Tag: "obesity"

Fattest Regions in the U.S., and Other Links

Weight Loss Therapy a Bargain for Medicare

Emory Professor, Kenneth Thorpe, examines the costs of treating obesity-related conditions and found medications that help Medicare enrollees lose weight could save money for Medicare in the long term.

Permanent weight loss of 10 to 15% will yield $9,445 to $15,987 in gross per capita savings throughout their lifetime, and $8,070 to $13,474 over ten years. Similarly, initial weight loss of 10 to 15% followed by 90% weight regain will result in gross per capita savings of $7,556 to $11,109 over their lifetime, and $6,456 to $8,911 over ten years. Targeting weight loss medications to adults with obesity (BMI ≥ 30) produces greater savings to the Medicare program.

Exercise Matters

There are four key patterns of results that emerge. First, the lagged effect of physical activity is almost always larger than the current effect. This suggests that current risk factors, not only obesity but also high blood pressure and heart rate, take years to develop, which underscores the importance of consistent physical activity to ward off heart disease. Second, we find that in general physical activity reduces risk factors for heart disease even after controlling, to some extent, for unobservable confounding influences. Third, not only recreational but work-related physical activity appears to protect against heart disease. Finally, there is evidence of a dose-response relationship such that higher levels of recreational exercise and other physical activity have a greater protective effect. Our estimates of the contemporaneous and durable effects suggest that the observed declines in high levels of recreational exercise and other physical activity can potentially account for between 12-30% of the increase in obesity, hypertension, diabetes, and heart disease observed over the sample period, ceteris paribus.

Source: NBER Working Paper.

Three Oreo Cookies a Day

That’s all it takes to make us fat. From Timothy Taylor at the Conversable Economist:

The rise in American rates of obesity can be traced back to what seems like a fairly small rise in daily calories consumed, I learned this lesson from an article on the causes of obesity about 10 years back in my own Journal of Economic Perspectives. In “Why Have Americans Become More Obese?” David M. Cutler, Edward L. Glaeser and Jesse M. Shapiro wrote that the “10- to 12-pound increase in median weight we observe in the past two decades requires a net caloric imbalance of about 100 to 150 calories per day. These calorie numbers are strikingly small. One hundred and fifty calories per day is three Oreo cookies or one can of Pepsi. It is about a mile and a half of walking.”

Chemicals that Lead to More and Larger Fat Cells, and Other Links

Healthy Behaviors Improve Your Self-Control, and Other Links

Why Are We Obsessing on Wellness?

Heresy at Health Affairs:

Virtually unheard of thirty years ago, workplace wellness is now embedded in large self-insured companies. These firms pay their workers an average of $460/year to participate in worksite wellness programs. Further, wellness is deeply enough engrained in the public policy consciousness to have earned a prominent place in the Affordable Care Act, which allows large employers to tie a significant percentage of health spending to employee health behavior and provides direct subsidies for small businesses to undertake these workplace wellness programs.

Yet the implausible, disproven, and often mathematically impossible claims of success underlying the “get well quick” programs promoted by the wellness industry raise many questions about the wisdom of these decisions and policies.

So why are we doing this? I proposed an answer in Priceless: wellness programs attract employees who are already healthy and repel those who aren’t.

Being Overweight = Longer Life + Higher Medical Bills

Re: last week’s finding that overweight people may live longer. Here’s the rest of the story:

“The study looked at quantity of life, not quality of life, and that’s a very important distinction,” noted Dana Goldman, director of the University of Southern California’s Leonard D. Schaeffer Center for Health Policy and Economics.

A higher body mass index — a standard measure for determining whether people are overweight or obese — is associated with a number of chronic illnesses, including diabetes, heart disease and hypertension. These chronic illnesses are expensive to treat. If, as it now turns out, overweight people are living longer in addition to racking up more chronic illnesses, that means Medicare is on the hook for paying for more expensive people for more years.

Catherine Rampell. Critique of the study here. A defense of fat here.

Should People Who Cause Their Own Illnesses Pay for Their Own Health Care?

David Friedman weighs in:

I recently came across a news story about a British legislator who proposed that patients suffering from life style illnesses, medical problems mainly due to behavioral choices such as being overweight, ought to have to pay for their own medicines rather than having them provided for free by the National Health Service. It is a proposal that I expect will provoke strong responses both against and for…

[I]t is not clear just how the logic of endogenous disability can be dealt with in a governmental system such as the National Health Service. There is a serious problem of lack of bright lines. Many sufferers from type 2 diabetes, an example mentioned in the news story, may have it because they choose to be greatly overweight, but presumably not all. Similarly in other cases.

Okay, commenters. What do you think?

Headlines I Wish I Hadn’t Seen