The Cost of Being Overweight

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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.

Comments

[Crystal @ BFS]

My husband and I joined Weight Watchers Online 3 weeks ago just to get some extra pounds off our bones...we're only in our late 20s but already started having some aches and pains. It's been 20 days and Mr. BFS is down 12 pounds and I am down 8. Woot for a better diet!

[Tuan]

It is the one goal I am working since I graduated college. Even though my vital signs are normal, my doctor recommended me to count my calories for two weeks in addition to my workout regiment that I had. Just seeing what you eat in that time span is surprising. I didn't know that I was literally stuffing myself silly.

For instance, I used to eat a Costco Muffin and a glass of milk for a morning breakfast. I didn't know that a Muffin contained 600ish calories and with milk I basically had a huge 800 calories breakfast every morning. Ever since, I've switched to eating a Costco Bagel (260-280 cals) or two eggo waffles (180 cals) and kept my milk and that alone has dropped my daily intake by 300-400 calories a day. Since there is 3500 cals = 1lb fat, I've dropped from 215lbs to 200lbs in the last 4 months by just switching one eating habit.

[Jacinda]

Ah, the Bullshit Mass Index-- causing insurance companies to cancel people's health insurance without warning since 1998.

This article is awful, by the way. I'm never reading your blog again (and I've been a faithful if lurkful reader since 2007.)

[KH]

I'm going to go ahead and blame the Disney meal plan....

Seriously, when I was reading that post all I could think about was, "OMG, does anyone really need to eat that much food for days on end?"

People have got to stop thinking that getting the most quantity of food for the money is the greatest deal.

Instead, think: quality, think: reasonable portion sizes, think: I only need to eat one meal a day, especially if all I'm doing is sitting on a plane/at a desk all day. Moderation, moderation, moderation.

[Russ Tarvin]

I am not sure I understand this article. Is this to save my life or my pocket book? Has this author been fat and understands the condition, or is just a person that has never struggled, and not with that last "10 pounds" that could really only be hiding in the marrow of their bones, with weight?

I understand what is trying to be said, but this article only works with a connection to the reader. Naturally (and continually) skinny readers may connect. The rest, you know, the people you are trying to speak down too, don't identify with your message.

I am overweight and have no physical reason to be so. Still it is a struggle. Don't talk down to us as if it is a simple calculation on a spreadsheet,act human and try first to understand.

[tom]

@Jacinda,

What is your evidence that the article is awful? The numbers it cites are from completely reputable sources.

The fact is that obesity is one of the biggest health risks in the country because it dramatically increases the probability of having bigger health issues.

If Americans spent half of their TV time actually exercising, we would have a much healthier and "cheaper" country.

If this blog has taught you anything it's to spend less than you earn, same thing with calories. It's not rocket science, it's simple math.

So before you go off and say how awful this article is and how you'll never read this blog because of it, take a good hard look around you. These figures are not difficult to believe.

[KP]

BMI is just a number, and only a number, it doesn't give a whole picture of someones physical health.

If you go by it my hubby is obese , yet his body fat % is acceptable, and he's in good health... I think the taller you are the less accurate it is (He's 6'5")

The BMI guidlines also says that I should weight 10 lbs less than I ever have, I'm guessing since it doesn't compensate for G cup breasts.

As far as clothes being more expensive for larger folks, I don't see a correlation unless we're talking amazing huge clothes. I regularly am frustrated since my step sister who is a 2X can find inexpensive clothes all the time at sales, while I cant find medium or large sizes in any sale or clearance racks.

Ironically the only people I know in my family with chronic health conditions are my father-in-law who has hypertension (and is extremely fit, eats only organic, and is a black belt who works out daily), and my grandfather who has diabetes (who eats well, follows a strict diet, and has never been overweight)

You want to start talking about uncontrolled healthcare cost, please include smokers/drinkers, unneccessary c-sections, and the doctors who drive up costs by practicing defensive medicine.

[Easychange]

@KP While I think you have a good point about the other factors, I think you sound a bit hostile. Like, you're probably have elevated blood pressure. I think you probably need a Complete Blood Count, x-ray, ekg, etc. What is your insurance number ;) j/k

@Jacinda, i hope you do come back. I have read FMF for years and i think he is just looking for some new angles; dont judge the whole site by one article.

changing habits are difficult, especially food related ones. Perhaps the content is a bit controversial as is the tone But the spirit of the article is good.

[Noah]

Wow, so many hostile responses.

Yes, we all know that you can't only go by someone's BMI. However, obesity is a huge problem and it WILL end up costing you in the long run, not only in money, but enjoyment of your life.

Of course, one could argue that being obese does allow you to not save as much for retirement, because chances are high that you probably won't live as long as someone who is physically fit. Sadly, my obese generation may be one reason that Social Security doesn't fail because a good portion of them will die before 65 of obese-related issues.

[JimL]

The hostile comments are just plain silly. Look around. Most of America is fat. We sit around and wonder why health care costs are going up and the answer is right in front of us. Take a look at the rising rate if diabetes. It is becoming an epidemic.

[Mert]

An excellent post! It may provide great awareness for objective critical readers, but not for the ones who just react. This is one of the best posts in FMF, IMO.

Yes, BMI has its flaws, we know. But for the least, it is a very simple (and free) measurement that helps us to track our health. It is a good indicator which is effective for majority of people. You want more? Yes, you can always take measurements, or measure fat% or whatever else (which I do). Then, it becomes harder to track, interpert and follow up. Not for the average Joe.

Obesity is not just only about money. It is about life. It affects everything: Self respect, energy, psychology, work performance, leisure activities, your love life, everything! And the sad thing is, such simple and small habit changes may change profoundly not only the lives of millions of people but also the future of an entire country (or countries). Still, very few people do those.

Just change one small habit at a time, until you become a person who moves gently 15-30 minutes 5 days/week and eats clean 80% of the time(only vegetables, fruits, beans, eggs and a little bit of meat). You can be lazy the other 2 days and eat whatever crap you want the other 20% of the time. At the end, you will have a happy retirement with an additional million dollar, and an extra 30 years to live healthy. That's just it.

[Squirrelers]

Really, there's a connection between money and health, no doubt. I have regularly preached that if you improve your health, you put yourself in a better position to preserve and create wealth. Keeping weight off and losing excess weight is important to the financial aspect but most importantly to overall quality of life. What does all the money one saves and invests mean if we aren't around for any enjoyment of it?

[Paul]

Another cost ... the possibility of having to buy 2 airline tickets. This happened to film director Kevin Smith.

[Jeannine]

All of the facts cited in this article are from reputable sources and I'm sure are 100% true. It shouldn't be a shock to anyone that being obese could cost you in many ways. However, let's not turn this into a discussion of why obese people are obese, i.e. laziness, ignorance, etc. In light of recent research that shows that the food industry is doing whatever it can to keep people hooked on unhealthy foods, the energy spent criticizing obese people for being obese would be better spent on educating people about the dangers of getting hooked on these foods in the first place. I highly recommend David Kessler's book "The End of Overeating". Obesity is a very complicated problem that actually isn't solved just by "calories in-calories out".

[jim]

KP, FMF has written several times about smoking and its costs. Check out the articles:

Stop Smoking, It's Killing the Nation's Finances
Smoking is Costing You a Fortune
Stop Smoking -- It's Killing Your Finances
Money Saving Tip: Stop Smoking
Don't Just Quit Smoking, Take the Next Step
Quit Smoking and Save Almost $6000 a Year
Saving on College Costs and Quit Smoking
The Five Most Expensive Addictions
How to Save 42% on Healthcare Costs

[KaseyD]

I think the hostility is a defense mechanism. Obesity and excess weight ARE problems for this country. Just take a look at the mall. And take a look at school kids these days. Just look around to see how everyone has "grown" since our childhoods. If the hostile posters are overweight and want to ignore it fine, but what about the children who will innocently enter adulthood with a problem not of their own making.

From someone who dropped their BMI (and yes it is not the holly grail, but it is a useful guideline as are weight and % body fat) from 28 to 21 after 30 years of struggling with weight I can honestly say that eating healthy can cost LESS. And the key to that is home cooking. We eat gourmet meals almost every night in our kitchen for less than $10 for 2. That’s much less than our dinners out in the past. Our home-cooked meals are well balanced, nutrition-rich totaling about 1500 calories for me and 2200 calories for DH each day. High quality protein, healthy-oils, whole grains and organic vegetables. Last night it was grass-fed steaks ($5.50), organic-greens salad (~2.00) and roasted winter squash ($1.50). You just can't get that eating out! Oh yeah, no wine or beer saved about $10 and 600 calories.

FMF, I think this was a great article, thanks for posting it.

[Josh]

This is article is spot on and I agree most of the hostility is just a defense mechanism.

Yes, there are a few medical conditions beyond people's control but the vast majority of people that are overweight are just making excuses, or trying to find an excuse when they only have themselves to blame.

[Jeff]

Agreed, hostility is a defense mechanism. People inherently don't want to think they've done anything wrong and/or are living a poor lifestyle. They blame it on a series of factors outside of their control. Take it from someone who was formerly the "fat kid" all through school turned Army Infantry soldier turned personal trainer. There are very few obese people who cannot lose weight.

[Georgia]

I was normal weight until about age 14. I had been in a bad fire & was hospitalized. I began overeating as a nervous habit. But, the doctor once told me, now that the nerves were settled, the habit remained. It was hard to break because you cannot go cold turkey like smokers and drinkers. You have constant temptation.

I am still overweight and still working on it. I am down about 40-45 lbs. from my highest weight. Still have about 60-70 to go. But, since retirement, my main problem is exercise. I was never extremely active and now I must put effort into. In the summer it is fine because, in my small town, you could walk to the other side of town in 1 mile. If I go for coffee, I walk .7 mile and the same back home. I can walk wherever I need to go - coffee, groceries, church, etc.

But - the problem is in winter. I now have a treadmill and am trying to get used to using it. Wish me luck. Good article.

[F P]

After reading countless articles on the subject it is clear that the author has done their due diligence. Though in our hyper sensitive politically correct society we are more worried about hurting ones feeling than actually dealing with realities.
As individuals we must start to take accountability for our actions and our position in life, If I am without money, its my fault, bad marriage, my fault, don't like my job, my fault, over weight, my fault. For some who commented on this article, if you think this is aggressively attacking the issue pickup a copy of Steve Seibolds book "Die Fat or get Tough"
I just spent a week in Disney World and was horrified by the number of young families, Dad's, Mom's and their children who are were over weight and worse obese.
Siebold so much to the point addresses the mind set of people and boldly states; "That diets work, but people often don't"
The issue that the author addressed in the piece is the cost of being overweight, funny how some people lives their lives always wanting to take someone or something down with them "but he did it to" 'or its not my fault"
People its time to stand in front of the mirror buck naked and despite your BMI number be honest with yourself. We must take full and total responsibility for our eating and our health, stop blaming the government and food companies and media and look stop looking for a diet messiah to come from out the streets.
Education is the key, but action is the response to the new found knowledge.