Point 4: Americans Are Obese And Inert -- Resulting In Huge Health Care Costs

We will spend about 17.6 percent of our GDP on health care expenses this year in America, primarily because we are not healthy in some very key areas.

We have the highest rate of diabetes in the world. We have nearly the highest rate of heart disease.

Why?

Because we are hugely overweight and we are so collectively inactive that large numbers of us are almost inert.

One third of all the expenses of the Medicare program go to people who are diabetic. It is the fastest growing disease in America. If our rate of diabetes was only at the average level for every other western country, we would not be facing a governmental financial projection right now that Medicare will be broke within a decade.

This problem can be addressed. Chronic disease can be prevented or significantly delayed. Most cases of diabetes do not have to happen.

What can we do? It's actually very simple.

Walk -- and eat right.

That seems too simple to be true -- but if people who are pre-diabetic walk half an hour a day four days a week, the likelihood of becoming diabetic goes down by 40 percent. Losing 15 pounds (from any weight) and then walking that same amount of time can reduce the rate of new diabetics by almost 60 percent.

Sixty percent is a big number.

The opportunities are huge and the problem is huge.

Seventy-five percent of the costs of care in America come from chronic disease -- and the incidence of each of these diseases can be hugely reduced by physical activity and healthy eating.

So any overall health care reform agenda for America that by-passes that opportunity is a reform strategy with a major plan flaw and an even bigger tactical deficit.

Childhood obesity in this country is growing. We have the heaviest kids in the world. We bemoan that fact -- and then we sadly do very little to deal with it. We don't even have good and basic exercise programs in our schools or our communities.

This set of problems isn't a secret. These facts are widely known. We should be ashamed of ourselves as a nation for not simply recognizing the problem of obesity and inactivity and then beginning to address those issues.

It can be done.

Finland used to be the country with the worst health in the western world. The Finns were overweight and had the highest heart disease mortality rate in the world. The Finns decided to face that issue head on and create a national culture of health -- with better eating, better food, more physical activity and a generic sense on the part of the government, employees, unions, communities and cities that health should be a goal and a value.

The Finns, a decade later, are 20 percent below the European averages for both obesity and heart disease.

They created a Finnish culture of health.

An American Culture of Health
We need an America culture of health. We need our leaders in Washington to make health a priority -- and we need our schools, employers, unions, communities and community organizations to get on board with that health improvement agenda.

Diabetes is the number one cause of kidney failure, blindness and amputations in America. The personal consequences of diabetes ruin lives and shorten lives. We need better and more coordinated team-based care for diabetes -- so that we have half as many people in the kidney dialysis units. We also need a culture of health so that we have half as many people getting diabetes in the first place.

These are achievable goals. This is not an idealist dream. It is purely practical and tactical advice. What we are doing now is functionally bad for America. We can do better. Employees, government agencies, schools and unions in America should all embrace our nation doing what we need to do to create a culture of health.

We can make health care much more affordable in this country if we have half as many heart attacks and half as many strokes. We also need to help our people understand more clearly the real consequences of less healthy behaviors.

Fat Creates Dementia
Good research from the Kaiser Permanente database shows that people who have both high cholesterol levels and high levels of body fat in their mid 40's are more than twice as likely to have Alzheimer's in their 60's and 70's. Mid-life fat increases late life Alzheimer's and dementia by 360 percent. Dementia is another rapidly growing health problem for America. It turns out that excess weight and high cholesterol issues accelerate the risk of diabetes, heart disease, cancer, stroke and dementia.

That combination of facts should be widely shared -- and it should make people think very hard about how we can each be healthier.

The dementia data is chilling, all by itself.

Let's be honest.

It can be hard to do health improvement activities alone. We need to support each other in improving our collective health. The Finns have proven that health improvement is easier to do together... and that people can encourage, support and reinforce each other's healthy behaviors -- and the Finns have shown that is more likely to happen when a country is mutually and collectively committed to creating a culture of health.

Why is that relevant to health care reform?

Let's include actual health in our overall congressional agenda to reform health. We need to cover everyone. Then we need to make the care we need more affordable by reducing the amount of care we need.

That's an absolute win win outcome.

It's a two-track agenda -- both tracks should be tightly linked.

Let's cover everyone -- and then let's create a national culture of health so we can afford to cover everyone.

 

Comments

[Martin 27514]

Chronic diseases are largely prevented through diet (eat nothing with a bar code) and exercise (x2 episodes of 30 minutes per day)
The mechanisms have been elusive but recent publications suggest they operate through the autonomic nervous system - those nerves that supply your organs. Persistent straining during defecation and during labour injure these nerves - as does surgery. Drugs, tobacco, alcohol, infection, etc exacerbate the problems.
Most Western diseases (as defined by DP Burkitt, 1971) are preventable with adjustments to diet, bowel habit, exercise, childbirth, posture and gait. Get off as many meds as you can - many have bad effects on autonomic nerves. Avoid tobacco and alcohol.
Acknowledgements.
John Robbins. Santa Cruz, CA www.healthyat100.com
Tom Harkins, (D-Iowa) www.senate.gov
Professor Jane Plant www.janeplant.co.uk

[jgrh]

The Finland information is very interesting. I live in Seattle, where most of the people, at least the ones I know, are healthy. When I decided it was time to climb out of my stupor and get in shape and lose weight, I ran through my mental rolodex and realized that I only knew one fat person and didn't know one single smoker. I recently took a trip to the east coast and my flight was routed through Milwaukee both directions. I saw at least 20 hugely obese people there, just in the airport. It really struck me how the cultural norm affects people and that change is possible if society addresses it. Thanks for the informative article.

[SeaBlood]

My health insurance company should be applauded. For years I was overweight, with high lipids, high BP and PAD. Did they drop me? No, they assigned me a coach who phones me every week to make sure I'm keeping to my health goals. So far it's working like a charm; I lost almost 50 lbs and soon feel like I can lose another 50 ! A little bit of accountability ( setting up my diet and exercise program} is doing the tick for me. Try it.

[kapalabhati]

And in the weather News of the Obvious, today will be light followed by dark.

[LarryMatt]

I did a quick look at the North Karelia Project from Finland that began in 1972. It was mainly a local community effort to combat heart diseases. It expanded throughout the country. They kept meticulous records on everyone. All records are on computer and not stuffed in a personal folder. They dropped the mortality rate from heart disease by 57% from 1970 to 1992. It has continued to drop.
They created a culture to avoid fats like butter and sausage and increased their intake of fruits from 20 kg per person in 1972 to over 50 kg today. They reduced sharply their consumption of sugar. Smoking dropped drastically. They got support from and communicated with the WHO consistently. We are beginning this same movement in the US but only in the more affluent populations. Poor inner city residents are most at risk here. They have little access to fresh fruits and vegetables because of the profit motive, few large grocery stores choose to operate in poor neighborhoods.
It will take a huge effort by community support groups to infiltrate our schools to create this movement. With 1 out of 3 children born in the US now destined to be a diabetic, it is past time to act. The profit motive in our society is the roadblock. Groups like Acorn must be allowed to thrive and be supported by our government. As long as we look at community activist as the devil , we are lost.

[benne]

're getting more of these articles -- blaming the fat -- as we get nearer to healthcare reform? Hey, heathcare costs rise as the obese profits of big-pharma and health insurance rises. It's so much easier to blame the fatties.

[khanti]

Must be those hamburgers, pizzas and hotdogs. The thin piece of lettuce and slice of tomato in your hamburger gives you false consolation that it is a balanced meal.

[ElMagnifico]

I've lost over 60 lbs thanks to the raw diet. my blood pressure is normal now and my diabetes is gone!

[LOCUTUS13]

I've lost 30lbs and also lowered my triglycerides, cholesterol levels and blood pressure by EXERCISE and avoiding fast foods. No radical change of diet except I now go for fresh foods and a slight decrease in meat and increase in vegetables. By cooking for myself I find that I enjoy the food more due to the spices I use and now find restaurant food bland and tasteless. There is a mistaken belief that diet is most the effective way for weight control but studies have proven that EXERCISE is the most effective way to control weight. Take a look at persons in the military who take on over 4,000 calories per day during basic training and still loose weight and lower blood pressure. If it didn't work the military wouldn't use it.

[1Duckie]

Yet another reason we need better control of insurance companies. I pay very good money for health care. I rarely am sick but due to several factors I am overweight..
Unlike my co-workers who were chunky deliberately gained over 200 lbs so they could get a free surgery to reduce the size of their intestines, I wanted assistance to help keep me on track without surgery.

Health care companies will not cover diet plans unless you at risk. I am currently seeing a doctor for weight control and paying $60 cash for prescription and $40 twice a month for a simple weigh in... every 2 months I pay $170 for blood work.. and $350 a month for my health care plan.. go figure.

[sonoffestus]

This is a great read and thank you.

Unfortunately, there are many Americans who would feel their personal liberties were being threatened if such things as sin taxes were levied against unhealthy foods, such as sodas, tobacco, alcohol, etc.. Folks are screaming now about the proposed soda tax.

I am continually amazed at how many folks work against their own self interest and well being. I would hope things change ,but I am doubtful they will.

[Catothemuchyounger]

They shoudl be screaming about the kinds of taxes you suggest. There are millions of people who are in decent shape and eat such things in moderation. Why the heck should they be taxed at exorbitant rates because there are other people who eat too much and don't exercise?

I am all for supporting exercise and the eating of healthy foods. But I draw the line at across the board sin taxes and the like. And I draw the line at policy that assumes we are all without free will or responsibility for ourselves.

All that is really needed is to up the exercise level. I dropped over 25 lb.s a few years back by cutting down on junk food (NOT cutting it out) and following decent weight lifting programs. Its not rocket science, and it does not require deprivation. It just requires consistent effort over time.

[bthechangeyouseek]

Well written, but is it from the heart?

[GodYesOrNo]

So why aren't we putting a stop to genetically modified this & growth hormone pumped that?
GodYesOrNo.com

[Aesthete]

I have lost over 25 pounds in four months and feel like a new person. My energy and endurance levels have soared. With the increased energy I am able to do more walking and get more exercise. I accomplished the weight loss by 1) restricting carbohydrates to no more than 45 grams per meal, 2) completely eliminating high fructose juices and soda pop, 3) controlling portion size, and 4) scrupulous examination of nutrition content on labels when grocery shopping. I don't feel at all deprived of anything. It's amazing how delicious a piece of fresh fruit tastes when excess sugar has been scrubbed from your daily diet. As an added bonus, being a woman, I look so much more attractive and clothes I was about to give away now fit attractively. It's even possible to enjoy cookouts and holidays without "pigging" out.

[CR46]

Congrats on your healthier lifestyle. I am sure the "change" in how you feel has been worth it :)

[mlaiuppa]

I used to be quite active. Now I'm pretty inert.

I used to be a normal weight. I've gained 60 lbs in 6 years.

I've been complaining to my Dr. for 12 years as I've slowly slowed down and gained weight. He said "You are getting old, you know" (I was 43), "You are overweight, you know" (I am *now) and "Bad genes".

My cardiologist just diagnosed me with Dyspnea.

Not everyone is inert and overweight just because they eat a lot. I eat healthy, don't overeat and don't snack. I'm just so tired all of the time and feel like I can't take in enough oxygen to sustain even the simplest of exercise, like walking around the block. Is sleeping 9 hours at night and then napping for another 2 normal?

Heart disease runs in my family. And I have reason to believe that the reason I've slowed down to inert and the reason I've gained weight to obese is because my Doctor ignored my family history and didn't listen to me all of the years I've been complaining about being tired, lacking energy and stamina.

And did I mention the high cholesterol (genetic on both sides of my family) that went untreated for years? No amount of diet and exercise could get it below 300 and still it went untreated for over 5 years. And then unmanaged (mid 200 with generic statins) for another 5 years.

I'll be getting a CT scan next week.

[Aesthete]

Look for a new doctor.

[ddanimal]

Do you have mercury amalgam tooth fillings? Root canals?

[DennyCrane]

Americans respond when there's money involved. It'll never happen, but imagine if people had to pay for their own health care. Then they'd think twice before having that burger, drinking that beer, or skipping that workout. When you realize you'll be paying for your own care, not some insurance company or even the government, you'll take more responsibility. As much as we complain about insurance companies, too many of us use them as a crutch. We know we're slowly killing ourselves with fast food and no exercise. But when we think about what might happen someday, we just shrug and say, "at least I have insurance."