Contributing Experts

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Carrie Rubin, MD Physician View bio
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Melissa Bailey, PsyD Licensed Clinical Psychologist View bio
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Dr. Nishant Rao, ND Primary Care Doctor View bio
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Philip Caravella, MD Chief of Family Medicine View bio
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Trish Lieberman, MS, RD, LDN Director of Nutrition View bio

I don’t have time to exercise. Eating healthy is too expensive. Fast food is convenient. If you haven’t said one of those lines yourself before, chances are you’ve heard others say it. Obesity continues to be an epidemic in the U.S.– one that leads not only to costly physical and emotional consequences, but financial setbacks as well. In fact, according to a study published in the Journal of Health Economics in 2012, obesity-related problems have added an additional $190 billion annually to medical costs. But things don’t have to be that way. Get the facts on the cost of obesity, as well as expert advice on how to lose weight and keep it off through healthier habits.

The Costly Consequences of Obesity

Most people are familiar with some of the ways obesity can affect your health, but few think about the impact it has on finances. Find out more about the little-known ways in which it can affect your bank account.

Economic Costs

Health expenses

Perhaps the most obvious cost, the Journal of Health Economics revealed that obesity amounts to additional healthcare charges of $1,152 and $3,613 a year for men and women, respectively. Not so obvious, however, is the fact that those who are not obese also pay a price in the form of higher taxes to support Medicaid and health insurance premiums – the same study found that obese women raise third-party healthcare costs by $3,220 annually, and obese men increase them by $967 each year.

Gasoline costs

Although the relationship between obesity and gasoline prices may not be readily apparent, the added weight of obese passengers on cars results in millions of additional gallons of gas each year, according to a 2006 article in The Engineering Economist. From the 1960s through the early 2000s, the average weight of Americans went up by 24 pounds, with each pound translating to 39 million extra gallons of gas each year. That’s some 938 million gallons annually, translating to approximately $2 billion in today’s prices.

Lower wages

Workers who are obese often earn less money for the same jobs than those who are in a healthy weight range. However, this is more likely to be the case if a company offers employer-sponsored health insurance, according to research conducted by Stanford University. Economists found that in order to offset the additional insurance costs that obese people incur—an average of about $732 per person in 2005—employers will cut back their wages.

Lost workplace productivity

Obese workers tend to take more time off from work because of doctor’s appointments. According to research published in 2010 by health economists from Duke University, obese men use 5.9 more sick days per year than their non-obese counterparts and obese women use 9.4 more sick days. The same study shows that worker presenteeism—when people go to work even though they’re ill—is also a consequence of obesity. The aches and pains that these workers suffer from make them work more slowly than those with a healthy weight, which leads to a loss of $30 billion each year—$3,792 and $3,037 for men and women, respectively. All together, the study estimates that obesity costs American businesses some $73 billion a year due to lost productivity.

Health Risks

Obesity can lead to a number of health issues. Find out what role obesity plays in some of the most common risks.

Cancer

Although the reasons are unclear and require further study, the Harvard T.H. Chan School of Public Health reports strong links between obesity and several kinds of cancers, including breast, colon, rectal, kidney, ovarian, prostate, gallbladder and liver cancers. A panel of experts from the American Institute for Cancer Research and the World Cancer Research Fund jointly concluded in 2007 that there is enough evidence to make a connection between cancer and obesity.

A higher risk of Alzheimer’s

A study conducted by the National Institutes of Health (NIH) found that a high BMI is correlated with Alzheimer’s disease among people who are at least 50 years old. Excess body fat is associated with amyloid plaques, which are toxic proteins that prevent the brain from functioning at normal levels.

Diabetes

Obesity is tied to insulin resistance, which causes blood sugar in the body to increase. In turn, these higher blood sugar levels can lead to type 2 diabetes.

Heart disease and related issues

There is a direct relationship between obesity and cardiovascular disease because fat builds up in the arteries and reduces the flow of blood to the heart. As a result, obese people are at greater risk of having heart attacks, chest pain and strokes.

High blood pressure

Obesity can cause an additional strain on the heart, as excess fat tissue requires the heart to work harder to circulate blood. As a result, there is more pressure on the artery walls, which increases blood pressure.

Infertility

Harvard T.H. Chan School of Public Health points out that people who have BMIs over 24 have a greater risk of infertility than those with lower BMIs. The Nurses’ Health Study cited by the university concludes that some 25 percent of ovulatory infertility may be caused by obesity, which can cause hormonal imbalances that affect ovulation.

Joint problems

Excess weight puts pressure on the joints, which can cause pain in the hips and knees. Even with joint replacement surgery, obese patients may not find relief, because their weight will still strain the artificial joint. But every pound you drop helps. Among people with osteoarthritis, losing one pound of weight will take four pounds of pressure off the knee, according to a study by the Arthritis Foundation.

Metabolic syndrome

Metabolic syndrome is a group of conditions that includes high levels of blood sugar and cholesterol, high blood pressure, insulin resistance, and glucose intolerance. The National Cholesterol Education Program considers the syndrome a precursor for heart disease, diabetes and stroke. According to Stanford Health Care, metabolic syndrome is associated with abdominal obesity, and one-third of people who are obese have the condition.

Psychological effects

Obesity often causes people to have low self-esteem and depression, which can pull them into a vicious cycle of emotional eating and further weight gain. Obese people may also experience weight-based discrimination, which may increase depression and other negative emotions.

Sleep apnea

Extra weight squeezes the lungs and chest, which constricts the ability to breathe. As a result, obese people may develop sleep apnea—a condition where breathing stops for short periods of time during sleep. Left untreated, sleep apnea can increase your risk of high blood pressure and stroke, according to the Mayo Clinic.

Overweight vs. Obese: What’s the Difference?

The number on the scale only tells part of the story when it comes to obesity. Obesity is the condition of having excess body fat. This is determined by measuring body mass index (BMI), which refers to the ratio between your weight and your height. Based on BMI, people are categorized in the following ways:

Healthy Weight

BMI 18.5 to 24.9

Overweight

BMI 25 to 29.9

Obese Class I

BMI 30 to 34.9

Obese Class II

BMI 35 to 39.9

Obese Class III

BMI 40 or more

What’s Your Body Mass Index?

Wondering whether you have a healthy weight or not? To find out what category you fall into, you need to know what your body mass index is. BMI, however, is just one way to find out and some health experts say it doesn’t take into account the difference between fat and lean tissue, which means it’s not completely accurate. Still, if you’re interested in getting an idea of where you are on the spectrum, try the BMI calculator below to find out.

What is your Body Mass Index
(BMI)?

How tall are you?
What is your weight?
Your BMI IS
00.00

What Are the Causes of Obesity?

Obesity is not just about overeating. A perfect storm of physical, social and lifestyle changes have contributed to the epidemic of extreme weight gain over the past two decades or so. In addition, factors like aging and emotional eating also play a role. Here are some of the most common reasons people are getting fatter.

Cause of Weight Gain Explanation
Aging

Although obesity can be a problem at any age, aging can increase the likelihood of obesity. You tend to lose muscle as you age, which slows down the body’s metabolism and contributes to weight gain unless you adjust your eating and exercise habits. Also, after women go through menopause, hormonal changes in the body contribute to increased belly fat.

Diet

Americans have an unhealthy diet that includes large portions of high fructose corn syrup, refined grains, unhealthy fats and red meat. According to the Journal of the American Medical Association, studies show that Americans also fail to incorporate enough fruits, nuts, whole grains and vegetables into their daily diets. In fact, only one in 10 Americans consumes enough fruits and vegetables, according to a recent CDC report.

Bigger portions when eating out

Since the 1950s, the average size of restaurant meals has quadrupled, notes the American Heart Association, making portion control more difficult. In addition, AHA data over the same time period shows there has been an exponential increase in the size of sugary drinks that are served with meals—climbing from 7 ounces to 42 ounces. The easy availability of fast food restaurants and processed foods add up to an abundance of bad choices that can increase weight gain and fat.

Emotional triggers

Emotional eating is how some people respond to being depressed, stressed out, angry or even bored. Emotional eating also often takes places late at night, when the body is more likely to store fat and calories rather than burn them as energy.

Unhealthy environments

Some people live in environments that make it more difficult to live a healthy lifestyle. People in poorer neighborhoods often lack neighborhood supermarkets that sell unprocessed foods, fresh fruits and fresh vegetables or, if they do, these items are usually too expensive. Similarly, some neighborhoods don’t have safe, free places to exercise—like parks and trails—or affordable gyms, making it difficult to remain active.

Genetics

Genes can influence how body fat is stored and distributed, as well as how your body burns calories. As a result, obesity may run in families.

Inactivity

A recent study in BMC Public Health found that 83 million Americans are more sedentary than ever before. Just how sedentary is suggested by another study from Common Sense Media, which found U.S. teens spend nine hours a day on media devices. Another favorite pastime, watching television, contributes to obesity because it not only keeps people in couch potato mode, it also exposes them to advertisements for unhealthy foods. Kids see an average of 4,000 such ads a year, according to the Prevention Institute, adding that those bombarded with ads for high-calorie snacks, soft drinks and fast food ate 45 percent more food than kids who didn’t see the ads.

Medication

Certain medications are known to be associated with weight gain, including antidepressants, antipsychotics, corticosteroids, beta blockers and medications used to treat diabetes and seizures.


Obesity can also be caused by certain medical conditions like Cushing’s syndrome, hypothyroidism and polycystic ovarian syndrome.

Pregnancy

All women gain weight during pregnancy to support their babies, but some women have difficulty taking this weight off—which can lead to obesity.

Lack of sleep

Lack of sleep may contribute to weight gain – a particular problem because a third of Americans don’t get enough sleep, according to the CDC. Lack of sleep causes hormonal imbalances that affect the way people respond to insulin, as well as their ability to feel full. Sleep deprivation is also associated with cravings for high-calorie foods.

Childhood Obesity

According to Philip Caravella, MD, former chief of family medicine at the Cleveland Clinic, childhood obesity is the most dangerous and common problem facing at least twenty percent of all children. Statistics from the CDC show that 12.7 million children and adolescents are obese. It’s not unusual for children to carry a little bit of baby weight during their development; however, if a child’s BMI falls in the 95th percentile or greater for children or teens of the same age group, he or she is considered obese. As with adults, childhood obesity can harm both physical and emotional health. Below are a few common questions regarding childhood obesity and some insight from Dr. Caravella.

What causes childhood obesity?

Many causes of childhood obesity mirror those of adult obesity –genetics, lifestyle, and the surrounding environment can all have an impact.

What are the consequences of childhood obesity?

Much like adult obesity, childhood obesity can lead to several physical health problems, including type 2 diabetes, asthma, metabolic syndrome, high blood pressure and early puberty or menstruation. There are also emotional and social consequences, including depression, learning problems and low self-esteem. Obese children are also likely to suffer from longer and more severe consequences than adults, and are more likely to be obese as adults.

What can parents do?

Caravella points out that parents can have a significant and positive impact early on. “Parents must set the example by exercising daily and stopping the purchase of processed foods – high sugar cereals, pastries, sugar-laden soft drinks (these are the worst), candy, and the like,” he says.

Many parental interventions can either prevent childhood obesity or help children who are already obese lose weight. These include:

Becoming a role model for a healthy lifestyle by showing children the importance of a proper diet, drinking plenty of water, and regular exercise/physical activity

Avoiding the use of food as a reward or comfort

Modifying children’s favorite dishes to make them healthier and serving reasonable portions

Avoiding putting too much emphasis on children finishing their meals. As Carrie Rubin explains, “Encouraging kids to ‘clean their plates’ may shut down their internal cues of fullness, cues that are important in moderating eating habits down the road.”

Putting a focus on overall healthy living, not just weight management or loss

Partnering with a pediatrician to come up with solutions for children who are obese or at risk of becoming obese

The Obesity-Diabetes Connection

Lack of physical activity and obesity are strongly associated with the development of type 2 diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes occurs when there is too much sugar in the blood, resulting from the body’s inability to produce insulin or to use it efficiently. Obesity is associated with diabetes because excess weight undermines the body’s ability to use insulin and control blood sugar levels.

Ways to Manage Diabetes

Although there is no cure for the disease, those with diabetes can do things to manage their symptoms and keep their weight and blood glucose levels within a healthy range. Exercise, a healthy diet and medication can help prevent or delay some of the ailments associated with diabetes, including problems that affect the heart, nerves, eyes and feet, and help people lead long and healthy lives.

Here are some of the financial costs you may want to plan for if you have diabetes. Check with your health insurance provider to see what it pays for.

Monitor blood sugar levels regularly

Glucose meter: $20 to $80

Test strips: $.35 to $1 each

Lancets: $5 to $22 per 100

Eat a healthy diet

Registered dietitian:

$100 to $200 for initial consultation

and $50 to $150 for each subsequent visit

Manage stress

Massage therapy:

$30 to $50 for 30 to 45 minutes;

$50 to $90 for 45 to 60 minutes

Yoga: $12 to $16 per class

Exercise regularly

Note: You should always check with your doctor before beginning any exercise regimen.

Gym membership: $35 to $40 per month

Walking or jogging outdoors: Free

Take prescribed diabetes medication

$4 to $100 per month for people with health insurance;

$8 to $200 per month for people without insurance

Control sleep apnea

Continuous positive airway pressure (CPAP) machine:

$1,000 to $3,000 to purchase or $250 per month to rent;

Dental devices worn during sleep: $100 to $1,200

Insulin therapy

Insulin pump:

$4,500 to $6,500 (may be covered in part by insurance and/or Medicare);

Replacement parts (syringes, infusion lines, etc.): $1,500 per year

Obesity Fast Facts

On average, medical costs for those who are obese are about 42% higher than those with a healthy weight

Obese Americans pay 105% more for prescription drugs than those who aren’t obese

For the first time in history, obese people outnumber those who are underweight

One-third of Americans are obese and two-thirds are overweight

In 2013, more than 90% of type 2 diabetics were overweight or obese

Sources: Brookings Institution 2010, Centers for Disease Control and Prevention, The Lancet, World Health Organization

Obesity Prevention and Treatment

Obesity doesn’t happen overnight, which means there are things you can do now to help prevent excessive, unhealthy weight gain. Even if you are currently dealing with obesity, you can still make lifestyle changes to lose weight and live a healthier life. Below are more expert tips on how to prevent and treat obesity.

Prevention

Walk it out

Not everyone can get to the gym or spend hours every week exercising, but you can easily add more steps to your daily routine, says clinical psychologist and weight loss expert Melissa Bailey of Scottsdale, Arizona. “Walk instead of drive. Park farther from the door at the mall or store. Walk around the block instead of watching television,” she advises. Buying a pedometer to count your steps is a good way to keep track of them. “By tracking your steps, you can set simple goals,” Dr. Bailey explains. Any time we objectively measure something, we tend to be more successful with it.”

Sweat it out

If you do have more time for exercise, find an activity that you enjoy to make you sweat, suggests Trish Lieberman, RD, of The Renfrew Center in Philadelphia. “Build up a sweat for least 30 minutes on five days per week,” she says. She recommends fun activities like cardio kickboxing, Zumba, spin classes, biking, or ice skating. Exercise is the best way to improve overall health and wellness.

Make sure you get enough sleep

Harvard University reports that not getting enough sleep can cause increased levels of hormones that stimulate appetite, while simultaneously decreasing hormones that regulate it, so it’s important to get at least eight hours of sleep each night. Also, sleep deprivation has been linked to unhealthy behaviors that cause people to put on weight, such as irregular meal patterns and increased snacking.

Take a break from technology

Whether staring at a computer, television, or mobile phone, technology tends to promote a sedentary lifestyle, which puts you at a greater risk of gaining weight. In order to avoid this, says Ohio physician and author Carrie Rubin, it’s important to cut down on screen time. “Not only does screen time keep us inactive, we eat more when we’re in front of it.” Rubin recognizes, however, that limiting computer time isn’t always feasible. “For those of us tethered to a screen for our jobs, creating a makeshift standing desk or walking at a slow pace on a treadmill with the laptop on a shelf is helpful,” she says.

Eat more fiber

Foods that are high in fiber help people feel full after meals, which can go a long way toward cutting snacks out of their diets. Increasing foods such as oatmeal, whole wheat bread, quinoa, legumes, and vegetables can help lower the risk of obesity. Fiber has also been associated with a number of other health benefits such as lower risk of heart disease, decreased blood cholesterol, and improved gastrointestinal health.

Avoid bad fats

Although some foods—like avocados, coconut oil, and salmon—contain fats that are healthy, many of the foods that people enjoy contain bad fats that increase the chances of becoming obese. “Avoiding a high-fat diet and reducing carbohydrates as much as possible will help to substantially reduce the risk of obesity,” says Caravella.

Make changes, but don’t deprive yourself

Making healthy choices and altering bad habits doesn’t mean you have to avoid cookies and ice cream for the rest of your life. “Don’t deprive yourself of desserts and other ‘fun foods,’” says Lieberman. “When we deprive ourselves, we end up overeating later on, which perpetuates the cycle of binge-eating disorder and obesity.” The occasional sweet treat is okay. The most important thing is learning how to develop a healthier, more balanced relationship with “good” and “bad” foods.

Eat mindfully

People have the tendency to eat without thinking about what they’re putting in their mouths—and how much they’re actually eating. Mindful eating means that when you have a meal, you slow down and really enjoy it. Focus on the taste, smell, and texture of what’s in front of you. This strategy can help you avoid overeating that can lead to obesity.

Treatment

Stop yo-yo dieting

Just as obesity doesn’t happen overnight, neither does weight loss. Some diet fads are effective in the short term, but the results typically don’t last because these approaches are difficult to maintain as a long-term lifestyle. Don’t focus purely on losing excess fat; instead, think about making more effective lifestyle changes that are sustainable over time.

Set realistic weight loss goals

Losing unwanted weight will be a process and as much as we all wish we could lose such weight immediately, that’s often not realistic. It can also be discouraging when you’re unable to reach such a goal and, most importantly, it can be very unhealthy. Most weight loss experts say losing between half a pound to two pounds a week is a healthy and attainable goal.

Make dietary changes one step at a time

Overhauling a diet can seem like a daunting task when trying to lose weight, and it can sometimes lead to failure. To avoid this, says Bailey, “I encourage patients to make small changes at first because focusing on one thing at a time can have longer, lasting results.” Once you’ve tackled the first step, you’ll feel more confident about facing the next.

Talk to a doctor about managing hormones

Since hormones and genetics can play a role in obesity for some people, it can be helpful to talk to a doctor and have some tests run for more information. “Getting hormones tested, along with a genetic analysis, can provide lots of very relevant data as to the best diet,” says Los Angeles physician and obesity expert Nishant Rao, ND.

Practice portion control

Paying close attention to portion sizes helps to shed pounds and avoid eating too much. Doing things like sharing restaurant meals and buying smaller plates helps to keep portions under control.

Partake in some food-free social activities

With so many food-centered social activities, it’s easy for a night out to turn into a problem that derails your goals for weight loss. To combat this, look for some social activities that do not involve food. For instance, instead of having brunch with friends on Saturday morning, try inviting them on a hike or bike ride instead.

Don’t forget about exercise

Diet is not the only thing that will need to change when it comes to treating obesity and getting weight down to a healthy number. Regular physical activity is just as important, but incorporating it into your daily routine takes time and practice. As with dietary changes, it’s best to start off small and work your way up. Be sure to incorporate activities that increase the heart rate, as they help burn calories and create the deficit needed to lose weight.

For more in-depth strategies on healthy living, check out MoneyGeek’s guide on eating and living well.

Resources on Obesity & Healthy Living

Fighting obesity can be a difficult job, but it’s easier if you’re armed with accurate, reliable information, have clear goals and strategies, and know where to turn when you need help. Following are some resources for additional information about obesity and ways to manage it.

American Academy of Pediatrics

AAP is dedicated to the health of all children. Its website devotes a to obesity, where families can find resources on reducing the occurrence of obesity and creating a healthier, more active lifestyle.

American Diabetes Association

This association provides information on diabetes, including how to manage the condition, current research, and recipes that promote healthy eating habits.

Add: American Heart Association – [huge heart disease/ obesity link] https://www.heart.org/HEARTORG/Conditions/Diabetes/Diabetes_UCM_001091_SubHomePage.jsp

CDC – Overweight & Obesity

The CDC offers comprehensive information on obesity for both adults and children, from data and statistics to resources for prevention and treatment.

Heath Intelligence

System engineer Ramon Martinez has a background in epidemiology, biostatistics, and public health. His personal data blog and website features an interactive data tool that shows global trends in obesity between 1980 and 2013.

International Diabetes Federation

The International Diabetes Federation is an umbrella organization for 230 diabetes associations in 170 countries around the world. Its mission is to address diabetes on a global scale.

Let’s Move

Created by First Lady Michelle Obama, the Let’s Move! initiative focuses on combating obesity and helping children live healthier and more active lives. The website has information on food and nutrition as well as physical activity.

National Institute of Diabetes and Digestive and Kidney Diseases

NIDDK supports medical research in several areas, including obesity. The site’s section features research on the causes and consequences of obesity and also offers resources for its prevention and treatment.

Obesity Action Coalition

In addition to up-to-date information on obesity, OAC offers several resources for support and advocacy, including state-specific resources for those living with the condition.

OSNAP

The Out of School Nutrition and Physical Activity Initiative (OSNAP) is dedicated to improving the practices and policies related to food, drinks, and physical activities in programs held before and after school, as well as at summer camps. Educators and parents can find tools and resources to help make their community’s programs healthy spaces for children.

Partnership for a Healthier America

PHA was founded in 2010 in conjunction with Let’s Move! The nonprofit is led by health and childhood obesity advocates and works with the private sector to solve the childhood obesity crisis. This site offers information and resources to help promote awareness and help individuals make healthier choices.

PHIT America

PHIT stands for Personal Health Investment Today. This cause and campaign is dedicated to improving the health of Americans through increased physical activity and fitness. On the site, visitors can find helpful information on how to get active and/or support the cause.

The Campaign to End Obesity

The Campaign to End Obesity is made up of lawmakers, public health professionals, academics, and industry leaders who have joined forces to disseminate information about obesity and how to combat it.

The Obesity Society

TOS is a nonprofit organization that aims to expand obesity research to help prevent and treat obesity, as well as reduce the stigma and discrimination associated with it. Professionals in the field can become members to gain access to its career and education benefits, while nonmembers can take advantage of publications, news, and other resources located on the site.

The State of Obesity

The State of Obesity is a project created by the Trust for America’s Health and the Robert Wood Johnson Foundation to raise awareness about obesity. Information includes annual reports, state briefs, and policy analyses.

Trust for America’s Health

TFAH helps protect communities from the spread of disease, including obesity. The site offers national and state data on adult obesity, policy and advocacy materials, and the latest news coverage on the issue.