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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Tuesday, June 28, 2005

    Soaring Associations: The CDC may have backed down from its exaggerated claims for the deadliness of fat, but other health advocates continue to beat the drums:

    Private health insurance spending on illnesses related to obesity has increased more than tenfold since 1987, according to the first research to quantify the trend.

    The growth in obesity has fueled a dramatic increase in the amount spent treating diabetes, heart disease, high cholesterol and other weight-related illnesses, says the study, which is published today in Health Affairs, an online journal of health policy and research.

    Overall, employers and privately insured families spent $36.5 billion on obesity-linked illnesses in 2002, up from an inflation-adjusted $3.6 billion in 1987. That's up from 2% of total health care spending on obesity in 1987 to 11.6% in 2002, the latest year for which data are available.

    On average, treating an obese person cost $1,244 more in 2002 than treating a healthy-weight person did. In 1987, the gap was $272.

    It's important to step back and consider these numbers. First of all, we aren't talking about the cost of treating obesity. We're talking about the cost of treating illnesses that occur in both thin and fat people. Although it's true that being overweight increases the risk of having those conditions - not every obese person suffers from those illnesses.

    Even more important, the growth in the spending gap for those illnesses is more likely due to other factors than to a growth in obesity alone. First of all, since 1987 we have lowered the thresholds for diagnosing and treating high cholesterol and diabetes. We used to be content if the "bad" cholesterol was less than 130. Now, it has to be less than 80 in someone with heart disease or 100 for a diabetic. We used to be content if a diabetic controlled his blood sugar so that his HbA1C was around 7.0. Now we strive for less than 6.5. To achieve these more stringent goals, we use expensive cholesterol and diabetes medications - which alone could account for the spending gap.

    In addition, in 1987 it was not yet fashionable to treat everyone with medications for their cholesterol. The medications were considered too risky. Only people with extremely high cholesterol readings were taking them. Now just about everyone with an elevated cholesterol level finds themselves placed on medication.

    The other problem is that all of these obesity-linked diseases - diabetes, high cholesterol, hypertension, heart disease, etc. - are also age-related, and there's no denying that our aging population is growing. Expect the spending gap for these illnesses to continue to grow as more and more baby boomers enter their so-called golden years. But it won't be because they're all fat.


    posted by Sydney on 6/28/2005 05:11:00 PM 0 comments


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