The economic impact of obesity.

I wrote the following article for a column in the New York Times, where I focused solely on the economic impact of obesity.


Obesity is a multi-faceted disease fueled by Americans’ poor eating habits, complacency and sedentary lifestyles. While the physical and emotional impact of obesity on a growing number of Americans is glaring, what truly makes obesity an epidemic is the economic impact it has on all of us.
People underestimate the economic effect obesity has on our society. The Center for Disease Control has concluded that illnesses associated with obesity cost the United States $93 billion a year in health care costs. Eric Finkelstein, a health economist at the nonprofit RTI Institute, wrote, “about half of the total cost of obesity-related health care is paid by the government through its Medicare program. For every American citizen, the out-of-pocket tax cost is an average $180.” This dwarfs the $13 billion businesses lose each year from obesity-related medical fees, absenteeism, and decreased productivity (as reported by the National Business Group on Health). Many of these obesity-related business costs are passed down to consumers in the form of more expensive goods and services.
Obesity, like many diseases, has no simple cure that alleviates its negative consequences. The government’s increased involvement and spending on health education, research and obesity programs, combined with our desire as a society to lead a healthier lifestyle, are the driving factors towards finding a solution. The question is, do we invest a lot of time and money fighting obesity now, or pay an even higher price down the road?

Childhood Obesity programs in Arkansas going the wrong way.

For those that weren't aware, Arkansas became one of the first states to have a childhood obesity report card program, where school children were weighed once a year, their BMI calculated, and this information, along with any obesity related concerns, were sent to the kids' parents.

Unfortunately, Arkansas just took a BIG step backwards in the fight against childhood obesity. While they did not ditch the obesity report card program, what was once yearly mandatory weigh ins for students is now an OPTIONAL every other year program. So the kids get weighed half as often, and parents who claim that these report cards "are bad for their child's self esteem" can pull them out of the program all together.

Kids that get pulled from the program won't be factored into the state's childhood obesity rates, making those statistics worthless.

But I guess in the end, legislators and parents feel that removing a once a year ding to a child's self esteem is more important than their long-term health.

To me this type of behavior is what's contributing to the out of control spiral of what is known as childhood obesity.

Pet Obesity

Pet obesity is considered one of the most common nutritional problems in cats & dogs, two scientists from the University of California, Davis, reported last year at the Waltham International Nutritional Sciences Symposium in Washington. Studies in Western Europe & the United States show that more than 24% of dogs & about 25% of house cats suffer from pet obesity. Why is fighting pet obesity important? Pet obesity can shave 2 to 5 years off your pet’s life.

Surprise surprise! One study found a strong correlation between extra weight in pet owners & in their pets.

Dogs & cats are considered overweight when their body weight is 15 percent above what is optimal for their breed, & obese when they weigh 30 percent above ideal.

Like mothers are poor at assessing their children’s childhood obesity risks, pet owners are notoriously poor at assessing their animals’ pet obesity risks.

Causes:

Normally pet inactivity & overfeeding are the main causes of pet obesity, including the feeding of human food. Human food is much higher in calories than most animal food.

Hypothyroidism (under activity of the thyroid gl&) & hyperadrenocorticism (disorder of the adrenal gl&s, a.k.a. Cushing's disease) are also known causes of pet obesity. You can have lab tests done to see if these are issues.

Genetics may have a role in a pet's chances of suffering from pet obesity. Dog breeds at higher risk: labrador retriever, cairn terrier, cavalier king charles spaniel, scottish terrier, cocker spaniel.

Cat breeds at higher risk: the domestic shorthair. Being neutered is a big risk factor for obesity in dogs & cats. In a French study, neutered dogs were more than twice as likely to be overweight as dogs that were not neutered.
Female dogs are more likely to be overweight than male dogs.
Pet obesity risk rises with age. 2 & 3 year old dogs were nearly three times as likely to be overweight as 1 year-olds. Dogs over 12 years old are 12 times as likely as 1 year-olds to be overweight.

Solutions:

Ridding your pet’s diet of people food & feeding light versions of adult dog food, coupled with increased exercise, are usually all that is necessary to fight pet obesity. Take your dog on more walks or to the dog park. Exercising your dog can be good for you too!

If light food & exercise are not enough, prescription special diet food may be necessary (see your vet for the type of food & instructions for feeding) to fight pet obesity.

Keep tabs on your pet’s progress with weekly weigh-ins at the vet; it’s usually free at most clinics.

Burger King Trans Fat ban, finally!

Burger King FINALLY jumps on the trans fat ban bandwagon, albeit a year and a half too late.

Burger King's own testing of a new non-trans fat oil blend passed with flying colors and consumers reported equal or better taste with the non-trans fat food compared to the trans fat foods they were given to sample.

While other fast food restaurants such as McDonalds stopped using trans fat oils in mid 2006, Burger King announced that they won't make the switch until the end of 2008. I have no idea what is taking them so long but this is unacceptable to me, especially considering how long they have known of the health risks of trans fats. Their excuse is a lack of supply but you'd think this was something they could have figured out years ago.

I just hope Burger King doesn't go on a marketing spree at the end of 2008 bragging that their food no longer contains trans fats, giving the large mass of uneducated people (when it comes to nutrition) the impression that their fries are now healthy.

Alli Diet Pills

Well another diet pill is hitting the market. For those of you who haven't followed the buzz, the next big play maker is called Alli, made by GlaxoSmithKline. The FDA claims that people taking Alli lost 2-3lbs extra per 5lbs of normal weight loss. To me that's huge! Well, a huge mess that is. What's this mess I speak of? Well, Alli blocks 25% of all the fat that people consume. Well where does that fat go you may ask? Needless to say I've already seen a warning by Alli that recommends users of Alli to bring an extra change of clothes just in case there's an "accident." Continuous diarrhea sounds like a blast, literally! This is definitely a user beware. Half of patients in experiments and trials experienced gastrointestinal side effects, listed as "leakages and oily discharges." So taking Alli is a 50/50 crap shoot.

Cost for the full 2 pill dose is about $2 a day. So what is Alli exactly? Just a lower dose version of Xenical (Orlistat). Books are already flooding the market for Alli which include exercise plans, eating plans etc, although the pill is not expected to be released until February 2008.

This pill will be a wonderful tool for those who use it in conjunction with a healthy diet and exercise, but I have a gut feeling there will be too many who view this as a magic pill that doesn't require any exercise or healthy eating to go along with it.

Estimated sales for year one are projected at $1.5 Billion. I bet they make a heck of a lot more than that. My money says GlaxoSmithKline runs right to the top of the diet pill market, using some movie star who has lost 10lbs to give his/her stamp of approval.

Big Medicine Obesity Surgery Show on TLC

While I am only a proponent of obesity surgery after exercise and healthy eating options have been exhausted (or in serious life threatening situations), I think this new TV show on TLC will offer a wonderful view into the world of weight loss surgery. I have a feeling though it will be slightly biased (not showing all the side effects and other negatives of obesity surgery). The other problem is that the weight loss results will be skewed because people will only see the immediate results and not the long term results. Obesity surgery has an impact right away on weight loss, but if one isn't careful, they can stretch their stomach all the way out through overeating and you'll gain all the weight back. Take Carnie Wilson of the music group Wilson Phillips. She had weight loss surgery, lost a ton of weight, and was constantly in the spotlight for losing all that weight. Then she gained it all back and guess what? She's disappeared off the face of the earth. Unfortunately, that's the dark side of obesity surgery if one doesn't make a permanent lifestyle change. I just hope that this show doesn't dupe people into thinking obesity surgery is an end all way to lose weight.

Diet versus dieting and the balloon effect

Diet versus dieting and the balloon effect

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Your diet versus dieting. People frequently refer to their overall eating habits as their "diet," not to be confused with dieting. Dieting is changing ones eating habits in an effort to lose weight. The idea behind dieting is weight loss. The problem is the hard core dieting (AKA crash diets) in the long run don't work. Why you ask? Many short-term diets require a dramatic drop in calories in an effort to lose weight. Sounds simple enough, eat less, lose weight, right? Maybe. Many of these "diets" require you to eat so little that you don't consume enough calories to maintain your body's muscle mass. Why is muscle important you ask? Each pound of muscle on your body burns 50 calories at rest each day. Lose just one pound of muscle from a hard core diet, and your body loses the ability to burn 18,250 calories a year. Since each pound of fat on our bodies is the equivalent of 3500 calories, that one pound of muscle loss reduces your body's ability to burn roughly 5lbs of fat over the course of a year. Say you lose just one pound of muscle due to your "dieting," when you go back to your normal eating habits, your body won't be able to burn off as many of those calories as before. Not only will you eventually gain back all the weight you lost, but you'll quite possibly tack on a few more now that your body's fat burning machine is a little less effective. This is known as a ballooning effect.

How do you avoid all this and effectively lose weight and keep it off you ask? The key is not to go diet crazy, and to make what I like to call a lifestyle change. That means eat a little less, and make what you eat healthier. To lose weight you need to create a calorie deficit, which means taking in fewer calories than your body can burn on its own. The best way would be to combine healthy eating with exercise. If exercise isn't possible, then your only other option is to start dropping the calories from a reduction your daily food consumption. Start logging how many calories you eat in a given day. If you can cut out say 500 calories a day, you'll lose a pound a week. Doesn't sound like much, but that's 52lbs a year, and doing it in a healthy way. But why not push yourself; combine eating less with exercise for a synergistic fat burning experience. Push yourself to go the gym 3 times a week, lift some light weights, and get a little cardiovascular exercise. If you can burn 600 calories 3 times a week at the gym (combined with a 500 calorie reduction in food consumption each day), you'll now be losing 1.5lbs a week, or about 75lbs a year JUST from the your reduction in calories consumption and burning of calories via exercise. What you need to keep in mind is that the 75lbs we just calculated does not factor in the extra calorie burning you will achieve from the added muscle you will gain through exercise. If you can add just 5lbs of lean muscle to your body over a 1 year period, you'll easy shed another 10-15lbs of fat on top of the 75lbs by the end of the year. Sounds like a no brainer to me! For all of you who say you don't have time to watch what you eat or go to the gym, making a little extra time now will add a lot of extra time to your life. A little now for a lot later. If that's not the bargain of the century I don't know what is.

BMI is a Joke when Measuring Obesity

Seriously, what was the government thinking? I cannot believe all the money they spent on this only to come up with such a flawed formula for measuring obesity.

BMI is a calculation derived from your height and weight. Per the government, there is a set guideline for how much a person should weigh based on their height. So why is BMI flawed you ask? BMI does not take into consideration deviations in the human body. It does not factor in someone with a big bone structure versus someone with a small bone structure. It does not factor in how bone mass lessens with age. It does not factor in how much muscle mass someone has. A professional football player with next to no body fat would be considered morbidly obese because of how much he weighs (which is really due to muscle, not fat).

The government needs to wake up and learn that body fat percentage is a much more accurate way to determine whether or not people are obese. Not just any body fat test will do, but the hydrostatic water tank method (the most accurate of all) should be the gold standard.

What is hydrostatic body fat testing? Bone, muscle, and connective tissue, (collectively known as lean mass) sinks, while body fat floats, is the premise behind hydrostatic testing. By figuring out your land weight and water weight (based on buoyancy), a computer program calculates your body fat as a percentage of your total weight. This type of body fat testing is based on the Archimedes principle which states "when a body is submerged under water, there is a buoyant counter force equal to the weight of the water which is displaced". Since bone and muscle are denser than water, a person with a larger percentage of lean body mass will weigh more in the water and have a lower body fat percentage versus someone with less lean muscle mass. A person with more body fat will make the body lighter in water and will have a higher percentage of body fat.

Yes hydrostatic testing is more difficult (price, time, availability, etc) than punching in a few numbers in some BMI calculator, but no one ever said the truth was easy.