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The following is reprinted with permission from Perigee books, a division of Penguin Group, USA from The Real Cost of Living: Making the Best Choices for You, Your Life, and Your Money by Carmen Wong Ulrich, 2010.
Obesity is becoming the norm in this country—a very dangerous and expensive norm. It’s partially the result of bad eating habits aided and abetted by our corn-syrup-addicted fast-food supersizes and the cheapness of the least healthy grocery choices. Obesity is defined by the Centers for Disease Control and Prevention (CDC) as having a body mass index (BMI) of 30 or higher, and being overweight is defined as having a BMI of 25 or higher. We’re being supersized at such a rate that experts say that in twenty years, more than half of American adults and the majority of children will be overweight. The costs of carrying too many pounds on your frame have little to do with the cost of the groceries, which are feeding said frame.
Yes, cutting down on groceries does save you money (as I’ll discuss in a later chapter), but that is merely pocket change compared to the repercussion costs.
The first and possibly most expensive costs of obesity have to do with direct and indirect healthcare costs and complications. Being overweight can contribute to many diseases and chronic conditions, including some cancers (breast and colon), diabetes, hypertension, heart disease, high cholesterol, and stroke, and this list contains four of the top six causes of death in the United States. Diabetes itself has dreadful side effects that severely hinder quality of life, such as loss of limbs and blindness not to mention an average cost of $13,000 a year. And note that more than half of diabetes cases are type 2 diabetes (also called adult onset), which is very preventable through diet and exercise.
So how high can these costs get? As of 2008, the CDC found that healthcare costs in this country were around $147 billion to cover health complications from obesity—over 9 percent of the nation’s annual healthcare budget. Some estimate that by 2018, that number will go up to $344 billion for medical expenses for obesity, closer to 21 percent of all healthcare spending. If you break down that price tag, obese Americans pay $1,429 a year more in medical costs than someone who has a BMI below 25; that’s 42 percent higher healthcare costs for an individual. If you’re overweight or obese, you’re also much more likely to take more medication than someone of lower BMI. According to the American Heart Association, obese men spent almost four times more on prescriptions, racking up an extra $700 in drug costs per year. All in all, the medical and healthcare costs of obesity and being overweight are 80 percent of the total amount spent on care for all cancers combined.
How do experts think they can mitigate what seems like an epidemic in healthcare costs (even with reform) and shorter life spans and lower quality of life? The Rand Corporation found that those who are obese or overweight can reduce their healthcare costs by 20 percent to 50 percent by just bringing down their BMI by 10 points. The 2008 CDC study showed a savings of $55 billion if couch potatoes got off the couch. Some experts want to get Americans to make healthier choices, thereby losing weight, by taxing soda—which may come to fruition in New York City as I write. Some New York City restaurants have recently started posting calorie counts, though one study found no positive effects as of yet; in fact, people consumed even more calories (a follow-up study did show the opposite). And, of course, if you’re a connoisseur of books such as The Omnivore’s Dilemma and Food Rules by Michael Pollan, you know that one proposed solution is to end our dependence on corn in the form of high-fructose corn syrup, an extremely unhealthy substance that is in everything from fries to ice cream.
The direct costs of carrying too many extra pounds seems stratospheric on their own, but add onto those totals the indirect costs of being overweight or obese, and you’ve got yourself a ripple effect that hits all our wallets.
Your paycheck pays the price. Wage discrimination exists as well as hiring discrimination. The majority of respondents in one recent study said that they’d always choose the thinner individual when deciding between two similar job applicants. Employees who are overweight, on average, make $1.25 an hour less than a low-BMI colleague, adding up to a six-figure loss over a career. Women get hit the hardest when it comes to paying a high price at work for being overweight—obese women can make up to 24 percent less than an average-size women while even slightly overweight women make around 6 percent less. Obesity also costs your company in lost wages due to illness and absenteeism; a 2007 study tallied the total costs to American businesses at $4.3 billion a year. Another study showed nearly $1,000 lost in annual wages due to illness from obesity or being overweight.
Moving extra weight costs more as well. The Engineering Economist says that 272 million gallons more of gas is used every year to fuel the cars that carry overweight Americans—that’s 39 million more gallons per year for every pound we gain as a country. (Another study says that the total is closer to an extra 9 gallons of fuel and $36 more dollars for gas per year per person annually.) Airlines, which continue to have a problem with managing growing American waistlines, say that the obese pay an average of $828 for extra seats over their traveling lifetimes and $275 million more a year on jet fuel.
Clothes cost more (around $500 a year more), and getting around costs more—anyone see Wall*E? Are we doomed to end up floating around in mini-hovercraft because we’re too big to get around? Or are the costs of being unhealthy enough to turn if not individuals’ then a nation’s food system around? Many experts hope that we’re heading toward a major reality check when it comes to obesity. When nearly every child develops diabetes and generations of families ex¬perience this chronic disease as a norm, something’s gotta give.
So what’s the hypothetical price tag of being overweight? Add together the higher annual costs of healthcare and medication ($1,429), wage discrimination ($2,500), travel costs (a conservative $25), and other lifestyle costs such as mobility and clothing ($2,500), and the cost of being overweight is around $6,454 a year, or that’s $538 a month. Over a lifetime (forty adult years), that’s more than $258,000. And had you instead put that $538 a month in your retirement account, earning a moderate average of 6 percent interest, you’d have $1,082,675. But that’s without diabetes or complications. Consider those pricey add-ons, and you’re looking at $19,454 a year in total costs—that’s $778,160 over a lifetime and over $3 million if that money had been invested.
These dollar amounts don’t even come close to the personal price you could pay. You may not be able to run and play with the kids. Diabetes may cost you your sight. (How much would you pay to be able to see again?) Surgeons may have to crack your chest open a couple of times, resulting in months of rehabilitation, disability, and pain. You could have a heart attack before your first child ever graduates from high school. There are so many what-ifs when it comes to being overweight because the health repercussions vary greatly. Some people can live without much medical drama into their eighties, whereas others have a first heart attack at age forty-five. When you gamble with your body and your genetics, you also gamble on the price you pay.