A national epidemic Featured

7:30am EDT October 29, 2004
"Obesity is our nation's fastest-rising public health problem, and it's increasingly affecting every segment of the American population- particularly young people," says Sen. Jeff Bingeman, (D-N.M.), a sponsor of the Improved Nutrition and Physical Activity Act of 2002.

Facing an alarming epidemic of obesity, lawmakers from both parties introduced federal legislation to get America off the couch and onto a track of healthier behavior. The bill authorized a quarter of a billion dollars to move people away from quarter-pounders by training health providers to identify risk factors and treatments for obesity, to help communities promote good nutrition and health, and to launch a media campaign on the benefits of healthy eating and exercise.

Bill sponsor Sen. William Frist, the Senate's only physician and a top health adviser to President Bush, believes that the problem is only getting worse.

"Only tobacco accounts for more deaths in the United States than poor diet and lack of exercise," he says.

According to a two-year study of nearly 200,000 employees of General Motors,

overweight and obese individuals incur up to $1,500 more in annual medical costs than healthy-weight individuals. Average annual medical costs for normal weight individuals in the study were $2,225, while costs for overweight and obese individuals rose steadily, from $2,388 for overweight individuals to $3,753 for the most severely obese people.

Multiple research studies designed to determine the increased cost for individual health risk report that:


* Severely overweight people have a 24 percent higher rate of outpatient visits, while moderately overweight people had a rate 17 percent higher.


* Annual hospital days were 74 percent higher among the severely overweight and 34 percent higher among the moderately overweight.


* There was a significant association between Body Mass Index and each category of outpatient costs, with the exception of surgery and radiology services.


* Pharmacy costs were 78 percent higher for the severely overweight and 60 percent higher for the moderately overweight


Not long ago, obesity was such a touchy subject that, as a nation, we were not willing to be aggressive about managing this crisis. Today, however, this attitude is changing. There is new awareness by corporations, schools and fast food marketplaces for an innovative strategy to end what appears to be an unsolvable issue.

Human resource and benefits managers are getting more aggressive in fighting the battle of the bulge by influencing medical treatment outcomes. Forward-thinking managers are looking to health and wellness programs in an effort to target obesity and reduce the overall health care tab. Benefits managers are also experiencing significant pressure regarding the coverage of bariatric surgery.

Given the high prevalence of obesity and the clearly elevated risk of diseases such as heart disease and diabetes, as well as the increased use of health services, there is potential for a reduction in health care expenditures through efforts in weight reduction and prevention of weight gain.

Innovative strategies can provide solutions for battling obesity, including new technology combined with awareness; education; award programs and incentives; and bariatric surgery

Tailoring programs to different employee categories will effect the greatest results. Categories are:


* Those who are fit and want to stay that way. These individuals will take advantage of fitness club memberships.


* Those who are moderately overweight and could benefit from a targeted intervention to assist them in losing 10 to 20 pounds. Education and incentive programs can motivate these individuals to accomplish their goals.


* Obese employees may require highly specialized programs, perhaps even surgery. One-on-one counseling and ongoing support can assist these individuals in long-term success.

There is still debate as to whether obesity is a disease or a lifestyle-related issue. Regardless, research supports the necessity for obesity education, prevention and treatment as a cost-effective approach to controlling health care costs.