The Societal Cost of Obesity

According to researchers at Ball State University in Indiana, obesity is on the rise. Estimates based on their early research show that by 2030, in the absence of any intervening actions, a third of all children between the ages of six and eleven will be considered obese or overweight.

No doubt that is a shocking statistic.

Lead researcher, Dr. Youfa Wang, pointed out that the study did rely on a small sample. Broader research is still necessary to see where current trends are genuinely heading, and if the outlook is as dire as many believe. But he did caution that obesity is an issue that society must deal with:

“It is unlikely that obesity and related health problems in the US will become less serious in the future. We need to continue and enhance our efforts in fighting the obesity epidemic.”

But what exactly is obesity? How is it defined, and is it really at epidemic levels? Or is the reality far less concerning than the research and news are telling us? And what are the actual costs of obesity, if any at all?

Let’s take a look at obesity in the US and see if these questions have any answers.

What is Obesity?

Since it’s not a simple measurement of your exact weight, to understand obesity in the United States, it’s helpful first to define it.

The basic definition of obesity is when an individual’s weight is higher than the commonly accepted norms for their height.

To measure whether or not you are overweight or obese, you must account for your Body Mass Index or BMI.

For adults, BMI consists of a person’s weight divided by their height squared. For example:

Using metric measurements of kilograms (kg) and meters (m):

A weight of 90.7 kg divided by a height of 1.78 m (or 177.8 centimeters) squared equals a BMI of 28.7.

Using pounds (lbs) and inches (in):

A weight of 200 pounds divided by a height of 70 inches (or 5 ft 10 in) squared equals a BMI of 28.7.

Your BMI number is then measured against four categories:

BMI Weight Status
Below 18.5 Underweight
18.5 to 24.9 Normal or Healthy Weight
25.0 to 29.9 Overweight
30.0 and above Obese (extreme obesity is over 40.0)

The chart universally applies to all adults, with the numbers measuring the same for all body types regardless of age or sex. To quickly calculate your own BMI, you can use the Center for Disease Control’s (CDC) adult BMI calculator.

For children, BMI is calculated using the same formula but is interpreted using the child’s age and sex. Those results are then measured amongst a percentile. This method accounts for the difference in adolescent development for those between the ages of 2 and 19.

To determine a child’s or teenager’s BMI, use the CDC’s child and teen percentile calculator.

The Cost of Obesity

So is obesity’s impact solely on the individual whose BMI lists them as overweight?

The answer is much more complicated, as the whole of society – fit or not – suffer some consequence.

Based on recent statistics, the nation’s overall obesity rate is nearing 40%.

As of September 2018, seven states have an obesity rate that exceeds 35%. Another 22 states have a rate above 30%. In all, 48 states have obesity rates above 25%. The expectations?

Hawaii and Colorado, with rates at 23.8% and 22.6%, respectively.

A more in-depth look into the numbers reveals even more upsetting trends. From the 2014 National Health and Nutrition Examination Survey (NHANES):

  • 2 in 3 adults were considered overweight
  • 1 in 3 adults were deemed to be obese
  • 1 in 13 adults were found as extremely obese
  • 1 in 6 adolescents ages 2 to 19 were considered obese

Being obese, however, is more than just numbers and percentages.

Numerous factors may play a role in why someone is or becomes obese. A few of the most common include:

  • Eating habits
  • Sedentary lifestyle (physical inactivity coupled with poor lifestyle – too much screen time or poor sleep habits)
  • Medical conditions or medications
  • Economic or social concerns (lack of education or positive influence on healthy eating habits)
  • Geography (limited access to healthy foods or safe areas in which to be physically active)
  • Heredity (although behavior and environment are shown to play a much more significant role, genetics may dictate where and how much fat you store and how effectively your body burns it)

Regardless of the source of obesity, genuine health and societal risks are associated with carrying too much weight.

The Physical Costs of Obesity

Health risks can occur in any individual, no matter their lifestyle or level of fitness. But for those who are obese, there is a far more heightened risk of experiencing serious health conditions. The list of potential health problems and complications is extensive and includes:

  • Type 2 diabetes
  • High blood pressure (Hypertension)
  • Risk for stroke
  • Sleep apnea
  • Difficulty breathing
  • Coronary heart disease
  • Problems regulating healthy cholesterol levels (high LDL, low HDL, high levels of triglycerides
  • Certain types of cancers including breast, colon, endometrial, gallbladder, kidney, liver, ovarian, or pancreatic
  • Gallbladder disease
  • Osteoarthritis (deterioration of bone and cartilage in joints)
  • Greater risk for mental illness including anxiety, clinical depression, and other psychiatric disorders
  • Reduced quality of life (excessive pain, limited mobility, problems performing everyday tasks, such as standing, walking, or using the restroom)

In practically all instances, obesity also enhances the risk of premature death.

The last point is especially concerning, with research showing that one in five US adults die from obesity. According to Columbia University Mailman School of Public Health researcher Ryan Masters, Ph.D.:

“Obesity has dramatically worse health consequences than some recent reports have led us to believe. We expect that obesity will be responsible for an increasing share of deaths in the United States and perhaps even lead to declines in US life expectancy.”

Healthcare Costs

Obesity, however, is not isolated to its impact on the health concerns of an individual. Increasingly, as obesity rates continue to climb, so do its economic consequences.

As we mentioned earlier, obesity impacts everyone, even those who are not obese.

Based on several estimates, the US has spent anywhere from $150 billion to upwards of $190 billion each year on obesity-related costs. Some put that range even higher. This includes diagnosis and treatment, as well as prevention-related costs.

By 2030 – a little over a decade away – those numbers could increase by as much as $66 billion a year.

Those figures, though, only take into account direct costs. They do not account for lost work (either in lost employee wages or lost employer productivity), insurance costs, or lower overall wages. According to some of the most prevalent reports, these secondary financial consequences are an even larger burden that the direct medical costs of obesity.

At its most extreme, obesity may prove to be one of humankind’s worst maladies. Taken from research firm McKinsey & Company, obesity’s impact on global GDP – at $2.1 trillion – ranks just behind that of smoking and the combined classification of armed violence, war, and terrorism – both with a $2.1 trillion global GDP impact.

In other words, obesity is one of the top three social burdens created by humans.

Is There Any Hope?

The prognosis may be grim, but there is some optimism with regards to combating and reducing obesity.  From the 2018 report, The State of Obesity 2018: Better Policies for a Healthier America:

  • Obesity rates for children dropped across most states between 2010 and 2014.
  • A 2018 study found that states which promoted CDC-funded nutrition and physical activity programs, the chance for obesity in adults dropped by almost 4%.
  • And according to Healthy Community Studies, children who lived in areas that made healthy eating and physical activity priorities had lower BMIs than those who lived elsewhere.

To reinforce the fact that an individual’s environment and promotion of healthy habits truly do matter the authors of the state of obesity report recommended that by –

  • Promoting and scaling of health-related programs across schools, local business, and health departments;
  • Making healthy activities, including eating and activity easier to access;
  • And investing in programs that reach those that may be at a social or economic advantage.

– the opportunity is present to reduce and prevent obesity.

As the CEO of Trust for America’s Health, John Auerbach agrees with the recommendations. He states:

“Obesity is a complex and often intractable problem, and America’s obesity epidemic continues to have serious health and cost consequences for individuals, their families, and our nation. The good news is that there is growing evidence that certain prevention programs can reverse these trends. But we won’t see meaningful declines in state and national obesity rates until they are implemented throughout the nation and receive sustained support.”

Ultimately, there is still a lot of work that must be done to reverse the growing trend of obesity in both children and adults. However, through the right mix of education, prevention, and investment, obesity can be overcome, and its prevalence in the US turned from the norm into the exception.