The price of obesity (long article)

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The price of obesity

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Beyond the health risks, the personal financial costs are steep, recent studies

show.

By Costello

Times Staff Writer

August 1, 2005

It's familiar news by now that America's obesity epidemic is both dangerous and

costly. Obesity significantly increases the risk of many diseases, including

heart disease and diabetes, and is associated with at least 112,000 deaths a

year. The economic impact is equally startling: Obese patients add an estimated

$75 billion a year to the nation's medical bill.

What has been less discussed and studied is the personal financial toll that

obesity has on the 60 million Americans who are seriously overweight. In recent

years researchers have been exploring that issue, and their findings raise a

provocative question: Could obesity be as dangerous to individuals' wealth as to

their health? The preliminary evidence suggests that the answer is yes.

It likely will be years before these costs can be pinpointed. No studies, for

example, have looked at whether obese people spend more on food. But some

economists estimate that obese people could be spending tens of thousands of

extra dollars a year because of their weight.

Recent studies have found that obese people spend more on out-of-pocket medical

costs than thinner people. They also have lower incomes, are less likely to hold

managerial jobs and are more likely to miss work. They are less likely to be

married and more likely to get divorced. When they marry, their spouses

generally earn less than non-obese people. They inherit less wealth from their

parents, who are more likely to be overweight themselves.

Beyond these research findings, experts say that obese people spend more on

diets and on items such as larger-size clothes or extra-sturdy furniture. A few

airlines have begun requiring severely obese passengers to buy two tickets.

Another finding: Obesity's financial burdens aren't distributed evenly between

the sexes. While both men and women who are severely obese make less money at

work than people of normal weight, women suffer a bigger wage penalty. This

summer, researchers at New York University found that an increase of 10% in a

woman's body mass decreased her income by 6%. The study also found that

overweight women are less likely to be college graduates and more likely to work

in less-skilled industries.

" There's no single smoking gun to explain it, " said economist Roland Sturm of

Rand Corp. in Santa . " But it's clear that for obese people, especially

the morbidly obese, their weight can affect how well they do financially. "

Experts say it's difficult to sort out the relationship between obesity and

wealth. Obese people are poorer than the non-obese, but no one can say exactly

why. Does being poor cause people to become obese, or does being obese keep

people poor? What does seem clear is that the economic situation faced by

seriously overweight people can make it harder for them to make the exercise,

diet and lifestyle changes that promote weight loss. More healthful foods, such

as fresh fruits and vegetables, generally cost more than less nutritious

alternatives like fast-food cheeseburgers. And the costs of weight loss

programs, personal trainers and gym memberships can be prohibitive.

The number of Americans who are considered obese has doubled in the last 25

years, according to the Centers for Disease Control, and now accounts for more

than 30% of the population. The number of morbidly obese people (generally

defined as 100 pounds or more overweight) has grown to 9 million.

Last year Jay Zagorsky, an economist at Ohio State University, released a study

that followed 2,000 teens for two decades, tracking their weight and wealth. By

the time the teens reached middle age (39 years old), there was a sharp

disparity in their finances. Normal-weight people had accumulated nearly twice

as much wealth as those who were obese (about a third of the original group).

The differences can be explained, in part, because obese people earn less money

on the job and inherit less money from their parents, Zagorsky said. " It may be

a small difference each year, " he said, " but it adds up over time into something

much bigger. "

Sara Flammang, a 44-year-old Tustin woman, understands well how costs can mount.

At 5 foot 3 inches and 324 pounds, Flammang has rarely dated since her teen

years, has never married and supports herself with a supervisory job at a

financial services company. She believes she was passed over for promotions with

previous employers because of her weight. Having never graduated from college,

she enrolled at a local college but dropped out because she was embarrassed when

she couldn't fit into the desks.

And there are other costs. Flammang shops for expensive plus-size clothes on the

Internet because she can't wear what's sold in most stores. Two years ago she

spent several thousand dollars more than she wanted to on a couch that was

sturdy enough to support her large frame. Flammang has been diagnosed with high

blood pressure, asthma and sleep apnea; she also suffers from chronic back and

knee problems. She estimates that she pays about $3,000 a year out of pocket for

medical costs. That includes $150 a month, not covered by insurance, in

medication for asthma and acid reflux disease exacerbated by her weight, and

twice-weekly visits to her chiropractor, at $15 each. The sleep apnea, which is

relatively common among the severely overweight, causes her fatigue throughout

the day.

Like many obese people, Flammang spends a lot on diets. Over the years, she's

tried Weight Watchers, NutriSystem and Craig, among others, and she has

spent money on nutritionists and gym memberships. Last year she considered

gastric bypass surgery but decided against it after her health insurer required

that she pay $250 for a psychiatric exam, $300 for a physical exam and $200 for

a nutrition class before it would authorize the costly procedure.

Zagorsky, the Ohio State researcher, has found that people who significantly

decrease their body weight may see a corresponding rise in their personal

wealth. Their salary likely increases once they lose the weight, he says.

Flammang hopes it isn't too late for her. This spring she began a two-month

program at the Lindora Medical Clinic in Costa Mesa, which is costing about

$1,000. She has lost 37 pounds so far. Last month she accepted a promotion at

work and now manages four employees.

" I honestly don't think I would have taken the promotion before, " she says. " I

would have worried I wasn't up for it or would be too tired. But I am feeling

better than I have in a long, long time. "

Copyright © 2005, The Los Angeles Times

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