The Economics of the Obesity Epidemic

“How much does obesity cost?”

The incidence of obesity in the US is currently around 40%, and it’s estimated that by 2030, about half of the US population will have obesity.  The greatest impact may be felt by those who are living with obesity, however, due to persistent growth of the problem, the consequences are now impacting our society as a whole. It is estimated that $147 billion is spent annually in the US on obesity-related expenses.

Not only does the disease of obesity cost everyone, but it’s also expensive to treat.  There are highly effective treatment methods available, but cost is a significant barrier to people getting access to the treatments they need. For instance, a person seeking to treat their morbid obesity by undergoing a weight loss surgery may have bariatric benefits through their health insurance plan.  So, in this case, most of the cost of treatment would be covered by the insurance carrier through an employer-sponsored plan.  If, however, the patient does NOT have this coverage included in their plan, they would have to pay the cost themselves.  In this part of the country, bariatric surgery costs range from about $12,000 to over $20,000, depending on where and what type of surgery it is.  If that same patient had access to anti-obesity medications through their insurance plan, they would be able to have these medications prescribed to them and their plan will cover most of the cost with the patient likely paying a copayment for each prescription. For a patient who pays for the medications themselves, they could be spending between $1000 to $2000 per month. Because obesity is a chronic and complicated condition, the reality is that most patients will require more than one treatment modality to manage their weight over time. So, as you can see, the cost of treating obesity can be very high, regardless of who is paying for it.

Most people may look at these price tags and decide they just cannot afford to treat their obesity, or they can’t justify the costs as necessary.  But, what most people don’t consider is how much their obesity is actually costing them. Furthermore, we must also ask ourselves if we can afford to NOT treat obesity.

“So, how does obesity cost impact society?”

One of the more obvious costs is associated with providing medical care.  According to a recent study, annual medical costs for adults with obesity were DOUBLE than those without obesity ($5,010 vs $2,504). The study found that these costs have doubled in size from the year 2001 to 2016, which demonstrates the growing urgency of the problem.  The costs increased proportionately with the severity of obesity (68% more for class 1 obesity-BMI 30-34.9, 120% for class 2-BMI 35-39.9, and 233% for class 3-BMI 40+). The higher costs were associated with inpatient care, prescriptions, and outpatient care.

The largest portion of the increased costs associated with obesity were covered by the government, which means the burden is ultimately felt by the American taxpayers. While most Americans have medical coverage through employer-sponsored plans, some are covered through governmental entities such as Medicare and Medicaid.  The consumers of these plans tend to have more chronic illness, so the burden is felt somewhat disproportionately by government payers. 

Unless there are major policy and systemic changes, by the year 2035, obesity could end up costing the world’s economy over $4 trillion EVERY YEAR as estimated by the World Health Organization.  This would account for about 3% of the gross domestic product (GNP), which is also how much the GNP grows each year.  This means that the wealth and growth being built by the world’s population will be eaten up by the cost of obesity as a disease if things remain as they are now.

“How much does living with obesity typically cost an individual?”

Since every person’s needs and circumstances are different, obviously, this can be highly variable.  But, there are some expenses associated with obesity that people may not think about. 

Clothing

Many people who have struggled with weight may have multiple sizes of clothing in their closet, because new sizes of clothing have to be purchased due to growing body size. In addition to having to replace clothing with bigger sizes, those bigger sizes (“plus,” “curvy,” and “big & tall”) also cost about 25% more. This difference is mostly due to increase in materials and re-designs for different proportions.  This is also true for undergarments, specifically bras for plus-sized customers, which require more materials and more support than do smaller sizes and styles.  On average, the cost is 200% to 300% more for plus sized bras versus smaller sizes.

Life Insurance

Life insurance premiums can be more than doubled because of extra weight. For instance, a woman at 166 lb. might get a policy for $260 per year. With an extra 50 pounds, the same policy would cost more than twice as much at $595.  A man could get a policy for $310 at 196 pounds, and at 246 pounds, the policy would cost $641 annually.  This can be a meaningful motivation for weight loss for policy holders, but even with weight loss, insurers may require weight loss to be sustained before premiums can be reduced.

Wages

Individuals in lower income brackets tend to have higher obesity rates, suggesting that obesity may be worsened by certain lifestyle and economic limitations such as less access to healthier foods and exercise opportunities.  It must also be noted that people’s obesity may actually cause them to be paid less.  Women with overweight or obesity earned an average of 9% less than female workers who are not overweight. Some of the underemployment may be attributable to weight stigma, and wages and productivity may be lowered due to lower functional productivity and higher absenteeism. Employers may be less inclined to hire or promote workers with obesity due to the economic impact on the organization.  Even if  individual is more qualified than others, they may not be hired simply due to expectant costs associated with employing them.

Travel

Obesity can make travel uncomfortable, and for some, obesity may be severe enough to prevent travel altogether. Travel can be more expensive with obesity as well. For instance, many airlines may require the purchase of 2 tickets rather than 1 if the passenger’s body size prevents them from fitting in a standard size seat.  Airlines also charge extra for luggage, which may create an issue for someone whose clothes and shoes require larger suitcases and more of them.

Travel by car may require a larger size vehicle to accommodate body size, and renting larger cars costs more.  Parking by valet is an extra expense that may be necessary if the walking distance from parking spaces isn’t feasible due to lower mobility or conditioning.  Shorter walks of just a few city blocks might not be possible, making taxis or Ubers necessary.

Food costs

As obesity rates in the US and around the world have soared in recent decades, there has been a lot of focus on food quality and prices. Research shows that just a 10 percent increase in spending on food prepared at home would reduce body fat by 9%.  Conversely, a 10 percent decrease in fast food spending would decrease body fat by 17% (almost double of the first figure!).  

Many patients complain that the cost of healthier food is more expensive than some less nutritious choices. But, if we are looking at overall spending habits, dining out or ordering carry out is more expensive than preparing food at home. In addition to negatively impacting finances, restaurant foods tend to be heavier in salt, fat, and sugar and have larger portions.

Individuals living with binge eating disorders may spend hundreds of dollars every week in restaurants, fast food drive-throughs, and food deliveries to feed their addictions (quite literally).  Getting binge-eating under control can not only improve your physical health but can also improve your finances as well.  

Sit down and examine your food spending habits to get a true picture of what you are actually spending financially and what it’s costing your health.  If you are spending $500 or more per month at restaurants, be honest with yourself about better ways to invest those funds in your health. The money spent on unhealthy behaviors could be spent on something that enhances your life like a gym membership, a therapist, or exercise equipment to name a few.

Household Services

As many people living with obesity can attest, moving around in a larger body makes everything harder and sometimes impossible.  If mobility is extremely limited, there may be many things throughout the day that require the help of another person. A person with obesity may not be physically able to clean their home, mow their grass, tend their garden, walk their dogs, wash their cars, decorate and maintain the house, among other things. Enduring weight stigma stereotypes people with obesity as being lazy or entitled, but the truth is that it’s a lot of work to carry around an extra 100 or 200 pounds.  A person may get out of breath even walking to their mailbox, so it only stands to reason that more significant tasks must require help.  That means that you may have to hire a housekeeper, a handyman or others to assist in these tasks.  

“What’s the bottom line on the bottom line?”

Before you decide that a medication or procedure that will likely improve and lengthen your life is TOO EXPENSIVE, ask yourself what costs you’re incurring now.  Sit down and honestly and earnestly examine your habits to find areas where you will profit in the long run for an investment in your health today.

The price tag of continuing to live with obesity is much higher than you think.  Your life is priceless, so you’re worth the investment.