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Obesity in America: What It Costs Us

Two generations ago my grandparents woke up before dawn and had a breakfast that might have consisted of bacon, country ham, eggs, plus bisuits and gravy made with lard. Then they went out to raise livestock and grow crops, stopping only for an equally sizeable lunch and dinner consisting of whatever they had butchered and grown that week. They ate heavy and worked hard. Farming takes lots of calories. Fast forward 60 years to the office worker stocking up on donuts, king size candy bars, and energy drinks at the convenience store on his way to work. These have to hold him over until he can hit the dollar value menu for lunch. He’s so tired after work, he will just pick up a pizza. Wow, you can get an extra one for only $5 more, plus double meat, sign him up! He really wanted to stop at the gym, but American Idol is on tonight, and he has to answer comments on the new blog he just started. Is it surprising that his pants were a bit too tight this morning?

Obesity in America is a huge problem, and it’s getting worse. Some recent statistics from the Center for Disease Control:

  • More than one third of US adults (35.7%) are obese. Not just over weight here. This means their body mass index or BMI is over 30.
  • Obesity related conditions like heart disease, stroke, type 2 diabetes and certain cancers are some of the leading causes of preventable death.
  • In 2008, medical costs associated with obesity were around $147 billion dollars. Costs for obese people averaged $1429 higher per year than those of people with normal weight.

Working in health care, I get to see the snapshot of a person’s overall health during the course of their eye examination. It is getting to the point where being obese with at least one complication like high blood pressure, diabetes, or high cholesterol is the norm rather than the exception.

In the past few weeks, I’ve seen a 15 year old type 2 diabetic (type 2 is usually because of being overweight) with high blood pressure. He weighed just under 300 pounds. I also had an emergency visit with an over 350 pound gentleman. He said his eye “felt like this when I had my first stroke.” He was in his mid 40’s.  I also saw an 85 pound five year old, and I live in Colorado, the least obese state in the U.S.

What did all these people have in common besides morbid obesity? They were all on Medicaid, meaning the government is paying for their chronic health care.  Arguably, they probably won’t live to a ripe old age, but until then, thousands of dollars will be spent annually to care for them.

Obesity is not only a problem of health care dollars. It affects a person’s self esteem. Obese people are often seen as lazy and become the butt of jokes. First impressions are very important whether they are fair or not. Most employers wouldn’t admit it, but I bet many obese people have been passed over for jobs because of their appearance or fear that they might not be healthy enough for the job.

What is the solution? You would think the threat of death might scare people into being more healthy, but apparently that isn’t working. I don’t know the answer. It does get harder to stay at a healthy weight as you get older. I think my metabolism stopped at age 35, so I have to work that much harder just to maintain. I can’t think of a valid excuse for having an obese child. Children can’t hop in the car and head over to the drive-in. They eat what adults feed them and join in with activities we provide for them. Since few seem to be stepping up to the plate, I’ll throw my two cents in.

  • What if we paid every person on Medicaid $1000 a year to have a healthy BMI? Would an incentive payment work? Maybe it should be higher if they also give up smoking. According to the earlier figure, we could save $429 per person and who knows how much in self esteem.
  • Let’s tax the heck out of sugared soda, candy, and cigarettes. If you follow me at all, you know I am addicted to fountain soda. Would I still drink it if it the cost was $5 a cup. Probably not. What if cigarettes were $25 a pack? I’m sure people would still find a way to buy them, but I bet the number of kids getting Cheetos and a Big Gulp Mountain Dew for breakfast would fall off fast. Use that tax money to do more education about healthy lifestyles in schools, classes for parents,  and for scholarships to local YMCA’s or recreation centers.
  • Put warning labels on food similar to those on cigarettes. Would people be as likely to buy that box of cinnamon rolls if the label said something like, “This food has no nutritive value and when consumed in excess can lead to a huge expansion in butt size”?

I think we all need to look at the problem and stop being so sensitive. I’ve never met anyone who set out to become obese. Just like with personal finance, we sometimes make bad decisions and don’t see a way out.  When was the last time you gave a word of encouragement to an obese person trying to work out? If we start a dialogue about how to help rather than making snide comments or putting people down, maybe we can encourage more healthy lifestyles. Otherwise, I guess we all need to buy more stock in health care products and fast food.

Do you think obesity is a problem? Are obese people treated fairly?


About Kim Parr

Kim Parr is a private practice optometrist, freelance writer, and personal financial blogger. You can follow her journey to 20/20 financial vision at Eyes on the Dollar.


  1. Medical bills of over $147 billion!!!! MENTAL – that is an outrageous statistic!
    I do however think BMI is a really badly designed metric… I am 6ft 4 and weight over 19stone, am not fat – I just go to the gym a lot – and my BMI is around 30.

    • Obviously other measures could be used. I’m sure Arnold Schwarzenegger had a high BMI in his body building days. I’m talking really unhealthy people with chronic health problems caused by or enhanced by obesity. Maybe a weight loss measure or being able to stop a medicine would be a better metric?

  2. Great post Kim! I know plenty of people who suffer with self inflicted obesity. I find that often they tend to blame everyone but themselves for their obesity and don’t correlate poor eating and exercise habits with excess weight.

    I’m not sure what would help fix the problem, my personal view is that people are just too lazy.

    As you said in your post – if the threat of death doesn’t motivate these people then I can’t see much else making a difference.

    • I think society makes it easier to be obese. You can find clothes up to a million double XL. Seating is getting larger. Look at all the movie theaters that have seats as big as recliners. They now even make super size wheel chairs. Kind of like a double wide for people who don’t fit into the regular size ones. Everyone likes to blame their thyroid or their knees, but if they lost weight, these problems would go away. I also think getting on meds is too quickly offered. If they were told to lose weight or lose their benefits, would that help? I’m not saying everyone needs to be model thin, but anyone can lose weight if they cosume less than they burn off.

      • Knee problems don’t really go away if you loose weight. They lessen a bit, but once you do damage to your knees, it never really goes away.

  3. There are some good incentive programs with health insurers that I think “attempt” to fight obesity, but there are workarounds (online coaching programs that are somewhat easy to pass). Unfortunately, unless food becomes much more expensive I don’t see obesity going away anytime soon.

    • You don’t see a lot of veggie wraps on the extra value menu for sure. I also think our sense of portion control is terribly out of whack.

  4. Good post! I do think it’s a problem and it’s always sad to see such young people that are struggling with it. I think an incentive would work for some, but for many I think it’s a bigger (no pun intended) issue of simply not having the discipline. Speaking from expeience, I know that I have more than a couple of pound to lose, but it all comes down to choices. We know putting that crap into our bodies while sitting on our butts is a bad combination, but we do it anyway. There’s nothing wrong with having a little junk food, but when that makes up 90% of your daily intake then there’s a problem.

    • I am certainly not harping on people who put on a few pounds as the years go on. Lord knows I could lose five pounds and not miss them at all, but when you can’t walk from my waiting room to the exam room without panting and breaking a sweat and you have to use the motorized cart at the store because you can’t walk, it’s a problem.

  5. Mandy - Money Master Mom

    DC, I agree that people will eat less when food becomes more expensive. They need to tax processed food, right now it’s cheaper (in the short run) to eat highly processed crap. They need to increase the incentive to eat raw, cleaner foods.
    Kim, I like the idea of positive incentives, but Savvy Scot brought up a good point and BMI as a dependable metric.
    Your story about the 15 year old makes me so sad, he really got a poor start in life.

    • It was about the saddest and most unbelievable things I’ve seen, and that’s saying a lot. I’ve always dealt with a high incidence of diabetes as we border two reservations and about 40% or more of adult Native Americans are diabetic, but just in the last few years they are getting younger and younger.

  6. I do think it is a problem. The costs are outrageous and just like with other things (such as smoking) it needs to be changed/fixed.

  7. It is getting out of hand. Food portions are just far too generous – and fast food is just so darned cheap. It is possible to lose weight fairly easy, but everyone seems to think you need a crazy diet or something. I did it without any programs and lost 40 pounds!

  8. Obese people are not treated fairly because people don’t understand their issues. Sometimes it’s genetics, but most of the time it’s a food addiction. Anorexics gets lots of sympathy, but obesity people don’t. However, for some people it’s just as hard to stop eating as it is to eat. I’m not obese but I’ve dealt with food issues all of my life as I have binge eating disorder and it’s a REAL problem. Why would I want to continue to stuff my face even though it’s making me sick?! We deal with our problems by turning to food, like alcoholics turn to alcohol or junkies turn to drugs.
    And many obese people don’t understand HOW to lose weight. We are stuck in the diet scheme because of the ads we see on TV and the internet. But diets DON’T work. We have to help them make a lifestyle change, not start a diet. It’s about learning how to eat healthy balanced meals and finding an exercise that you love. They also have to learn about portion sizes. And it starts from WITHIN, they need to learn how to cope and deal with their problems without turning to food. If a person has never been overweight, they can’t understand what it’s like and how hard it is to start. Starting is the hardest part, but once you get used to it, eating healthy and exercising will become a part of your every day life. It will become a habit like over-eating was once a habit. Losing weight is a major lifestyle change.
    It’s sad because most of the people that I’ve seen making fun of obese people and calling them lazy eat a lot themselves and also don’t exercise. It’s very hypocritical. You can’t judge an obese person for eating a lot if you eat a lot too, you just have a fast metabolism and they don’t. If you didn’t have a fast metabolism, you’d be obese too. And how dare call someone lazy if you don’t exercise yourself.
    What obese people need is help and support, they need to be educated on how to lose weight, and they need to figure out how to cope without food. And if they’re busy people, they need to learn to make quick healthy meals instead of going to fast food just because it’s easy. There are a lot of healthy recipes that take only 10-20 mins!
    Anyway, this was a good article and I agree with all you said.

    • Thanks Hannah for sharing. I do agree that obese people aren’t treated the same as others with addiction problems. Maybe their problems are just easier to see and that makes them an easy target. I think it has to start at an early age. If we never learn to eat when we are hungry, eat nutritious food, exercise, and have good general health, it goes down from there. There is not easy solution, and it’s hard to change your life. I don’t have all the answers for sure, but I see it every day, and it’s really sad, especially for the young ones.

    • Financial Samurai

      Best cure I’ve found is to think of the hundreds of millions of starving children on the world and flying to places like India to see how wasteful Americans are.

      • Sadly, most of the people I see on a daily basis in this situation don’t even know where India is, let alone have any chance of ever going there.

  9. I live in Indiana and most people here are fat. It’s crazy and I think it’s getting worse. Not only is it unhealthy, but its costly in medical care dollars as well. It is a huge problem in my area for sure!

    • I kind of feel like that when I go home to visit KY and you can buy fried chicken at every convenience store. We took my Dad out for Father’s Day to one of those steakhouses, like Lone Star or similar. I could not believe the girth of the patrons or the size of the portions.

    • I live in Indiana too, the Lafayette area, and I agree, obesity and poor nutrition is a huge problem here. To most of my girlfriends, a good homemade dinner is something like ribs and velveeta cheesy potatoes with no vegetables. People also like to eat chicken and noodles ON TOP of mashed potatoes, a culinary delight I, as a former Oregonian, had never even seen before! Talk about carb overload! I think people need to learn as kids to get used to veggies and fruit.

  10. Speaking as a formerly obese now normal weight person:

    A major contributing factor to this problem is the fact that the federal government (i.e. the USDA) won’t use their platform for telling the public what to eat to give scientifically sound nutritional advice. Since the ’60s they have been stuck in a fat-phobic, grain-promoting phase (MyPlate being the latest iteration) – and look at the results. So I am not really optimistic about Medicaid giving incentive for staying healthy when the feds can’t give the potential recipients useful information about how to reach a better health status in relation to metabolic syndrome. They still promote the caloric balance theory of weight control!!

    Now, private insurance companies could give incentives and they don’t have the problem that the feds have of admitting they have been giving demonstrably wrong and harmful nutritional advice for 50 years. I actually participate in an incentive program through my health insurance company – I log my produce intake and workouts and get gift cards. If they added something about maintaining a normal BMI I would participate in that, too.

    • I don’t have much faith in Medicaid either. It is a source of ire almost daily. When we can’t fund our Medicaid/Medicare system any more, maybe change will happen, but maybe not. I love that program that your insurance plan offers. I wish more would offer things like that.

  11. It’s quite scary how our culture has evolved and the path we’re now headed down. I do believe obesity is a serious problem but I’m not sure it will ever change; most people don’t change unless they’ve been scared straight and many do not change even after that. I’m not saying there is no hope, but I personally don’t believe it will ever be fixed. It all starts with the parents though and until they take their health seriously, their children certainly won’t know any better.

  12. Ironically enough, my post today laughs at our eating habits in this country. Your attitude is much more apt! What a serious problem! Unfortunately, I think things are just the way our government (businesses that lobby in/run our government) want it. Sugar is subsidized by the government. It’s so cheap because it’s so cheap to make it because our tax dollars go to producing it and maintaining the environment it grows in. Phillip Morris has big money in people buying cigarettes, too. It’s the reason legislation was passed a few years ago banning sales of all flavored cigarettes. Menthol didn’t count as flavored. Because the bill’s sponsor produces it.

  13. In France after each commercial for food, healthy or not, there is a warning, “for your health, don’t eat to greasy or sugary”. We have unfortunately turned to junk food too but much less than the US. I like pizza and burgers but try to make homemade versions so I know what is in there. It is very hard to change people, but a health class at school and healthy diet at the cafeteria could go a long way, turning the kids into responsible adults.

    • I read the most fascinating book about how and what children eat in France. I hope the commercialization of fast food doesn’t wreck the whole world.

  14. While I think obesity is a problem, I think that the weight charts are rediculous. Once upon a time, I lost 80 pounds and got down 170. According to the hiegh-weight charts, I was still overweight. I was wearing the smallest jeans sold in the men’s department but I was overweight!?!

    At the end of the day, it’s not a one-size-fits-all problem and one-size-fits-all solutions are destined to fail. I was always a heavy child but we almost never ate out and I like to think I was moderately active. The only way I was able to get the weight off was to go to extreme lengths. I walked 5 miles EVERY day and was averaging about 1000 calories per day. And it took me 2 years to get down to the weight I mentioned above.

    • But you did it rather than just accept that you would be overweight. Even throwing BMI out the window, you can tell by a person’s health if they are getting better or worse. It is really not fair that some people have it easy and others have to work twice as hard for the same result, but we can’t just give up because it’s hard.

  15. Obesity is a problem all over the world and for the most part people that are obese are fighting battles that most would never understand unless you’ve walked in their shoes. Sure some may turn to food as a stress reliever but others may feel so depressed they turn to food because that is their only friend. It will take everything the person has got to seek help or to motivate themselves to make the change. Just like giving up smoking eat can be an addiction that needs to be conquered one step at a time. Long term and short term health costs are a growing trend and education is key as well as motivating others. I had a guest post recently on my blog by a good mate of mine who is almost at her goal loss of 100lbs this year. Her transformation is remarkable and her fans love her and although she motivates them they motivate her to reach her goals. All they need is to believe in themselves and have others believe in them. -Mr.CBB

    • I think just like with anything else that is hard, getting started is the hardest part. If you don’t have someone to be supportive and hold you accountable, it is nearly impossible to reach a goal.

  16. Some very thoughtful post and comments, I think the article hit close to home for many people – as almost all of us know a friend or family member who is obese. (if not ourselves) The problem is so multifaceted that it is hard to know where to begin to find solutions. Certainly a big problem is the link of depression to food and inexpensive nature of food that is killing us. I agree with many of the comments that there is very little solutions possible if people are unwilling to take the steps necessary to defeat the problem.

    • We are too PC to every talk about someones weight like it’s a bad thing. I don’t think anyone should be mistreated or teased, but as long as we keep making bigger seats and larger clothes, people aren’t encouraged to lose weight. What if you ran out of sizes? Would that make a difference? I don’t know.

  17. It’s because we live more sedentary lifestyles and all of the chemical junk that is added to food. It’s like the movie Walley where no one walks, they just hover around.

  18. Obesity is definitely a big problem and that’s unfortunate because a lot of it is preventable. I feel like a lot of it has to do with the abundance of sugar-heavy “foods” like soda. I’ve mentioned it before but Brian gave up soda, and with no other changes in diet or exercise, lost almost 15 lbs. We should only be having around 20g of sugar a day but a regular soda has over 30g. :S

    • My husband switched from regular to diet a few years ago and lost quite a bit of weight as well. I’m sure there are other issues with the chemicals, but at least it’s not all calories.

  19. Ah, I wish weight loss was easier! I definitely agree with the portion size thing. I find US portions to (generally) be larger than here (Canada) and the ones overseas to be smaller (Australia, NZ, the UK, for example). I never really felt hungry at restaurants in any of those places, nor do I here, but I could definitely afford to scale back my portions! That is, both at home and when out.

  20. I’m with you 100% on putting warning labels on foods that contribute to obesity.

    And taxing these foods, then using the revenue to treat obesity, would also be a productive route to go.

  21. I think incentives for people who aren’t overweight would be AWESOME. It’s like getting a reward for taking care of ourselves. Of coufse taking care of ourselves should be reward enough, but apparently that’s not true. The cost of healthcare for fat people doens’t seem to bug them, but if they knew losing weight would put some money in their pocket every year? Boy I think that would do something for people!

  22. Financial Samurai

    I really think everything is rational. We enjoy food more than we feel bad being overweight. If we didn’t, we’d be fitter.

    I lost my four pack abs in college because I don’t care anymore. If I didn’t, I’d lose 10 pounds and get back to super fighting weight.


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