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Costs of Obesity

A study published in the New England Journal of Medicine estimated that by the year 2030 the obesity rate will reach 48.9%, which means that nearly 1 in 2 adults will be obese. However, adults may be becoming obese at even faster rate. The most recent data from the Centers for Disease Control and Prevention (CDC) shows that 42.4% of adults are currently obese as of February 2020. The CDC defines obesity as having a BMI of 30.0 or higher, so when you include people who are overweight but not yet obese that percentage is even higher. The National Institute of Health (NIH) reported in 2014 that “more than 2 in 3 adults (70.2%) were considered to be overweight or have obesity” (NIH, 2017).

Obesity comes with many costs. The medical expenses of people with obesity can be $3,429 higher than those of normal weight, totaling more than $342 billion per year (Biener, Cawley, & Meyerhoefer, 2017). There are indirect costs of obesity as well, such as value of lost work, higher insurance premiums, and decreased income. Obesity’s contribution to absenteeism results in nationwide productive costs between $3.38 billion and $6.38 billion.

The costs of obesity are not just financial. Obesity is associated with poorer mental health outcomes, reduced quality of life, and the leading causes of death in the U.S. and worldwide, including diabetes, heart disease, stroke, and some types of cancer. One study looked at the data from 1.46 million Americans and found that those who were overweight had a 13% increased risk of death, with a higher weight being associated with a higher risk of dying (Berringotn de Gonzalez et al, 2010).

Obesity Compromises the Immune System

Obesity is a high risk factor for type 2 diabetes. Overweight people without diabetes are still likely to experience high blood sugar (hyperglycaemia) and insulin resistance. Chronic levels of high blood sugar may contribute to an impaired immune system and increased vulnerability to disease. A study published in 2017 has found “compelling evidence for a harmful effect of severe and/or persistent hyperglycaemia on immune function…. “[I]mmune dysfunction, leading to an impaired defence[sic] of the host against infection, might in part be caused by failure of immune cells to adapt glucose metabolism” (Ingels, Vanhorebeek, & Van den Berghe, 2017). The study also found that maintaining normal blood sugar levels results in a reduction of both morbidity and mortality.

Obesity itself has been shown to impair the immune system, even when accompanied by otherwise healthy habits such as good nutrition and exercise. Studies have found that obesity can contribute to Decreased cytokine production, Altered monocyte and lymphocyte function, Natural killer cell dysfunction, Reduced macrophage and dendritic cell function, and Decreased response to antigen/mitogen stimulation all of which can contribute to an increased risk of infection.

Obesity Linked to Opioid Use

New research has found that more than quarter of long-term opioid prescriptions in the United States are given to obese people.

  • Patients with higher BMIs are 158% more likely to use prescription opioids long-term.
  • 27% of long-term opioid prescriptions from 2000 to 2015 were attributable to higher BMIs.

A study published in JAMA Open Network found that osteoarthrits, other joint disorders, and back disorders were the most common reasons for opioid prescriptions to individuals with obesity. The lead author of that study noted that these studies “offer new evidence for policymakers to consider how addressing the roots of this crisis will require attention to the underlying sources of demand for pain relief, including obesity through its association with pain” (Wood, 2020). Obesity can lead to pain because of excess mechanical stresses and inflammation.

References:
Adult Obesity Causes & Consequences. (2020). CDC. Retrieved from: https://www.cdc.gov/obesity/adult/causes.html
Adult Obesity Facts. (2020). CDC. Retrieved from: https://www.cdc.gov/obesity/data/adult.html
Overweight & Obesity Statistics. (2017). NIH/NIDDK. Retrieved from: https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity
Biener, A., Cawley, J., & Meyerhoefer, C. (2017). The High and Rising Costs of Obesity to the US Health Care System. Journal of general internal medicine32(Suppl 1), 6–8. https://doi.org/10.1007/s11606-016-3968-8
Wood, J. (2020). Opioid Prescriptions Linked to Obesity. PsychCentral. Retrieved from: https://psychcentral.com/news/2020/04/07/opioid-prescriptions-linked-to-obesity/155478.html
Ingels, C., Vanhorebeek, I., & Van den Berghe, G.(2017). Glucose homeostasis, nutrition and infections during critical illness. Clinic Microbiology and Infection, 24-1, 10-15. https://doi.org/10.1016/j.cmi.2016.12.033
Berrington de Gonzalez, A., Hartge, P., Cerhan, J. R., Flint, A. J., Hannan, L., MacInnis, R. J., Moore, S. C., Tobias, G. S., Anton-Culver, H., Freeman, L. B., Beeson, W. L., Clipp, S. L., English, D. R., Folsom, A. R., Freedman, D. M., Giles, G., Hakansson, N., Henderson, K. D., Hoffman-Bolton, J., Hoppin, J. A., … Thun, M. J. (2010). Body-mass index and mortality among 1.46 million white adults. The New England journal of medicine363(23), 2211–2219. https://doi.org/10.1056/NEJMoa1000367
Deivert, S., & Fleetwood, M. (2013). Obesity and the Immune System. Obesity Action Coalition. Retrieved from: https://www.obesityaction.org/community/article-library/obesity-and-the-immune-system/

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