By Makalla Phelps, Intern
We’ve written briefly about obesity in our blog post about MIPS Measure #128, but the condition is more complex than the simple issue of needing to lose weight. Obesity is at the forefront of diseases plaguing The United States. Over a third of Americans suffer from obesity. Due to this high rate, the life-expectancy of obese individuals has dropped to a short 40 years. Even more concerning is the potential for obesity to become a world-wide epidemic. By 2030, it is estimated that almost half of the world’s population will be considered obese if this trend continues. The need for a change is imminent.
An individual with a Body Mass Index (BMI) of 30 or higher is considered obese. This seemingly arbitrary number is wreaking havoc on the individuals who fall into this category. In addition to decreased quality of life, obesity can cause or exacerbate many serious and difficult to treat ailments including:
- Poor mental health (such as depression)
- Some cancers
These ailments are not only costing the individual, but physicians and society as well. Individuals with a body mass index greater than 35 represent only 37% of the obese population but are responsible for 61% of all excess medical costs. This accumulates to approximately $147 billion annually. The Medicare prescription drug cost of this expense is $7 billion dollars alone. Moreover, the cost of the value of lost productivity in the workplace due to obesity comes in at a massive $73.1 billion annually. An individual with a healthy weight and is physically active costs roughly $1,019, annually. The culmination of medical expenses of obese patients amounts to around $1,429 more per individual. Studies suggest that if there were an increase in physical activity among the 88 million inactive adults in America, there would be a $76.6 billion decrease in medical costs.
There are many different factors that contribute to an individual becoming obese. The most common cause of obesity is an individual’s behavior. These behaviors include dietary patterns, physical activity (or more likely lack thereof), social aspects, and medication use. A very common excuse that obese patients use is that their ailments are caused by genetics. However it is usually a learned behavior from an individual’s parents. In most cases, an individual may have a genetic predisposition to a certain weight range or an increased risk for diabetes, but it is the individual’s lifestyle habits that will truly determine their fate. Interestingly, the popular personal genomics and biotechnology company, 23andMe, has launched a massive study into the genetic basis of weight loss and obesity. The company hopes to provide their clients with information on how to maintain and/or lose weight based on their genome sequence in the future. Another common social factor contributing to the continuation of obesity can be found in the various body positivity movements that have gained popularity. These social movements began with the message to improve an individual’s self-image. However, what was once something positive turned dangerous when individuals began interpreting the movement as a means of condoning unhealthy behaviors and weights.
Obesity is extremely difficult to treat. Even if social and emotional factors were to be removed, the availability of cheap high-calorie foods and an absence of any obligatory need for exercise has resulted in obesity being very difficult to reverse. Thus, it is important that physicians stress the importance of prevention to their patients when possible. Because obesity is such a complex issue, even the most receptive patients may be easily discouraged when trying to change their lifestyle. Most physicians will find they have to try multiple approaches before something clicks with each individual patient.