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The Costs of Obesity Are "Staggering" But Women Are Paying The Highest Price, Says Dr. Koop

Washington, DC; March 16, 1998 — With new evidence that obesity has become a multibillion dollar drain on the U.S. economy, Dr. C. Everett Koop — the former U.S. Surgeon General — today called for stepped-up efforts to make the prevention and treatment of obesity a national priority.

Reacting to a newly published estimate that obesity now accounts for 6 percent of the nation’s health care expenses — or nearly $100 billion annually in direct and indirect costs — Dr. Koop said: "The staggering costs of obesity affect all Americans in higher health care costs and lost productivity. Just on the basis of cost alone, obesity has mushroomed into a public health crisis."

Dr. Koop’s remarks come in response to a new article in Obesity Research in which health economists, using prospective studies and national health statistics, have calculated the cost to society for obesity at $99.2 billion in 1995. This new estimate does not factor in the $33 billion spent each year on diet products and services, which had been calculated into previous cost estimates. Even without these diet-related costs, the new calculations find that obesity now accounts for $51.6 billion in direct costs, such as hospital care and physician services — or 5.7 percent of all health care costs.

Further, the new estimates put the indirect costs of obesity, including lost work days and restricted activity, at $47.56 billion a year, which is comparable to the impact of cigarette smoking. The number of work days lost in illness attributable to obesity amounted to 58.5 million in 1995. This lost productivity cost employers $5.7 billion in that one year alone.

Besides providing updated figures on the costs of obesity, the new estimates also provide compelling evidence that expenditures for unhealthy weight continue to escalate as Americans grow fatter and more sedentary. Compared to 1988 statistics compiled by the same researchers, the new estimates show that the direct costs of obesity increased by $5.8 billion in seven years ($51.6 billion in 1995 compared to $45.8 billion in 1988) while the indirect costs more than doubled ($47.56 billion in 1995 compared to $18.9 billion in 1988). At the same time, lost work days jumped from 52.5 million in 1988 to 58.5 million in 1995 and physician office visits went up by 88 percent — from 42.9 million to 81.2 million in 1994.

"If there was any question that obesity has reached crisis proportions in this country, these new cost estimates should put these doubts to rest. Obesity is now a pervasive public health problem that can no longer be overlooked," said Dr. Koop.

What is especially disturbing to Dr. Koop and his anti-obesity initiative, Shape Up America!, is that women are paying significantly higher costs for their obesity, both in terms of health expenditures and their quality of life. In terms of physician office visits, the health economists found that women spend significantly more time and money seeing a doctor for obesity-related conditions than do men. Specifically, in 1994, 67 percent of office visits were for obese women. The researchers further found that 70 percent of lost work days were taken by obese women and these women accounted for 89 percent of total restricted activity days and 98 percent of total bed days in 1994.

At the same time, the economists found that obese women are disproportionately afflicted by diseases associated with obesity — diseases that worsen as the degree of obesity increases or improve as the obesity is treated. Specifically, the economists found that 63.5 percent of the cases of Type II diabetes were diagnosed in obese women. Further, women at an unhealthy weight had a two-fold greater risk for developing osteoarthritis, especially in the knee.

According to Barbara J. Moore, Ph.D., President of Shape Up America! "When it comes to obesity, women are truly disadvantaged. Not only are they more likely to become immobilized by obesity than are men, but they become less able to run errands, buy groceries and lead independent lives. They take to their bed more often and lose wages as a result."

Because there is a clear link between obesity and many of the major diseases affecting Americans, the economists calculated the costs attributable to obesity for a range of conditions. Using 1995 data, these costs include:

"The economic impact of obesity is now comparable to that of diabetes and ranks along with what this nation spends on heart disease and hypertension," said Dr. Koop. "Until we put the same resources behind obesity as these other serious diseases, the costs of unhealthy weight —in terms of dollars spent on health care and in human suffering — will severely affect our nation’s future."

With the matter of resources clearly in mind, Shape Up America! specifically advocates more funding and an expansion of programs that promote increased physical activity by women and teens. Another key priority is new education efforts that teach Americans, and especially women, how to balance food intake with physical activity. Accordingly, Shape Up America! has developed a CyberKitchen on the World Wide Web ( that will help any person make simple changes in dietary choices and exercise habits based on that individual’s height, weight, age, sex and normal activity level. At the same time, Shape Up America! has joined with TOPS (Take Off Pounds Sensibly) to design a national walking program which is geared to women of all ages. Anyone interested can call 1-800-932-8677.

The new estimates of the cost of obesity were developed by Anne M. Wolf, M.S., R.D., of the University of Virginia, and Graham A. Colditz, M.D., Dr. PH, of Harvard Medical School. Their paper — "Current Estimates of the Economic Cost of Obesity in the United States" — was published in the March 16 issue of Obesity Research.

Note:For specific information on the new costs estimates, contact Anne Wolf at: 804/982-0360.