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Perspectives on Health Care – Obesity

Compliments of Anthem Blue Cross and Blue Shield

Obesity has reached epidemic proportions in the United States, according to the Surgeon General.¹ Many people feel this issue is a personal problem. But, as the prevalence of obesity increases, it is clear that this is a community issue, too. Obesity can be tied to increased health risks and greater health care spending. In fact, workdays lost to obesity-related conditions have increased by 50 percent since the late 80s.² This is not about personal appearance. This is a public health issue that affects individuals, companies and the nation as a whole.

THE DEFINITION OF OBESITY

Is a 150-pound woman overweight? Is a 200-pound man obese? To accurately define overweight and obesity, you need to consider more than what appears on the scale. Height plays a role, too. That’s why doctors and scientists rely on the Body Mass Index (BMI). This mathematical formula takes a person’s weight in kilograms and divides it by height in meters squared (BMI=kg/m2). The result is a number that represents a person’s weight to height ratio. BMI weight classifications include^3:

Weight class	BMI (kg/m2)
Underweight	Less than 18.5
Normal weight	18.5-24.9
Overweight	25-29.9
Obese	30-39.9
Morbidly obese	more than 40

According to the Centers for Disease Control and Prevention (CDC), 65 percent of adults, 20 years and older, fit into the overweight or obese category.⁴ And, almost 5 percent of the population is morbidly obese.⁵ That means up to 136 million Americans are overweight or obese and nearly 10 million are morbidly obese.⁶

WEIGHING IN

According to the BMI, a person who is 5’ 8” tall will fall into the following weight categories:

normal weight:	between 125 and 164 pounds
overweight:	between 165 and 196 pounds
obese:	between 197 and 262 pounds
morbidly obese:	263 pounds or more

A BMI calculator can be found on the National Heart, Lung, and Blood Institute’s Web site at www.nhlbisupport.com/bmi/bmicalc.htm. Or, go to MyHealth@Anthem®, accessed through anthem.com, and click on the section titled “Cool Tools.”

THE HEALTH CONSEQUENCE OF OBESITY

Being overweight or obese puts an individual at greater risk for many health problems.

The health risks

Those who are overweight or obese have an increased risk of more than 20 health conditions, including⁷:

• diabetes
• osteoarthritis
• heart disease
• sleep apnea and other breathing problems
• stroke
• some forms of cancer
• hypertension

The heavier a person is, the higher the risks for these and other related health problems. Furthermore, a morbidly obese adult is three times more likely to have a disability that is characterized by the inability to perform activities of daily living.

Also, obesity appears to lessen life expectancy, especially among younger adults.⁸ In fact, an estimated 300,000 deaths a year may be attributable to obesity.⁹

The good news

While many of these statistics are alarming, there is some good news. Even modest weight reductions can have substantial lifetime health benefits.¹⁰ Losing just 10 percent of a person’s body weight can help lower the risk of developing diseases associated with obesity.¹¹

THE COST OF OBESITY

Obesity has a tremendous impact on health care costs. In 2000, obesity’s total economic impact on the economy was $117 billion, which breaks down to $61 billion in direct costs and $56 billion in indirect costs.¹² This spending can be seen at work, at the doctor’s office and at home.

At work

Businesses feel the impact of obesity through lost productivity and increased health and disability insurance costs. When evaluating business costs linked to obesity-related conditions, one analysis found that in 1994¹³:

• Employees lost 39.9 million workdays, made more than 62 million visits to doctors’ offices and had 239 million restricted activity days.

• Employers paid almost $13 billion for obesity-related health problems. This accounts for $8 billion for health insurance expenditures, $2.4 billion for sick leave, $1.8 billion for life insurance and almost $1 billion for disability insurance.

At the doctor’s office and hospital

Health problems associated with obesity are sending many people to the doctor’s office and the hospital:

• Compared to normal weight ranges, obesity is associated with increased medical spending for inpatient care, outpatient care and prescription medications. Obesity is estimated to increase health care costs by 44 percent and prescription costs by 77 percent.

• Direct obesity-related medical expenditures were estimated to be $75 billion in 2003.¹⁴

At home

• More than 8 percent of total private insurance medical spending is attributable to overweight and obesity.¹⁵

• Americans spend $33 billion each year on weight-loss products and services.¹⁶

What can employers do?

By promoting healthy lifestyles through nutrition and physical activity, businesses can make a difference. Worksite wellness programs can improve the health of employees, increase productivity, improve morale and reduce absenteeism.¹⁷ These types of programs vary from business to business. Some examples of wellness initiatives include:¹⁸

• educating employees about the direct and indirect costs of obesity
• creating incentives for employees to join local fitness centers
• creating opportunities for physical activities during the workday
• offering incentives for employees to live healthy lifestyles
• eliminating unhealthy or high-fat foods from company cafeterias and vending machines

The Greater Indianapolis Chamber of Commerce, along with Anthem Blue Cross and Blue Shield, is helping to provide additional health and wellness programs for you and your employees through ChamberFit.  This program is available to central Indiana employers that have between 2 and 99 employees and are a member of the Greater Indianapolis Chamber of Commerce.  For more information, please contact your local health insurance agent, the Greater Indianapolis Chamber of Commerce, or Anthem at 1-877-814-4327.

SOURCES:
1 The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity, 2001.
2 Prevention Makes Common “Cents,” Department of Health and Human Services, www.aspe.hhs.gov/health/prevention/index.shtml, 2003.
3 National Institute of Health, www.nhlbisupport.com/bmi/bmicalc.htm, Feb. 15, 2005.
4 National Health and Nutrition Examination Survey 1999-2002, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2002.
5 Prevalence and Trends in Obesity Among U.S. Adults, 1999-2000, JAMA, October 2002.
6 United States Census Bureau Annual Population Estimates for July 1, 2003.
7 Overweight and Obesity Health Consequences, http://www.cdc.gov/nccdphp/dnpa/obesity/consequences.htm. Feb. 17, 2005.
8 Years of Life Lost Due to Obesity; JAMA, Jan. 8, 2003.
9 Annual Deaths Attributable to Obesity in the United States, JAMA, Oct. 27, 1999.
10 The Effects of Obesity, Smoking and Drinking on Medical Problems and Costs, Health Affairs, March/April 2002.
11 National Heart, Lung, and Blood Institute, Aim for a Healthy Weight, http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/risk.htm, Feb. 17, 2005.
12 The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity, 2001.
13 Prevention Makes Common “Cents,” Department of Health and Human Services, www.aspe.hhs.gov/health/prevention/index.shtml, 2003.
14 State-level Estimates of the Annual Medical Expenditures Attributable to Obesity, Obesity Research, January 2004.
15 National Medical Spending Attributable to Overweight and Obesity: Who’s Paying?, Health Affairs, May 2003.
16 Weight-control Information Network, http://win.niddk.nih.gov/about/, Feb. 17, 2005.
17 Prevention Makes Common “Cents,” Department of Health and Human Services, www.aspe.hhs.gov/health/prevention/index.shtml, 2003.
18 The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity, 2001.