That’s at least how much this country could save in health care costs and worker productivity if people lived healthier lives and if the health care system helped them do it.
A recent national study announced in a press release by the Milkin Institute reported that 40 million cases of seven chronic diseases — cancers, diabetes, heart disease, hypertension (high blood pressure), stroke, mental disorders and pulmonary (lung) conditions — could be prevented in the year 2023. How? By re-orienting the focus of health care resources more toward prevention and early detection of disease, rather than focusing primarily on treatment. In other words, let’s head off disease before it happens, rather than waiting until we get sick.
The study concluded that this would reduce anticipated treatment expenses associated with the seven diseases and improve productivity by $1.1 trillion that year. The report notes that the most important factor is obesity, which if rates declined could lead to $60 billion less in treatment costs and $254 billion in increased productivity. We know from other sources that the obesity epidemic in this country is already leading to an alarming increase in Type II diabetes — not only in adults, but in children as well.
To reduce the human and economic cost of disease, the Milken Institute calls for:
• More incentives to promote prevention and early intervention, and
• A renewed national commitment to achieve a “healthy body weight.”
“By investing in good health, we can add billions of dollars in economic growth in the coming decades,” said Ross DeVol, Director of Health Economics and Regional Economics at the Milken Institute and principal author of the report. “The good news is that with moderate improvements in prevention and early intervention such as reducing the rate of obesity, the savings to the economy would be enormous.”
We have been hearing from our doctors for years that that by choosing more nutritious food, exercising regularly and reducing the stress in our lives, we can take significant steps toward improving our health as well as preventing disease, suffering and premature death. Now, policy think tanks, government agencies and insurers are telling us that we can save money as well.
So what is stopping us?
Own Your Health 
I think what’s stopping people is that many don’t mind chugging toxic, synthetic medicines than altering their diet or lifestyle. The answer to me is not telling people what’s good for them, but what’s bad for them and explain why in clear detail. Shock is the way to go.
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Genetics is stopping us. Eliminating obesity is not going to eliminate type 2 diabetes (there are thin type 2 diabetics too, ya know?). Eliminating obesity is not going to get rid of cancer, heart disease, or any other disease that is supposedly caused by fat. All of the diseases mentioned in the article have correlations to obesity, but correlation is NOT causation. Since there is no guaranteed way to lose weight and keep it off permanently, and yo-yo dieting is worse than not losing the weight at all, obesity is NOT a health problem, it’s an aesthetics problem. It’s not that my fat is going to kill me, and in the process run up millions of dollars in health care, it’s the fact that society tells us fat is ugly, smelly, stupid, lazy. And the obesity epidemic sells lots of unnecessary pills, weight loss surgeries and diets that do absolutely nothing to improve our health in the long run, and can cause a LOT more problems than they are supposedly curing. Health is not one-size-fits-all, health is not a moral mandate, nor is anyone’s health anyone else’s business. When you set a standard of health that is unattainable for the majority of the population (and ‘ideal weight’ is just that, unattainable), you are setting up lots of people for failure and lowering their self-esteem.
I’m sorry, I’ll remain fat, healthy, and happy, and probably outlive a lot of thin, unhealthy, unhappy people, and cost the health care system a lot less than they do. THAT is no one’s business either.
Did you ever stop to think that the reason health care costs are so high is because of this so-called obesity epidemic, fat people go to the doctor with an ailment that has nothing to do with being fat, and the first thing they are told is that they need to lose weight. I’m sorry, losing weight is not going to get rid of an ear infection, nor will it cure any other ailment without proper treatment for that ailment, whatever it is. When all you ever hear from a doctor is that anything that is wrong with your health is caused by your fat, you soon decide that you aren’t going to get the care you need from fat-phobic doctors, and you quit going to the doctor until it’s a medical emergency or the ailment has gotten so bad you can’t deal with life anymore.
You want to bring health care costs down? Try treating all people, no matter their size, the same. Treat them all with respect and dignity, and look for the true causes of illness and disease instead of taking the easy way out and blaming it all on fat.
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Your thoughtful comment deserves a thoughtful response. I do agree with you that society’s attitudes toward overweight people are both unhelpful and disturbing. I also agree — and there is increasing scientific evidence to support this — that genes play role in obesity. (See the Joslin Diabetes Center website, for example, and you might also be interested in the research evidence on the site linking obesity to type II diabetes) But I disagree with you about the causal connection between obesity and health problems. Obesity is, in fact, a significant cause of the problems I listed in the post. If you like, I can send you multiple studies that support this conclusion.
I asked one of the doctors for whom I write for her reactions to your comment. She is a board-certified internist and the author of “Healthy to 100” and “Health 2 0.”Here is what she says:
“If genetics were the only cause of obesity, excessive weight would have shown up earlier in history. In more meager times, even the genetically disposed people were slim. By necessity.
“I grew up in Europe after World War II. People were hungry and thin, they died mostly of typhoid, tuberculosis and other infectious diseases. By 1970, post-war prosperity had caught up with them, and they began to die of heart disease, obesity and cancer. And they were overweight. We all know the occasional chubby or chain-smoking people who make it to ninety; they are definitely not the norm. Statistically, a severely overweight person will be sicker earlier and will die sooner.
“You are right in that there are thin type 2 diabetics. They often have celiac disease (an intolerance to gluten) or other malabsorption problems. So, even they could be helped with better diets. In the case of ear infections however, I have to contradict you: Overweight people, with high blood sugars, are generally more susceptible to infections, and to more severe infections. Bacteria just love sugars.
“Dieting, and especially yoyo dieting are not the answer to the obesity epidemic, as you point out. But still: Overweight people eat too much food, and the wrong kind. Why? Digesting and absorbing carbohydrates takes B vitamins – which have been pretty much milled out of white flour. Consequently, a ‘hunger’ for B vitamins remains after we have downed a donut. That’s why we reach for the next one. The body doesn’t know that donuts, pizza, bagels, cookies are devoid of B vitamins – so it craves more of them. Nutritionist and author Annemarie Colbin once said: ‘If you pop a vitamin A pill in the morning, the body keeps looking for the rest of the carrot all day’ (paraphrased). The same mechanism seems to underlie food cravings, triggered by processed food devoid of natural constituents that the body ‘expects’. – This is but one example how inferior fare leads to food cravings and more fat on your hips.
We eat more and more, because our highly processed foods give us less and less what we need: whole nutrition. And the depleted foodstuff makes us sick – diabetes, high blood pressure, depression, arthritis, heart disease, cancer are all linked to the fake foods we ingest. But we can reverse this by eating a healthier diet and by exercising.
It’s pretty nigh impossible to overeat on a healthy diet: you soon will feel full. But considering the obesity epidemic, we also have to take into account how much people move – we all know that they don’t move enough. Studies have shown that overweight people who are very active are indeed less prone to disease than plain fat people who sit on their couch all day.
It sounds as if you are dissatisfied with the medical care you are getting from your doctors. If that is the case, I urge you to “own your health” and find another doctor!”
Alexa Fleckenstein, M.D.
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Not related to this, but please check out Grand Rounds today at http://runningahospital.blogspot.com/2007/10/grand-rounds-volume-4-number-6.html. Some moving and insightful stories about experiences in hospitals. Thanks.
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Thank you for sharing this
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Thank you for writing. I wish you health and happiness
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