The Cost of Obesity in America

[Raikas]

With those statistics though, keep in mind the only definition used for being overweight or obese is BMI, which is woefully inaccurate. Lots of people with decent amounts of muscle mass end up in the overweight category. In fact, half of the NFL is probably obese from a BMI standpoint.

I'm not wanting to downplay the problem, just pointing out that the statistics are inaccurate (as most tend to be, if they aren't made up outright

Eh, as Athena said, populations are exactly what the BMI was designed for - less than accurate for individuals of course, but the larger the group you're looking at the more meaningful it becomes. So while the BMI for an individual atheletic person might not be meaningful, in a group it's offset by people who are represented on the other end (i.e. amputees are lower on a non-adjusted BMI raking).

Unfortunately, I worry just as much about the way things are going here in the UK. Here, the NHS (nationalised health service) means that everyone who pays tax bears the brunt of rising costs of obesity. Every single public service, including healthcare, is funded by our taxes. With all the other rising costs of living and shrinking "take-home pay", obesity is going to affect every single person tax-paying person in the country. It makes me angry. Of course I should be healthy for myself, but when the cost isn't inflicted directly on those responsible for rising obesity costs, it seems to encourage the attitude in many that it isn't their problem because the government pays to look after their health anyway. There doesn't seem to be much of a notion of personal responsibility.

But what happens if you take away coverage? That doesn't just hurt the obese person (or the smoker with lung cancer, or helmetless cyclist with the head injury, the or the skier with the broken leg, etc), if effects their family's situation as well. What happens to the dependants of those people if the system stops looking after them? Or the parents/partners/friends who end up paying for private care? Even if a health problem is partially caused (or even completely caused) by choice, does that really mean that they (and their families) don't deserve the same benefits - after all, the obese (smokers, cyclists, skiers, etc) presumably and their families are still paying their taxes too, right?

[21katykat01]

But what happens if you take away coverage? That doesn't just hurt the obese person (or the smoker with lung cancer, or helmetless cyclist with the head injury, the or the skier with the broken leg, etc), if effects their family's situation as well. What happens to the dependants of those people if the system stops looking after them? Or the parents/partners/friends who end up paying for private care? Even if a health problem is partially caused (or even completely caused) by choice, does that really mean that they (and their families) don't deserve the same benefits - after all, the obese (smokers, cyclists, skiers, etc) presumably and their families are still paying their taxes too, right?

Like I said, I believe everyone is entitled to the very best medical care, and that I was just sympathising with those who are experiencing increasing medical costs, because it's a problem here too. I think, regardless of costs and taxes and medical bills, it's scary when you see the numbers in black and white like in the article. And I don't mean the financial ones there, I mean the sheer escalation in obesity.

I certainly wouldn't be the one responsible for trying to change the health of a whole country. All I can do is take responsibility for myself. Sometimes that's hard enough!

[Raikas]

I think, regardless of costs and taxes and medical bills, it's scary when you see the numbers in black and white like in the article.

Sure, but at the same time the article mentioned other stats that might mean savings in other areas, so I don't think it's quite such a clear cut message.

ETA: I think there must be some huge cultural differences as well. It's a running joke here (when people head to the US for shopping holidays) to see who has the wildest, largest and least healthy meal, which is great for a laugh a couple of times a year, but it must have a totally different meaning when that same kind of food is accessible all the time/everywhere. And that's aside from the structure of their health system and all that.

[concretecavewoman]

Japan fines companies for overweight employees http://abcnews.go.com/Health/story?id=5254825&page=2#.UFh4ylHcuF8 http://current.com/community/91548028_japan-fines-fat-people-companies-must-measure-waist-lines-of-employees-peek-alternet.htm

Japan also doesn't have a food system or food culture that fundamentally contributes to obesity.

While I can understand and sympathize with the frustration people have over the accomodations made for the morbidly obese, consider how challenging it is in America to obtain something as stupidly simple and anachronistic as fresh vegetables, let alone organic, grass-fed meats. Yes, it CAN be done, and yes, many people here make health a priority despite the obvious challenges thrown up by self, friends, family, and society, but given how counterproductive our environments are to health, and given how intentional people have to be in order to be healthy makes me think that it's a freaking miracle the entire country isn't obese. Let's consider just a handful of our structural hurdles to health:

1) Transit vastly favors drivers over mass transit over pedestrians

2) The food system subsidizes and favors highly refined grain product over fresh vegetables; grain is cheap to store and transport. Meat and vegetables require refridgeration and rapid time to market, which is sub-optimal in our monoculture, consolidated system. In the inner city you can't even find produce, and what little there is is much more expensive than subsized corn/soy/wheat products.

3) Entertainment revolves around sedentary activities (even our sports focus on spectatorship over participation)

4) We lack a distinct and holistic food heritage (very much unlike the Japanese) that favors cooking, mealtimes, methodical eating, and a variety of traditional ingredients.

5) Medicine seems to default to treatment over prevention; perscriptions and procedures are more profitable than advice to eat healthful foods and exercise.

Yes, personal responsiblity is important (I'm a libertarian, and I take care of my health), but I'm not sure it's reasonable to expect societal health when our institutions seem to mirror the Wall-E ship.

[Gobnait]

I don't drink, smoke, or drive. But your general point is still well made. We're all drains on society in our own special ways.

I must admit I have a vague plan that if I ever go to America, I'm going to order a giant soft drink and a heart-attack-size burger or sandwich (seriously, I've seen photos of how much meat and cheese some stores load on sandwiches, it's weird), take a photo of myself with it, then give the food away to a homeless guy, or the next person in the queue.

In return you're all free to mock Australia's love of meat pies and beer.

Like in Pulp Fiction, it's the little things. An expat American friend of mine says no-one in America puts grated carrot on a sandwich except for trendy health nuts. It's such a staple of a salad or meat 'n' salad sandwich here.

I haven't bought one recently, but I think you can buy egg salad or tuna salad sandwiches here. Ten years ago, I was buying tubs of chicken salad from the local grocer and we would eat it on crackers.

Then again, I can just imagine a subway footlong with three can's-worth of tuna, a few slices of cheese..... I think only the vegetarian sandwiches have more than one leaf of lettuce, so I think your point is valid.

I think that I cannot eat sandwiches any more, perhaps a well-made Monte Kristo. Fluffy bread gives me a stomachache and my bread doesn't react well-enough with my teeth for the physics of sandwiches.

[CyningaDena]

As a cultural artifact, societies have always had an interest in policing bodies in their own unique ways. The "new" interest in policing obese bodies and punishing them (through social sanctions, insurance premiums, or fines) is just the latest version of an old fascination. Taxes and insurance premiums will be taxes and insurance premiums, and if they aren't going toward the "cost" of obesity, then they will be going toward the "cost" of unwed mothers or the "cost" of heroin junkies or the "cost" of whatever else we decide to vilify next year. I think it says something very interesting and important about our priorities when an entire nation can talk about the cost of obesity (which, predictably, can be over-simplified into a personal choice) rather than the cost of war, the cost of pharmaceutical lobbying, or the cost of farm subsidies for your corn syrup and sugar beets (which, also predictably, cannot be laid at the feet of a single person making "bad choices").

Is it unfortunate that such a large number of people are unhealthy? Absolutely. If they all magically became fit tomorrow, would it change my personal out-of-pocket expenses? Doubt it. Because if politicians and insurance companies are talking, then they're lying and shifting the blame onto someone else who can't fight back. There seems to be a lot of misplaced moral outrage directed at people who are obese today. It's unfortunate, because I think that what's really bothering us isn't obesity -- it's something nebulous that we can't quite pin down and that doesn't have a face like those "fat people" next door.

And thusly, I have used up my yearly quota of ironical quotation marks.

[CyningaDena]

Let's consider just a handful of our structural hurdles to health:

1) Transit vastly favors drivers over mass transit over pedestrians

2) The food system subsidizes and favors highly refined grain product over fresh vegetables; grain is cheap to store and transport. Meat and vegetables require refridgeration and rapid time to market, which is sub-optimal in our monoculture, consolidated system. In the inner city you can't even find produce, and what little there is is much more expensive than subsized corn/soy/wheat products.

3) Entertainment revolves around sedentary activities (even our sports focus on spectatorship over participation)

4) We lack a distinct and holistic food heritage (very much unlike the Japanese) that favors cooking, mealtimes, methodical eating, and a variety of traditional ingredients.

5) Medicine seems to default to treatment over prevention; perscriptions and procedures are more profitable than advice to eat healthful foods and exercise.

Yes, personal responsiblity is important (I'm a libertarian, and I take care of my health), but I'm not sure it's reasonable to expect societal health when our institutions seem to mirror the Wall-E ship.

THIS. This is what I was trying to indicate but failing in the particulars. It's too easy and too comfortable to point at individuals as the cause of the problem rather than at a whole constellation of systemic failures with no simple solution. We have magically found the meeting ground between a libertarian and a Marxist. When you run for office, concrete, I'll be your running mate.

[RaeVynn]

Japan also doesn't have a food system or food culture that fundamentally contributes to obesity.

While I can understand and sympathize with the frustration people have over the accomodations made for the morbidly obese, consider how challenging it is in America to obtain something as stupidly simple and anachronistic as fresh vegetables, let alone organic, grass-fed meats. Yes, it CAN be done, and yes, many people here make health a priority despite the obvious challenges thrown up by self, friends, family, and society, but given how counterproductive our environments are to health, and given how intentional people have to be in order to be healthy makes me think that it's a freaking miracle the entire country isn't obese. Let's consider just a handful of our structural hurdles to health:

1) Transit vastly favors drivers over mass transit over pedestrians

2) The food system subsidizes and favors highly refined grain product over fresh vegetables; grain is cheap to store and transport. Meat and vegetables require refridgeration and rapid time to market, which is sub-optimal in our monoculture, consolidated system. In the inner city you can't even find produce, and what little there is is much more expensive than subsized corn/soy/wheat products.

3) Entertainment revolves around sedentary activities (even our sports focus on spectatorship over participation)

4) We lack a distinct and holistic food heritage (very much unlike the Japanese) that favors cooking, mealtimes, methodical eating, and a variety of traditional ingredients.

5) Medicine seems to default to treatment over prevention; perscriptions and procedures are more profitable than advice to eat healthful foods and exercise.

Yes, personal responsiblity is important (I'm a libertarian, and I take care of my health), but I'm not sure it's reasonable to expect societal health when our institutions seem to mirror the Wall-E ship.

This ^^

In our economy, a lot of people cannot afford much more than cheap, filling food. Plus, they are getting Food Bank/USDA Commodity foods... all of which tend to be starch. Starch is cheap. Corn is cheap. This includes pasta, beans, rice, breads... all great ways to fill tummies for very little money. All designed to exacerbate obesity.

Something else to consider, is all those "diseases of obesity" could very well be caused by underlying reactions to all the grain & starch (sugars)... metabolic syndrome is not caused by obesity... it is caused by what we eat.. which leads, often, THOUGH NOT ALWAYS, to obesity.

[Waldo]

Or people just sit too much...

[Nocturnis]

Here is a menu from the Heart Attack Grill http://www.heartattackgrill.com/menu.html It was also in the Guinness book of records http://www.heartattackgrill.com/guinness.html

[rtalencar]

This ^^

In our economy, a lot of people cannot afford much more than cheap, filling food. Plus, they are getting Food Bank/USDA Commodity foods... all of which tend to be starch. Starch is cheap. Corn is cheap. This includes pasta, beans, rice, breads... all great ways to fill tummies for very little money. All designed to exacerbate obesity.

Something else to consider, is all those "diseases of obesity" could very well be caused by underlying reactions to all the grain & starch (sugars)... metabolic syndrome is not caused by obesity... it is caused by what we eat.. which leads, often, THOUGH NOT ALWAYS, to obesity.

There are plenty of examples of cultures with extremely high starch intakes that don't have near the obesity problem we do in the US. It's the calories, in my opinion.

[chairohkey]

+1 for the fatties.

In ‘Obesity Paradox,’ Thinner May Mean Sicker

[Waldo]

+1 for the fatties.

In ‘Obesity Paradox,’ Thinner May Mean Sicker

Anecdotally, cancer survival rates are much higher for people that are overweight. The extra energy reserves an carry them through chemo far better than those that are not overweight.

[Nocturnis]

However there are studies that show that obesity increases the risk of cancer. Plus proper nutrition can help reduce cancer risk and obese people aren't known for eating healthy. I would rather reduce my chances of getting cancer then increase my chances of surviving chemo.

[ETFnerd]

[CyningaDena]

Is there any situation for which you don't have a ready supply of someecards? It's starting to feel like a very creepy tarot deck.

[Avistew]

But then you'd have to cut it! Or if they bite into it, they could hurt their jaws! Plus they're giving out way less than an apple, as it is. Whole apples would mean less portioning.

I agree that it's ridiculous that fast food places charge so much for salad. But in fancy restaurants, salads are usually the cheaper option. And at home, salads are pretty cheap to make.

I tend to get annoyed at the suggestion that eating crap food is cheaper, because it seems to me junk food costs more than healthy food, and making your own meals is cheaper than going to the fast food place (and in many cases, faster! You don't have to get dressed and get into your car).

[MuayTyson]

I tend to get annoyed at the suggestion that eating crap food is cheaper, because it seems to me junk food costs more than healthy food, and making your own meals is cheaper than going to the fast food place (and in many cases, faster! You don't have to get dressed and get into your car).

Watch Food Inc. It used to be that eating healthier was cheaper that has ceased to be the case. Fast food is factory made and pumped with cheap chemicals. Soda is far cheaper than water in fast food restaurants and the return is much much more profitable.

There is very very good research that many over weight people are starving for nutrients and can have vitamin deficiencies because of their poor diet.

[Avistew]

Ask for tap water, they give it to you for free. I never get bottled water, it seems silly to pay for a product you can get for free.

I always carry a water bottle anyways, and you can refill it at the water fountain. Once again, free.

I think fast food restaurants must cost more here than in the US. I definitely spend less by eating home than I would by going to a fast food place. I can buy food for a couple of days for the amount a single fast food meal costs, and that meal isn't even filling.

[Eurydice]

I think fast food restaurants must cost more here than in the US. I definitely spend less by eating home than I would by going to a fast food place. I can buy food for a couple of days for the amount a single fast food meal costs, and that meal isn't even filling.

Part of the reason the US has the obesity issues it does is that food here is not, in fact, priced in the same way that it is in a lot of other countries. I have a British friend who had the same confusion, because she can get fresh fruits and vegetables easily and cheaply. She was shocked when I told her that in the US you can easily double your grocery bill by buying fruits and vegetables instead of pre-packaged pasta and other grain-based crap. Eating healthy may be cheap in other countries, but unless you're either lucky in where you live or willing to invest a lot of time in clipping coupons and finding sales, it is not cheap here.

[Kirkor]

Salads cost more than burgers because of the labor and ingredients costs: there's more ingredients that are less shelf stable, plus there's more labor in cutting everything up and mixing it together. Also the sales volume of salads is lower because of cultural conditioning as well as them being less suited for 'grab and go'-type eating.

[ellystar]

Has anyone tried those apple slices from McDonalds? They're really disgusting (at least the ones we get in Australia). They're so dry and flavourless, and apple that stays white after its cut is deeply suspicious to me. I stopped buying them for my kids, because I seriously didn't want them to learn to hate apple. What's wrong with handing out a whole apple?

Personally, I like them. I don't find them dry or flavorless at all. In the US, they add calcium ascorbate, a blend of calcium and vitamin C, to keep them from turning brown. From a quick google search, I can't tell either way if it's okay to have or something to avoid. But store brands of apple slices have the same thing.

[Gobnait]

I have never seen pre-sliced apples in stores. Only at McDonalds.

Why would anyone feel the need to buy pre-sliced apples from a store? Is this another thing like cheese in a spray can, that I'm just not going to be able to understand?

Here is a guide that should help you with cheese in a can: It's very salty, I think you have something made from the by-products of making beer? It's also fun. Not only is it brite yellow, but have you ever played with a can of hair mousse or shaving creme?

[katpower]

I have never seen pre-sliced apples in stores. Only at McDonalds.

Why would anyone feel the need to buy pre-sliced apples from a store? Is this another thing like cheese in a spray can, that I'm just not going to be able to understand?

Dude, cutting up apples is way hard!!!

[Nocturnis]

Dude, cutting up apples is way hard!!!

Not with this it isn't http://www.amazon.com/Norpro-5118-Fruit-Corer-Wedger/dp/B004ZEMSDO/ref=sr_1_10?s=home-garden&ie=UTF8&qid=1348194686&sr=1-10&keywords=apple+slicer