. They’re people. You treat them. And if healthcare costs are a problem, you look wherever else you can in the system to cut those costs before you start deciding that keeping certain kinds of people alive and well is costing too much.

    Andrea’s right, BTW – in the UK as well, the biggest chunk of healthcare costs is taken up with looking after our elderly people, and most of us will have more money spent on us in the last six months of our lives than in all the years before put together. But we’re not about to start hating on elderly people, because we rightly recognize that that’s unacceptable. What the UK is doing, however, is, increasingly, hating on disabled, long-term sick and mentally ill people, who are being painted as ‘scroungers’ by our ever-loving media. Often this gets conflated with fat hate – plenty of people assume that any fat person on a mobility scooter ‘ate themselves sick’, regardless of any other mobility issues they may have, others assume that cutting benefits is a good way to slim people down because of course, all fat people are too sick to work, right?

    In tough financial times, people are looking for scapegoats, and what Susan says about ‘divide and conquer’ also applies here: get people hating their equally cash-strapped neighbors for ‘spending hard-working taxpayers’ money’, and they won’t bother looking for the real financial injustices way further up the social scale.

    1. “When you start seeing any group of people purely in terms of how much they cost the taxpayer, you’re heading away from seeing them as people – and that’s an incredibly dangerous direction. ”


  9. Of course, blaming people for increased health care costs isn’t really about facts, but more about who’s considered worth having money spent on them. Emotional appeal seems to be a big factor here. Disabled people are divided into the “Thinking about them gives me the warm fuzzies, and I’m not being asked to do anything seriously inconvenient” category of ‘real’ disabled people who deserve help, and the “I don’t instantly get how their disability works, so obviously those people are fakes!” and “I feel icked out or sad contemplating them, so obviously those people are better off dead!” categories for everyone who doesn’t create sufficient warm fuzzies. Elderly people are currently mostly considered legitimate, because Boomers are becoming increasingly aware of their own inevitable aging and feel sympathy. And fat people are considered just bad, therefore unworthy of health care, which makes any money spent on us too much (unless it’s to transform us into thin people, or at least make us suffer while attempting to achieve thinness).

    1. I find this a lot with the way people with mental illness are treated even in this day and age. I have several identifiable mental illnesses (type II bipolar disorder, borderline personality disorder, and OCD.) and I am also a health care worker. I have had people refer to those with bipolar disorder as “crazy” when I was standing right there. I had just been diagnosed and was still afraid of people finding out. These days I’d say “that I am, but really, you don’t need to compliment me in front of everyone!” or something equally snarky. I’ve had fellow health care workers say of people who self-injure that “they’re just crybabies looking for attention. Hopefully they’ll do everyone a favor and do the job right next time.” Meanwhile there I was with a bandage on my wrist because I had been cutting myself. This was before I was diagnosed with bipolar disorder, and I had been raped a few months before and was having panic attacks on and off for literally 5 hours a day at a time. Nobody was listening to me and I felt horribly lost.
      People with mental illness scare the nice “normals” so they would rather we’d just go away. I’m both fat and mentally ill so I get the “thing that shouldn’t exist” messages from all quarters!
      I’ve always really identified with H.P. Lovecraft’s story “The Outsider.”

      1. Wow, that’s a heavy burden to shoulder. I’ve dealt with depression before and I learned there really is nothing scarier than knowing that you can’t control your own thoughts; if you don’t have control of your mind, you don’t have control of anything. Also the fear of what people will think, I was scared of losing my job (because of course I wasn’t performing well… it’s hard to do your job when you feel as if you’re being smothered by a damp mattress!). It’s definitely a horribly isolating experience. Glad you’re still here to share what you’ve learned and teach others about your experience.

  10. There executive summary of the CBO report seems to contradict you. Did the cut off quote come from the full report? What page (since the damn thing isn’t searchable).

    1. Hi Hazel,

      In the report itself you want to look at page nine, second column. They found that if obesity didn’t increase then per capital spending would go from $4,550 in 2007 to $7,500 in 2020. If Obesity continued to rise at regular rates then the increase would be 3% more, $7,760 per capita. So $160 of the increase could be attributable to obesity and the other $3,050 would be due to other factors. Therefore, obesity is not a major cause of the increase. They acknowledge that it’s an estimate, and they point out that “How reducing obesity would affect both total (rather than per capita) spending for health care and the federal budget over time is less clear. To the extent that people, on average, lived longer because fewer individuals were obese, savings from lower per capita spending would be at least partially offset by additional expenditures for health care during those added years of life.”

      They also acknowledge that Research and experimentation in this area [decreasing obesity] are ongoing, but the literature to date suggests that the challenges involved in reducing the prevalence of obesity are significant.


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