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Obesity

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Title: Obesity


1
Obesity
  • The Economics of an Epidemic

2
Outline
  • Basic Facts
  • Health Effects
  • Economic Costs (Direct and Indirect)
  • Model Problem
  • Economic vs Non-Economic Reasons
  • Govt Intervention?

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Measuring Obesity
  • Body Mass Index (BMI)
  • Underweight lt18.5
  • Normal weight 18.5-24.9
  • Overweight 25-29.9
  • Obesity BMI of 30 or greater

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  • http//www.cdc.gov/obesity/data/adult.html

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Percent Adults Overweight/Obese 2011
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Problems with being Overweight
  • Hypertension
  • Dyslipidemia (for example, high total cholesterol
    or high levels of triglycerides)
  • Type 2 diabetes
  • Coronary heart disease
  • Stroke
  • Gallbladder disease
  • Osteoarthritis
  • Sleep apnea and respiratory problems
  • Some cancers (endometrial, breast, and colon)

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Number of deaths for leading causes of death
  • Heart disease 652,091
  • Cancer 559,312
  • Stroke (cerebrovascular diseases) 143,579
  • Chronic lower respiratory diseases 130,933
  • Accidents (unintentional injuries) 117,809
  • Diabetes 75,119
  • Alzheimer's disease 71,599
  • Influenza/Pneumonia 63,001
  • Nephritis, nephrotic syndrome, and nephrosis
    (kidney disease) 43,901
  • Septicemia (blood poisoning) 34,136

19
Number of Deaths from Obesity
  • Allison et al. 1999
  • 280,000-325,000
  • Mokdad et al. 2004
  • 400,000
  • Flegal et al. 2005
  • 112,000

20
Paradoxical Effect of Overweight
  • Historical evolutionary advantages to efficiently
    storing fat. It is a buffer against disease and
    famine

21
Economic Costs
  • Around 10 of medical spending in US
  • More than cigarette smoking 147 billion in 2008
  • Americans spend 33 Billion on weight reduction
    products

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Economic Costs
  • Direct
  • are costs where money is actually exchanged
  • Indirect
  • are most often costs that measure productivity
    loss and represent the value of time

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Direct
  • Average increase in annual medical expenditures
    is 732 per person
  • A total of 5.3 to 5.7 of total annual medical
    expenditures in the
  • United States when combining per person costs and
    prevalence
  • Government finances roughly half the costs
    attributable to obesity

24
Direct
  • Perhaps only 4.3 of lifetime costs (in the
    United States) when accounting for increased
    annual costs and premature mortalitySource
    (2005). Annu Rev Public Health, 26, 239-57.
  • 147 Billion per year Finkelstein et. al. 2009
    (similar to smoking)
  • 33 billion in weight loss aids. Rashad and
    Grossman 2004

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Direct
  • Across all payers, obese people had medical
    spending that was 1,429 greater than spending
    for normal-weight people in 2006.
  • Finkelstein 2009
  • The costs attributable to obesity are almost
    entirely a result of costs generated from
    treating the diseases that obesity promotes.

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Lifetime Medical Costs of Obesity Prevention No
Cure for Increasing Health Expenditure
  • Although effective obesity prevention leads to a
    decrease in costs of obesity-related diseases,
    this decrease is offset by cost increases due to
    diseases unrelated to obesity in life-years
    gained. Obesity prevention may be an important
    and cost-effective way of improving public
    health, but it is not a cure for increasing
    health expenditures.

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Indirect
  • How can we calculate indirect?
  • What are examples?

28
Indirect
  • Absenteeism
  • Presenteeism
  • Disability
  • Premature mortality
  • Workers compensation
  • Indirect costs ranged from 448.29 million (204
    per obese person) in Switzerland to 65.67
    billion (1627 per obese person) in the United
    States (33).

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Basic model of Weight Gain
  • Calories InCalories Out
  • Women BMR 655 ( 4.35 x weight in pounds )
    ( 4.7 x height in inches ) - ( 4.7 x age in years
    )
  • Men BMR 66 ( 6.23 x weight in pounds ) (
    12.7 x height in inches ) - ( 6.8 x age in year )
  • Dynamic Equations (150 calories 10 pounds in
    233 days)
  • 3,500 calories one pound

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Calorie Expenditures
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Calorie Consumption
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Food Technology
  • Price of food has fallen
  • Time cost of food prep has fallen more

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Fattening of America
  • Since 1983 prices of healthy foods
  • Fresh fruits 190 increase
  • Fresh vegetables 144 increase
  • Fish 100 increase
  • Dairy 82 increase
  • And not so healthy foods
  • Fats and oils 70 increase
  • Sugars and sweets 66 increase
  • Carbonated beverages 32 increase

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Non-Economic Reasons
  • Women Working
  • Medications
  • Changes to Cigarette Prices
  • Climate Control
  • Pollution
  • Sleeping Less

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Behavioral Aspects of Eating
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Obesity and Food Out
  • Supersize Me.
  • Anderson, M. L., Matsa, D. A. Are Restaurants
    Really Supersizing America?

47
Obesity and Income
  • White women pay a 9 wage penalty for being
    obese.
  • Maternal employment and childhood obesity
  • Working mothers lead to obese children.

48
Economic Costs of Obesity and Health Insurance
  • The problems with not pricing insurance for
    weight risk.
  • This leads to non-optimal weights.

49
Government intervention and regulation in food
  • South LA
  • Transfats
  • Ag subsidies.
  • Import quotas on sugar.

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Food Pantries and Poverty
  • A Cruel sort of Altruism

52
Do food stamps cause obesity? Evidence from
immigrant experience.
53
Misc Artifacts of food intake
  • Improved nutrition has lead to early onset of
    menstruation among women.
  • Taller population

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Health care bill requires calories on menus at
chain restaurants
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Research
  • No effect
  • Why?

58
Social Norms
  • 66 of the moms were overweight or obese, and 39
    of kids were too heavy. Both numbers are close to
    the national trend.
  • Most obese women (82) underestimated their
    weight when looking at the silhouettes 42.5 of
    overweight women did the same. About 13 of
    normal-weight women thought of themselves as
    thinner than they were.

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Social Norms
  • Most overweight or obese children (86)
    underestimated their weight, compared with 15 of
    normal-weight kids.
  • 47.5 of moms with overweight or obese children
    thought their kids were at a healthy weight.
  • 41 of the children thought their moms should
    lose weight.

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Is poor fitness contagious?
  • http//www.bakadesuyo.com/is-poor-fitness-contagio
    us
  • More Peer Effects

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Solving the Problem
  • How?
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