Obesity Study Questioned

Published November 1, 2006

Obesity isn’t just hurting Americans’ self-esteem, a study released this summer concludes. It’s hurting the nation’s pocketbook as well.

Some health policy analysts, however, question the study’s validity, amid disagreement over what’s causing obesity rates to increase.

Medicare beneficiaries’ health care costs rose steadily from 1987 to 2002 and are continuing to rise, the study notes. Almost all of the increased spending is linked to growing numbers of patients getting medical help for five or more diseases a year. Since 1987, obesity among Medicare beneficiaries has doubled, and spending on obese Medicare patients has nearly tripled.

Those findings come from Kenneth E. Thorpe and David H. Howard, whose report, “The Rising Prevalence Of Treated Disease: Effects On Private Health Insurance Spending,” published in the July/August 2006 issue of Health Affairs, analyzed the rise in treated disease prevalence with the growth in Medicare beneficiaries’ health care spending.

Thorpe is chair of the Department of Health Policy and Management at the Rollins School of Public Health at Emory University in Atlanta, and Howard is an assistant professor in that department.

“More than half of all beneficiaries report receiving medical treatment for five or more conditions during a year,” Thorpe and Howard wrote. “Clearly, increases in obesity levels play a role. Many obese people have multiple morbidities such as hyperlipidemia, diabetes and hypertension.”

Misleading Statistics

Justin Wilson, a research analyst at the Center for Consumer Freedom, a Washington, DC-based nonprofit coalition of restaurants, food companies, and consumers promoting personal responsibility and individual choice, said the study’s numbers may be misleading because obesity is not the only reason overweight patients might go to the hospital.

“If you’re fat, but then you have high blood pressure and diabetes, the times you go to the doctor, you get double and triple counted,” and patients all get recognized primarily for being overweight, Wilson said. “So, a lot of people have said the number [of obese people] is probably much lower than a lot of people would estimate it to be.”

Like Wilson, Thorpe and Howard recognize that many obese people have other health problems. However, they maintain obese patients continue to drive up spending, saying most spending growth is linked to these patients being treated for five or more conditions.

Additional Factors

Many factors might contribute to increased Medicare spending, Thorpe and Howard acknowledged, citing the rise in occurrences of diseases treated, the availability of more aggressive medical treatments, stronger detection of disease, and improved technology. Better technology is more expensive.

Also, medical professionals’ improved ability to diagnose and treat patients may postpone deaths, giving people more opportunities to visit their doctors over their life spans. “Spending may continue to rise, as increases in longevity for people with chronic conditions prolong the period over which they incur high costs year in and year out,” the authors note.

The authors also note mental disorders are being treated more often, resulting in more spending, because more selective serotonin reuptake inhibitors (SSRIs) are available. Also, since diabetes and obesity sometimes are related to depression, the growing number of obese and diabetic patients may mean more of them are getting SSRIs.

Expansive Issue

According to the Centers for Disease Control and Prevention, obese individuals have elevated risks of developing more than 30 diseases, including coronary disease and cancer, and obesity directly causes an estimated 400,000 deaths annually.

Childhood obesity has quadrupled over the past 25 years for children between ages 6 and 11–and obese children often become obese adults.

For that reason, Thorpe and Howard expect Medicare spending to nearly triple by 2030, motivating some policymakers and government officials to look for ways to curb Medicare spending.

Responsible Parties

Jeff Levi, executive director of Trust for America’s Health–a nonprofit, nonpartisan group in Washington, DC that received funding from the left-leaning Robert Wood Johnson Foundation for an obesity study released earlier this year–said in an August 29 news release that the government, employers, and people in the food industry should highlight the importance of being more physically active, while schools should eliminate snack food from their campuses.

Individuals should be responsible for their own health, said Wilson. People are not as active as they once were, partly because more people today than in the past have desk jobs. Blaming restaurants and food companies for the country’s obesity problem oversimplifies the obesity situation, he said.

“With all health issues, it boils down to the individual,” Wilson said. “There are activist groups out there that are trying very, very hard to put the blame on food companies and food producers. That’s because they feel helpless in trying to change consumers’ behavior.”

Mary Susan Littlepage ([email protected]) is a freelance writer in Chicago.

For more information …

An abstract of the July/August 2006 Health Affairs study by Kenneth E. Thorpe and David H. Howard, “The Rising Prevalence Of Treated Disease: Effects On Private Health Insurance Spending,” is available online at http://content.healthaffairs.org/cgi/content/abstract/25/5/w378.

U.S. Centers for Disease Control and Prevention, http://www.cdc.gov/

Trust for America’s Health, http://www.healthyamericans.org/