Talk about your weighty issues: Obesity is poised to pass smoking as America's top health threat. Two out of three adults and one out of seven children weigh too much.
Obesity raises our risk for diabetes, heart disease, high blood pressure, stroke, cancer, breathing difficulties, dementia and arthritis, the National Institutes of Health says. Obesity's effects mimic 20 years of aging, adds the Journal of Health Affairs.
If that's not enough to make you skip dessert and lace up your walking shoes, take a look at your pocketbook. If it looks a little thin and you don't, the experts say, that may be no coincidence.
Being overweight or obese adds as much as $93 billion a year to U.S. medical bills, according to a study by RTI International and the Centers for Disease Control and Prevention. "And every taxpayer in the United States shares the cost -- approximately $175 per person -- when you figure in that half of those expenditures are covered by Medicare and Medicaid," says RTI study leader Eric A. Finkelstein, Ph.D.
On average, each overweight or obese American spends $700 more a year on medical bills than trim neighbors, he says. "In fact, an obese person will likely spend 36 percent more on doctor visits and 77 percent more on medications annually."
Obesity's impact on U.S. firms is staggering. The U.S. Department of Health and Human Services puts the yearly cost to American business at $13 billion. Health insurance tops the bill ($8 billion), followed by paid sick leave ($2.4 billion), life insurance ($1.8 billion) and disability insurance ($1 billion).
A study in the American Journal of Health Behavior (2003) linked weight with absenteeism and productivity. The study found that obese employees were absent an average of an extra day every year. "We found that absences from work increased proportionally as people got heavier," says lead author Timothy Bungum, Dr. PH, associate professor of health promotion at the University of Nevada-Las Vegas. Overweight people missed work at least one extra day a year. Other studies blame obesity for 39 million lost work days and 239 million days of restricted activity a year.
Claims of discrimination and bias toward overweight and obese workers are on the rise, too. Surveys show they're given more menial tasks, passed over for promotion and may even earn less than thinner coworkers.
Life insurance premiums tend to rise with girth no matter what your health. For example, a $500,000 life insurance policy for a 45-year-old man with a body mass index (BMI) of less than 25, seen as normal, would cost about $375 a year. An overweight man (with a BMI of 25 to 29) of the same age would pay nearly twice as much, $740 a year. An obese man (with a BMI of 30 or more) would shell out up to $1,500.
Obese Americans also face higher charges for disability insurance, if they can get it.
It's not so much what we spend as how we spend it, the experts say.
"Snack foods and sodas are served in schools, fast-food restaurants open new franchises every few hours, our busy schedules leave us little time to cook at home. Is it any wonder that we're spending more and more on the foods that make us fat?" asks Kelly D. Brownell, Ph.D., director of the Yale University Center for Eating and Weight Disorders.
Commercials prompt us to "super-size" or "value-size" our meals, Dr. Brownell says. "While it might seem like you're saving money with the special deal, the truth is you probably wouldn't buy the extra food if the deal wasn't available. And in the long term, the extra calories and fats will cost your health more."
A March 2004 University of Pittsburgh study found consumers "eat what they're served." They don't think about how hungry they are or how big a portion should be. The researchers say Americans tend to equate size -- not quality -- with value.
But that trend may be peaking. After years of pressure, McDonald's and other fast-food chains are ending super-size meal offers.