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Obesity Healthcare Costs US 147 Billion Dollars A Year, New Study

The annual healthcare cost of obesity in the US has doubled in less than a decade and may be as high as 147 billion dollars a year says new government-sponsored research.

  • In 1998 the medical costs of obesity in the US were estimated at around 78.5 billion dollars a year, half of which was financed by Medicare and Medicaid.
  • Between 1998 and 2006, the prevalence of obesity in the US went up by 37 per cent.
  • This rise in obesity prevalence added 40 billion dollars to the annual healthcare bill for obesity.
  • The annual healthcare costs of obesity could be as high as 147 billion dollars for 2008.
  • Obesity is now responsible for 9.1 per cent of annual medical costs compared with 6.5 per cent in 1998.
  • The medical costs for an obese person are 42 per cent higher than for a person of normal weight.
  • This equates to an additional 1,429 dollars per year: the costs for an obese person on Medicare are even greater.
  • Much of the additional Medicare cost for an obese person are the result of the added prescription drug benefit.
  • Medicare prescription drug payments for obese recipients are about 600 dollars a year more than for normal weight recipients.
  • Obesity accounts for 8.5 per cet of Medicare expenditure, 11.8 per cent of Medicaid expenditure, and 12.9 per cent of private insurance expenditure.

"As a result, the medical costs attributable to obesity are almost entirely a result of costs generated from treating the diseases that obesity promotes," he added, suggesting that as long as obesity prevails to the extent that it does today, it will continue to be a significant burden on health care."

The study was conducted by researchers at RTI International, the Agency for Healthcare Research and Quality, and the US Centers for Disease Control and Prevention (CDC) and is published in the 27 July issue of the health policy journalHealth Affairs.

Weight Loss Surgery Overview


If you suffer from uncontrollable weight problems, you need to know about your disease (obesity/morbid obesity), and about the most successful way of treating it; through weight loss (bariatric) surgery.

The treatment works by reducing food intake, and reducing the feeling of hunger. The result is a very early sense of fullness, followed by a very profound sense of satisfaction therefore less calories are consumed. Find out more detailed information about the various weight loss surgery treatments here. With one operation, a person can be potentially cured of numerous obesity related medical diseases (called comorbidities) including:
  • diabetes (a disease characterized by abnormally high glucose levels in the blood)
  • hypertension (persistent high blood pressure)
  • high cholesterol (collects on the walls of arteries and interferes with blood flow)
  • sleep apnea (temporary suspension of breathing occurring during sleep)
  • chronic headaches (constant pain in the head)
  • venous stasis disease (discoloration around ankles and lower legs)
  • urinary incontinence (loss of bladder control)
  • liver disease (accumulation of fat in the liver cells resulting in inflammation)
  • arthritis (joint disorder featuring inflammation)

How do you, your doctor and or insurance determine whether you are a candidate for weight loss surgery? Generally, if you are or have:
  • a BMI that is greater than 40, surgery should be considered.  If it is greater than 35, and is accompanied by a serious comorbidity, surgery may be medically necessary.  To find out your BMI, use the BMI calculator.
  • comorbidities from being overweight? We look for health effects that are known to be caused by, or aggravated by serious obesity.
  • tried dieting, especially medically supervised dieting, and been unable to achieve a sustained healthy body weight.

According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk. Today 97 million Americans, more than two-thirds of the adult population, are overweight or obese. An estimated 8 to 11 million of those are considered morbidly obese and generally eligible for weight loss surgery. Globally, there are more than 1.7 billion overweight adults, at least 300 million of them obese.

Weight loss surgery is a tool that helps you control the calorie intake. And by doing this, you hope to avoid the negative health effects of obesity.

What is Obesity and Morbid Obesity?

Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. The terms also identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems. For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the "body mass index" (BMI). BMI is used because, for most people, it correlates with their amount of body fat. It is important to gain a fundamental understanding of your condition, so you can communicate and make educated decisions about your obesity and how to treat it.

To get started, you need to understand how the terms "Obesity" and "Morbid Obesity" are used to determine your eligibility for weight loss surgery. The term "obesity" specifically refers to an excess amount of body fat; individuals that are at least 20 percent above the weight recommended for one's height can be considered obese. Morbid obesity is a chronic disease, meaning that its symptoms build slowly over an extended period of time. An estimated 8-11 million Americans are considered morbidly obese. Obesity becomes "morbid" when it reaches the point of significantly increasing the risk of one or more obesity-related health conditions or serious diseases (also known as co-morbidities).

It is also important to understand the term "body mass index" or "BMI". BMI is a number calculated from a person’s weight and height. BMI provides a reliable indicator of body fatness for most people and is used by Doctors and Health Insurance companies to screen for weight categories (obesity or morbid obesity) that may lead to health problems. The categories are listed below.

BMI Classification
Health Risk
Probability of Insurance Coverage
Surgery
Category
Under 18.5 Underweight Minimal none n/a
18.5 - 24.9 Healthy Weight Minimal none n/a
25 - 29.9 Overweight Increased none cosmetic
30 - 34.9 Obese High unlikely cosmetic
35 - 39.9 Severely Obese Very High likely when comorbidities exist* medically necessary when comorbidities exist
40 & over Morbidly Obese† Extremely High very likely usually medically necessary
*A person with a BMI between 35.0 – 39.9 may be eligible for weight loss surgery if they have co-morbidities (medical illnesses/diseases that are either caused by or contributed to by the excess weight that can result either in significant physical disability or even death.) †Morbidly Obese: "Morbid obesity" means that a person is either 50%-100% over normal weight, more than 100 pounds over normal weight, has a BMI of 40 or higher, or is sufficiently overweight to severely interfere with health or normal function.

 

What Is Morbid Obesity?
Obesity becomes "morbid" when it reaches the point of significantly increasing the risk of one or more obesity-related health conditions or serious diseases (also known as comorbidities) that result in either significant physical disability or even death. As you read about morbid obesity you may also see the term "clinically severe obesity" used. Both are descriptions of the same condition and can be used interchangeably. Morbid obesity is typically defined as being 100 lbs. or more over ideal body weight or having a Body Mass Index of 40 or higher.

According to the National Institutes of Health Consensus Report, morbid obesity is a serious disease and must be treated as such. It is a chronic disease, meaning that its symptoms build slowly over an extended period of time. Obesity treatment is available, and weight loss surgery may be a good option for you. In general, insurance companies require a Body Mass Index (BMI) of 40 or higher. A BMI of 35+ may be allowed depending on the number and severity of the patient's related comorbidities.


Obesity-Related Health Conditions (comorbidities)

Obesity-related health conditions (comorbidities) are health conditions that, whether alone or in combination, can significantly reduce your life expectancy and as a result, weight loss surgery may be deemed a medically necessary treatment. A partial list of some of the more common conditions follows. Your doctor can provide you with a more detailed and complete list:

  • Shortened Life Span

    The cumulative effect of these co-morbidities can interfere with a normal and productive life, cause endless frustration and can seriously shorten life, as well.

  • Dysmetabolic Syndrome X

    This recently recognized syndrome, involving abdominal obesity, abnormal blood fat levels, changes in insulin sensitivity, and inflammation of the arteries, is associated with a markedly increased risk of heart and blood vessel disease.  It is also a precursor to the onset of Diabetes in adults.

  • Heart Disease

    Severely obese persons are approximately 6 times as likely to develop heart disease as those who are normal-weighted. Heart disease is the leading cause of death in the United States today, and obese persons tend to develop it earlier in life, and it shortens their lives.  Coronary disease is pre-disposed by increased levels of blood fats, and the metabolic effects of obesity. Increased load on the heart leads to early development of congestive heart failure. Severely obese persons are 40 times as likely to suffer sudden death, in many cases due to cardiac rhythm disturbances.

  • High Blood Pressure

    Essential hypertension, the progressive elevation of blood pressure, is much more common in obese persons, and leads to development of heart disease, and damage to the blood vessels throughout the body, causing susceptibility to strokes, kidney damage, and hardening of the arteries.  If your doctor finds you have high blood pressure, the first thing he or she will recommend to you is weight loss...(but doctors have never been able to tell us how).

  • High Blood Cholesterol

    Cholesterol levels are commonly elevated in the severely obese -- another factor predisposing to development of heart and blood vessel disease.  This abnormality is not just related to diet, but is an effect of the massive imbalance in body chemistry which obesity causes.

  • Diabetes Mellitus

    Overweight persons are 40 times as likely to develop Type II, Adult-Onset, Diabetes. Elevation of the blood sugar, the essential feature of Diabetes, leads to damage to tissues throughout the body: Diabetes is the leading cause of adult-onset blindness, a major cause of kidney failure, and the cause of over one half of all amputations. It is the #4 cause of death in the United States.  Diabetics suffer severely from their disease, and once Diabetes occurs, it becomes even much harder to lose weight, because of hormone changes which cause the body to store fat even more than before.

  • Sleep Apnea Syndrome

    Sleep apnea -- the stoppage of breathing during sleep -- is commonly caused in the obese, by compression of the neck, closing the air passage to the lungs.  It leads to loud snoring, interspersed with periods of complete obstruction, during which no air gets in at all. The sleeping person sounds to an observer like he is holding his breath, but the sleeper is, himself, usually unaware that the problem is occurring at all, or only notices that he sleeps poorly, and awakens repeatedly during the night. The health effects of this condition may be severe, high blood pressure, cardiac rhythm disturbances, and sudden death. Affected persons awaken exhausted and often fall asleep during the day -- sometimes even at the wheel of their car, and complain of being tired all the time. This condition really has a high mortality rate, and is a life-threatening problem.

  • Obesity Hypoventilation Syndrome

    This condition occurs primarily in the very severely obese -- over 350 lbs. It is characterized by episodes of drowsiness, or narcosis, occurring during awake hours, and is caused by abnormalities of breathing and accumulation of toxic levels of carbon dioxide in the blood. It is often associated with sleep apnea, and may be hard to distinguish from it.

  • Respiratory Insufficiency

    Obese persons find that exercise causes them to be out of breath very quickly, during ordinary activities. The lungs are decreased in size, and the chest wall is very heavy and difficult to lift. At the same time, the demand for oxygen is greater, with any physical activity. This condition prevents normal physical activities and exercise, often interferes with usual daily activities, such as shopping, yard-work or stair climbing, making even ordinary living difficult or miserable, and it can become completely disabling.

  • Heartburn - Reflux Disease and Reflux Nocturnal Aspiration

    Acid belongs in the stomach, which makes it to help digest your food, and it seldom causes any problem when it stays there. When it escapes into the esophagus, through a weak or overloaded valve at the top of the stomach, the result is called "heartburn", or "acid indigestion". The real problem is not with digestion, but with the burning of the esophagus by the powerful stomach acid, getting to where it doesn't belong.. When one belches, the acid may bubble up into the back of the throat, causing a fiery feeling there as well. Often this occurs at night, especially after a large or late meal, and if one is asleep when the acid regurgitates, it may actually be inhaled, causing a searing of the airway, and violent coughing and gasping.

    This condition is dangerous, because of the possibility of pneumonia or lung injury. The esophagus may become strictured, or scarred and constricted, causing trouble with swallowing. Approximately 10 - 15% of patients with even mild sporadic symptoms of heartburn will develop a condition called Barrett's esophagus, which is a pre-malignant change in the lining membrane of the esophagus, a cause of esophageal cancer.  The incidence of this type of cancer is increasing in the United States, in parallel with the increase in obesity.

  •  

  • Asthma and Bronchitis

    Obesity is associated with a higher rate of asthma, about 3 times normal.  Much of this effect is probably due to acid reflux (described above), which can irritate a sensitive airway and provoke an asthmatic attack.  The improvement of asthma after surgery is often very dramatic, even before much weight loss has occurred.

  • Gallbladder Disease

    Gallbladder disease occurs several times as frequently in the obese, in part due to repeated efforts at dieting, which predispose to this problem. When stones form in the gallbladder, and cause abdominal pain or jaundice, the gallbladder must be removed. 

  • Stress Urinary Incontinence

    A large heavy abdomen, and relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the valve on the urinary bladder to be weakened, leading to leakage of urine with coughing, sneezing, or laughing. This condition is strongly associated with being overweight, and is usually relieved by weight loss.

  • Degenerative Disease of Lumbo-Sacral Spine

    The entire weight of the upper body falls on the base of the spine, and overweight causes it to wear out, or to fail. The consequence may be accelerated arthritis of the spine, or "slipped disk", when the cartilage between the vertebrae squeezes out. Either of these conditions can cause irritation or compression of the nerve roots, and lead to sciatica -- a dull, intense pain down the outside of the leg.

  • Degenerative Arthritis of Weight-Bearing Joints

    The hips, knees, ankles and feet have to bear most of the weight of the body. These joints tend to wear out more quickly, or to develop degenerative arthritis much earlier and more frequently, than in the normal-weighted person. Eventually, joint replacement surgery may be needed, to relieve the severe pain. Unfortunately, the obese person faces a disadvantage there too -- joint replacement has much poorer results in the obese, and complications are more likely. Many orthopedic surgeons refuse to perform the surgery in severely overweight patients

  • Venous Stasis Disease

    The veins of the lower legs carry blood back to the heart, and they are equipped with an elaborate system of delicate one-way valves, to allow them to carry blood "uphill". The pressure of a large abdomen may increase the load on these valves, eventually causing damage or destruction. The blood pressure in the lower legs then increases, causing swelling, thickening of the skin, and sometimes ulceration of the skin.  Blood clots also can form in the legs, further damaging the veins, and can also break free and float into the lungs -- called a Pulmonary Embolism -- a serious or even fatal event.

  • Emotional/Psychological Illness

    Seriously overweight persons face constant challenges to their emotions: repeated failure with dieting, disapproval from family and friends, sneers and remarks from strangers. They often experience discrimination at work, and cannot enjoy theatre seats, or a ride in a bus or airliner. There is no wonder, that anxiety and depression might accompany years of suffering from the effects of a genetic condition -- one which skinny people all believe should be controlled easily by will power.

  • Social Effects

    Seriously obese persons suffer inability to qualify for many types of employment, and discrimination in employment opportunities, as well. They tend to have higher rates of unemployment, and a lower socioeconomic status. Ignorant persons often make rude and disparaging comments, and there is a general societal belief that obesity is a consequence of a lack of self-discipline, or moral weakness. Many severely obese persons find it preferable to avoid social interactions or public places, choosing to limit their own freedom, rather than suffer embarrassment.

You may have experienced one or more of these co-morbidities as a result of being obese and you may have become aware of other co-morbidities you did not know you had. Be sure to tell your surgeon about these. Should you see a Doctor? Are you a candidate for weight loss surgery? Find out in the next section click here.