A study by the Brookings Center for Social Dynamics and Policy pegged the average lifetime cost of obesity at $92,235. But at least one doctor, with a professional and personal interest in the subject, said that estimate was off target.
“That sounds pretty conservative,” said Dr. Craig Backs, a Springfield, Ill., internist and former president of the Illinois State Medical Society.
Obesity is defined as a body mass index of 30 or above. Backs speculated that the number was low because about 20% of the obese population is generally healthy. That may have somewhat offset the healthcare costs of the other 80% who are often diabetic or pre-diabetic, have heart disease or other chronic diseases, and are at greater risk for stroke and some cancers.
He agreed with Brookings researchers, however, in that the economics go beyond healthcare costs.
“I think it's probably very difficult to quantify, but obesity limits certain occupational choices,” Backs said. “In general, people who suffer from obesity are discriminated against, maybe not overtly, but their opportunities are less in general.”
The Brookings researchers' figure of $92,235 included obesity-related healthcare costs, lost work productivity, costs of Social Security Disability Insurance, disability claims and forgone taxes because of lower wages earned.
Penn State College of Medicine researchers reported recently that obesity and depression are the two main causes of excessive daytime sleepiness, which they said is a leading cause of absenteeism, errors at work and low productivity.
The National Institutes of Health-funded study, published in the journal Sleep, found that body mass index is associated with being tired regardless of how much sleep a person gets.
“Excessive daytime sleepiness has huge implications for public health and policy,” Julio Fernandez-Mendoza, a Penn State assistant professor of psychology, said in a news release. “Fatigue and sleepiness are the most common causes of poor work productivity and fatal car crashes. In our study, we were able to causally link obesity and depression—disorders of epidemic proportions—with daytime sleepiness through different mechanisms; in fact, we found that individuals who lost weight did not complain of daytime sleepiness anymore.”
Two years ago, the American Medical Association House of Delegates voted to classify obesity as a disease. The move had the support of the American Association of Clinical Endocrinologists, American College of Cardiology, American College of Surgeons, American Society for Reproductive Medicine, American Urological Association, Endocrine Society and Society for Cardiovascular Angiography and Interventions.
But many delegates were not convinced. Backs, a member of the Illinois delegation, testified in favor of the classification.
“A year ago, I had this disease,” Backs told the delegates during the 2013 annual meeting. “This is much more complex than a lifestyle choice.”
Backs said he had a BMI of about 31. Instead of going to a fellow doctor, he went to an athletic trainer who put him on a rigorous exercise regimen and eliminated sugar and refined carbohydrates from his diet. He lost 40 pounds in 90 days and then lost another 10, which he has kept off “without feeling deprived.”
Backs says the AMA made the right call. He said that, if hypertension is considered a disease because it contributes to the risk of stroke and heart disease, “Then, clearly, obesity is a disease, too.”
Since losing weight, Backs said his blood pressure improved significantly and he is in much better health “physically, mentally and emotionally.”
He noticed much higher productivity and predicts he will be able to keep practicing longer as well.
“At first blush, that may not seem more desirable,” Backs said. But he added how, as people live longer, working to an older age will be required in order to make their retirement more financially secure.
Backs said his weight loss has led to changing his practice to focus more on wellness and stroke prevention.
“I'm attracting patients interested in improving their health,” he said. “It's made it a lot more professionally satisfying to work in a partnership with my patients.”
And, unlike with other physicians, he said patients listen to him now when he gives advice on weight loss.
“If I can change at age 56, it's possible for anyone to make these changes,” he said. “Before, my story was, 'I can talk until I'm blue in the face, but patients are not going to change.' That changed dramatically after I became a good example.”
Backs said his story is not unique, as many doctors and nurses struggle with their weight. One problem is that medical training does not prioritize teaching nutrition and, when it does, the emphasis is on reducing animal fat with little emphasis on reducing sugar.
“I was focusing on fats and thought I could eat carbohydrates with impunity,” Backs said.
He added that healthcare professionals often work long hours and that leads to late meals or eating what's convenient—and that means fast food and highly processed food.
“We don't make self care a priority,” Backs said.