Obesity weighs heavily on American health and wealth.
Carrying extra pounds undermines several major weight-bearing pillars of value-based healthcare, including disease prevention, population health management, and cost control. In interviews and email exchanges over the past week, a trio of obesity experts helped me gauge the crisis and suggested ways to slash obesity rates.
Jay H. Shubrook Jr., DO, a diabetes specialist and professor at Touro University College of Osteopathic Medicine in Vallejo, CA, says the societal costs of obesity are becoming too great to bear.
"Our public health is at stake," he says. "We will not make meaningful headway on the prevention and treatment of chronic disease until we change the infrastructure that supports unhealthy habits. An immigrant from almost any other country who moves to the U.S. becomes at higher risk for diabetes once they live here. We have a sedentary lifestyle with an abundance of high caloric foods at our disposal."
Shubrook has been witnessing the impact of historically high obesity rates in his patients for nearly two decades.
Before moving to California this year, he served in several clinical, leadership, and academic positions at OhioHealth O'Bleness Hospital, a 132-bed acute care facility in Athens, Ohio. In 2013, O'Bleness identified obesity and poor dietary infrastructure in Athens County as "areas of concern" in the organization's Community Health Needs Assessment. In addition to pegging the adult obesity rate in Athens County at about 31%, the O'Bleness health needs assessment sounds an alarm over limited access to healthy foods in low-income areas and an overly high percentage of fast food restaurants among the area's eateries.
"Obesity is a crisis for two reasons," Shubrook says. "We are seeing lower life expectancy rates among our children, and we already know we can't handle the economic impact of diabetes. It will wipe out healthcare."
Otis Brawley, MD, chief medical officer at the American Cancer Society, says obesity is one of the top cancer risk factors in the United States.
"The combination of high caloric intake, obesity, and lack of physical activity will surpass tobacco as the leading cause of cancer death within the next two decades. It is already a leading cause of heart disease, diabetes, and orthopedic injury," he says.
Poor dietary habits and high obesity rates threaten to cripple the healthcare industry and the broader economy, Brawley says. "It is imperative that we reverse the trend, as healthcare costs associated with [the obesity] epidemic are already dragging our economy down and eventually will collapse our economy if it continues over the next several decades."
Justin Noble, a certified nutrition coach, children's book author, and co-founder ofMyBodyVillage.com, says the healthcare industry will be unable to "move the needle" on cost of services as long as obesity and other lifestyle-related health risk factors remain out of control.
"The main issue with healthcare in America is that it is focused on treatment instead of prevention. Eighty-six percent of all healthcare spending in 2010 was for people with one or more chronic medical conditions. The gross majority of these conditions are brought about by lack of exercise, poor diet, stress, smoking, and alcohol consumption. In a nutshell, these ailments are brought on by the choices people make. If we put more effort into giving people the tools and the resources they need to make healthy choices, we will find ourselves paying less for the diseases associated with these poor choices. Until that happens, I only see the needle moving up."
