scholarly journals Who Pays for Obesity?

2011 ◽  
Vol 25 (1) ◽  
pp. 139-158 ◽  
Author(s):  
Jay Bhattacharya ◽  
Neeraj Sood
Keyword(s):  
Public Policy ◽  
Health Insurance ◽  
The United States ◽  
Self Control ◽  
Obesity Prevalence ◽  
Obese People ◽  
Obesity Epidemic ◽  
Positive Externalities ◽  
Starting Point ◽  
Prevalence Of Obesity

Adult obesity is a growing problem. From 1962 to 2006, obesity prevalence nearly tripled to 35.1 percent of adults. The rising prevalence of obesity is not limited to a particular socioeconomic group and is not unique to the United States. Should this widespread obesity epidemic be a cause for alarm? From a personal health perspective, the answer is an emphatic “yes.” But when it comes to justifications of public policy for reducing obesity, the analysis becomes more complex. A common starting point is the assertion that those who are obese impose higher health costs on the rest of the population—a statement which is then taken to justify public policy interventions. But the question of who pays for obesity is an empirical one, and it involves analysis of how obese people fare in labor markets and health insurance markets. We will argue that the existing literature on these topics suggests that obese people on average do bear the costs and benefits of their eating and exercise habits. We begin by estimating the lifetime costs of obesity. We then discuss the extent to which private health insurance pools together obese and thin, whether health insurance causes obesity, and whether being fat might actually cause positive externalities for those who are not obese. If public policy to reduce obesity is not justified on the grounds of external costs imposed on others, then the remaining potential justification would need to be on the basis of helping people to address problems of ignorance or self-control that lead to obesity. In the conclusion, we offer a few thoughts about some complexities of such a justification.

Abstract 17019: Obesity and Cardiovascular Health in Young American Adults

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sarabjeet S Suri ◽  
Vibhu Parcha ◽  
Rajat Kalra ◽  
Garima Arora ◽  
Pankaj Arora
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Cardiovascular Health ◽  
Piecewise Linear ◽  
The United States ◽  
Obesity Prevalence ◽  
Logistic Regression Models ◽  
Prevalence Of Obesity ◽  
Adjusted Logistic Regression ◽  
The Impact

Background: The growing epidemic of obesity in the United States (US) is associated with cardiovascular (CV) morbidity and mortality. We evaluated the impact of the increasing obesity prevalence on the CV health of young American adults. Methods: The age-adjusted weighted prevalence of hypertension, diabetes, and hypercholesterolemia was estimated from the 2008-2018 National Health and Nutrition Examination Survey (NHANES) in American adults aged 18-44 years, stratified by the presence of obesity. The trends were evaluated using a piecewise linear regression approach. The odds for CV risk factors were estimated using multivariable-adjusted logistic regression models. Results: Among 14,919 young adults, the prevalence of obesity was 33.9% (95% CI: 32.6-35.3%). Obese young adults were more likely to be non-Hispanic Blacks and in lower socioeconomic and educational attainment strata (p<0.05 for all). Obese young adults had a greater risk of having hypertension (adjusted odds ratio [aOR]: 3.0 [95% CI: 2.7-3.4]), diabetes (aOR: 4.3 [95% CI: 3.3-5.6]), and hyperlipidemia (aOR: 1.47 [95% CI: 1.3-1.7]). Among obese, hypertension increased from 36.5% (33.9-39.1%) in 2007-2010 to 39.4% (35.6-43.1%) in 2015-2018 (p= 0.07) and diabetes increased from 4.7% (3.6-5.8%) in 2007-2010 to 7.1% (5.3-9.0%) in 2015-2018 (p=0.11). A modest increase in diabetes was seen in non-obese individuals ( Table ). Hypercholesterolemia prevalence remained unchanged from 12.6% (95% CI: 10.6-14.7%) 2007-2010 to 10.9% (95% CI: 9.0-12.8%) in 2015-2018 (p=0.27) among obese young adults. Non-obese young adults showed a decline in hypercholesterolemia from 9.5% (95% CI: 8.0-11.0%) in 2007- 2010 to 7.1% (95% CI: 5.8-8.4%) in 2015-2018 (p=0.002). Conclusions: Nearly one-in-every three young American adults have obesity, which is accompanied by a two-fold higher prevalence of CV risk factors. The CV morbidity in young adults is expected to increase with an increasing prevalence of obesity..

Abstract MP10: Increasing Obesity Prevalence in the United States End-stage Renal Disease Population

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Brittany Shelton ◽  
Deanna McWilliams ◽  
Rhiannon D Reed ◽  
Margaux Mustian ◽  
Paul MacLennan ◽  
...  
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
The United States ◽  
Obesity Prevalence ◽  
The Us ◽  
Prevalence Of Obesity ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: Obesity has become a national epidemic, and is associated with increased risk for comorbid diseases including end-stage renal disease (ESRD). Among ESRD patients, obesity may improve dialysis-survival but decreases likelihood of transplantation, and as such, obesity prevalence may directly impact growth of the incident dialysis population. Methods: Incident adult ESRD patients with complete body mass index (BMI, kg/m 2 ) data were identified from the United States Renal Data System from 01/01/1995-12/31/2010 (n=1,822,598). Data from the Behavioral Risk Factor Surveillance System of the Centers for Disease Control and Prevention (n=4,303,471) represented the US population when weighted. Trends in BMI and obesity classes I (BMI of 30-34.9), II (BMI of 35-39.9), and III (BMI ≥40) were examined by year of dialysis initiation. Trends in median BMI slope were compared between the ESRD and US populations using linear regression. Results: Median BMI of ESRD patients in 1995 was 24.2 as compared to 28.0 in 2010, a 15.7% increase, while the US population’s median BMI increased from 24.2 in 1995 to 25.6 in 2010, a 5.8% increase. Comparable trends were noted with respect to prevalence of obesity classes I, II, and III (Table). BMI increase among the ESRD population was significantly more rapid than among the US population (β: 0.15, 95% CI: 0.14-0.17, p<0.001) (Figure). Conclusion: The median BMI of ESRD patients and prevalence of obesity among ESRD patients is increasing more rapidly than the US population. Given the increased dialysis-survival and decreased likelihood of transplantation associated with obesity, healthcare costs will likely increase, and thus, future research should be directed at examining medical expenditures.

scholarly journals Cross-Country Variation in Obesity Patterns among Older Americans and Europeans

2007 ◽  
Vol 10 (2) ◽  
Author(s):  
Pierre-Carl Michaud ◽  
Arthur H.O. van Soest ◽  
Tatiana Andreyeva
Keyword(s):  
Physical Activity ◽  
Economic Status ◽  
The United States ◽  
Calorie Intake ◽  
Obese People ◽  
Older Americans ◽  
Health Aging ◽  
Prevalence Of Obesity ◽  
The Difference ◽  
The Right

While the fraction of obese people is not as large in Europe as in the United States, obesity is becoming an important issue in Europe as well. Using comparable data from the Survey of Health, Aging and Retirement in Europe (SHARE) and the Health and Retirement Study in the U.S. (HRS), we analyze the correlates of obesity in the population ages 50 and above, focusing on measures of energy intake and expenditure as well as socio-economic status. We find that obesity rates differ substantially on both sides of the Atlantic and across European countries, with most of the difference coming from the right tail of the weight distribution. The well-known SES gradient in the prevalence of obesity differs across countries and cannot be fully explained by the variation in food expenditure or physical activity. Obesity is associated with lack of physical activity, calorie intake, time spent on cooking, and time and money spent on eating at home and away from home, but some of these associations vary across countries. More research is needed to analyze why this is the case.

scholarly journals Large heterogeneity of the obesity epidemic in Danish adults

2004 ◽  
Vol 7 (3) ◽  
pp. 453-460 ◽  
Author(s):  
Berit L Heitmann ◽  
Ulla Strøger ◽  
Kim L Mikkelsen ◽  
Claus Holst ◽  
Thorkild IA Sørensen
Keyword(s):  
Age Groups ◽  
Secular Change ◽  
Obesity Prevalence ◽  
Birth Cohorts ◽  
Linear Change ◽  
Cross Sectional ◽  
Men And Women ◽  
Obesity Epidemic ◽  
Increasing Trend ◽  
Prevalence Of Obesity

AbstractObjective:To examine to what extent the obesity epidemic is a general phenomenon in adults by assessing the secular change, by birth cohort and age, in the prevalence of obesity and median body mass index (BMI) in Danish men and women measured between 1964 and 1994.Design:Multiple cross-sectional population surveys.Setting:The greater Copenhagen area of Denmark.Subjects:The study included 17 065 men (30 336 observations) and 13 417 women (24 065 observations), aged 20–84 years.Main outcome measures:Trends in median BMI and prevalence of obesity estimated from measured height and weight in 10-year age groups.Results:In general the prevalence of obesity was increasing, although in an irregular way: among men in two phases, during the 1970s and 1990s and among women only during the 1990s. Great heterogeneity was observed between birth cohorts and age groups. There was only little indication of an increasing trend in obesity prevalence for women, except for the 55–64-year-olds. In men, the prevalence of obesity was increasing in all age groups except in the youngest ones, and it was statistically significant only for men aged 35–74 years. There was no significant linear change in median BMI in any group, except for an increasing trend among men aged 50 years and above.Conclusion:Although the overall Danish trend for obesity prevalence, similar to trends world-wide, showed a marked increase, the trend was very heterogeneous and generally neither uniform nor significantly positive; the changes were irregular, different among men and women, and different in the different age and birth cohorts. The obesity problem in middle-aged and older men of certain birth cohorts poses a specific public health challenge. Future studies of determinants behind the heterogeneity in the development of the obesity epidemic may provide clues to its causes.

scholarly journals The obesity epidemic – Nature via nurture: A narrative review of high-income countries

2020 ◽  
Vol 8 ◽  
pp. 205031212091826 ◽  
Author(s):  
Sarah E Jackson ◽  
Clare H Llewellyn ◽  
Lee Smith
Keyword(s):  
Body Weight ◽  
Energy Expenditure ◽  
Genetic Susceptibility ◽  
Obesity Prevalence ◽  
Rapid Rise ◽  
Obesogenic Environment ◽  
Obesity Epidemic ◽  
Global Epidemic ◽  
The World ◽  
Prevalence Of Obesity

Over the last three decades, the prevalence of obesity has increased rapidly in populations around the world. Despite a wealth of research, the relative contributions of the different mechanisms underlying this global epidemic are not fully understood. While there is growing consensus that the rapid rise in obesity prevalence has been driven by changes to the environment, it is evident that biology plays a central role in determining who develops obesity and who remains lean in the current obesogenic environment. This review summarises evidence on the extent to which genes and the environment influence energy intake and energy expenditure, and as a result, contribute to the ongoing global obesity epidemic. The concept of genetic susceptibility to the environment driving human variation in body weight is discussed.

Crime, Immigration, and Public Policy

2019 ◽  
pp. 163-184
Author(s):  
Michael Gottfredson ◽  
Travis Hirschi
Keyword(s):  
Public Policy ◽  
Control Theory ◽  
The United States ◽  
Crime Rates ◽  
Self Control ◽  
High Rate ◽  
Criminal Involvement ◽  
Theory Versus ◽  
Causes Of Crime ◽  
The Relationship

This chapter uses self-control theory to explain the generally low crime rates for immigrants in the United States. The benefits of control theory versus other common sociological theories of crime is demonstrated with contemporary and historical research on immigration and crime. The misinterpretation of the relationship historically in American criminology was used to support sociological perspectives on the causes of crime, such as cultural deviance and social disorganization, by implying a high rate of criminal involvement by immigrants. Modern research on causes and consequences of immigration disputes these earlier depictions and illustrates how characteristics of recent immigrants result in comparatively low crime rates, consistent with the theory of self control. The immigration–crime relationship illustrates the theory of self control and how the theory can be used for effective public policy.

scholarly journals Using Electronic Medical Record Data to Better Understand Obesity in Hispanic Neighborhoods in El Paso, Texas

2020 ◽  
Vol 17 (12) ◽  
pp. 4591
Author(s):  
Jennifer Salinas ◽  
Jon Sheen ◽  
Malcolm Carlyle ◽  
Navkiran Shokar ◽  
Gerardo Vazquez ◽  
...  
Keyword(s):  
Hot Spot ◽  
El Paso ◽  
Delayed Diagnosis ◽  
Positive Association ◽  
The United States ◽  
Median Income ◽  
Obesity Prevalence ◽  
Ethnic Concentration ◽  
Prevalence Of Obesity ◽  
El Paso County

The prevalence of obesity has been persistent amongst Hispanics over the last 20 years. Socioeconomic inequities have led to delayed diagnosis and treatment of chronic medical conditions related to obesity. Factors contributing include lack of insurance and insufficient health education. It is well-documented that obesity amongst Hispanics is higher in comparison to non-Hispanics, but it is not well-understood how the socioeconomic context along with Hispanic ethnic concentration impact the prevalence of obesity within a community. Specifically studying obesity within Hispanic dominant regions of the United States, along the Texas–Mexico border will aid in understanding this relationship. El Paso, Texas is predominantly Mexican-origin Hispanic, making up 83% of the county’s total population. Through the use of electronic medical records, BMI averages along with obesity prevalence were analyzed for 161 census tracts in the El Paso County. Geographic weighted regression and Hot Spot technology were used to analyze the data. This study did identify a positive association between Hispanic ethnic concentration and obesity prevalence within the El Paso County. Median income did have a direct effect on obesity prevalence while evidence demonstrates that higher education is protective for health.

Trends in obesity among patients registered to SWOG cancer clinical treatment trials.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 126-126
Author(s):  
Riha Vaidya ◽  
Cathee Till ◽  
Heather Greenlee ◽  
Dawn L. Hershman ◽  
Joseph M. Unger
Keyword(s):  
Clinical Trials ◽  
Linear Trend ◽  
The United States ◽  
Clinical Treatment ◽  
Research Network ◽  
Good Representation ◽  
Obesity Prevalence ◽  
Treatment Trials ◽  
Treatment Type ◽  
Prevalence Of Obesity

126 Background: Rising obesity rates have been documented in the United States population since the 1980s. Several studies have shown links between obesity and the incidence of – and the outcomes of – specific cancer types. Few studies have examined the prevalence of obesity among cancer patients at the time of diagnosis or among those who participate in clinical trials. We examined the prevalence of obesity over a 35-year period among patients enrolled in clinical treatment trials conducted by the SWOG Cancer Research Network. Methods: We analyzed body mass index (BMI) at registration among patients enrolled in phase II or III clinical trials conducted by SWOG. Adult patients (age≥18) participating in trials in obesity-related cancers between 1985 and 2020 were included. Obesity was classified as BMI ≥ 30 kg/m2. Multivariable logistic regression was used to examine time trends, adjusting for age, sex, race, and treatment type. Time was defined as year of enrollment and examined in separate models as continuous years and as 5-year intervals. We examined trends among patient subgroups by sex and by treatment type (chemotherapy, immunotherapy, and targeted therapy). Results: 16,374 patients enrolled in SWOG clinical trials conducted between 1985 and 2020 were analyzed. Patients were most commonly enrolled in trials for breast cancer (n = 6,327, 38.6%), colon cancer (n = 2,408, 14.7%), multiple myeloma (n = 2,112, 12.9%), and rectal cancer (n = 1,785, 10.9%). Overall, 32% of patients were obese (n = 5,252). Unadjusted obesity rates among trial participants increased from 18% in 1985-1990 to 42% in 2016-2020, compared to an increase from 23% to 42% among US adults over a similar period. Obesity prevalence rates increased over time for all sex, age, and race subgroups. Overall, there was an increasing linear trend in obesity (OR = 1.36 for each 5-year increase, 95% CI: 1.33-1.39, p < .0001). These trends persisted with adjustments for age, sex, race, and treatment type (OR = 1.35 per 5-year increase, 95% CI: 1.31-1.39, p < .0001). Positive linear trends in obesity prevalence were observed for all subgroups by sex and treatment type. There was no evidence of difference in trends between males and females or between the three treatment types. Conclusions: We observed an increasing trend in obesity among patients participating in clinical trials for obesity-related cancers, mirroring US adult obesity rates. Our findings indicate good representation of obese patients in clinical treatment trials, which has favorable implications for the applicability of trial findings to this group of patients.

scholarly journals Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic

2020 ◽  
Vol 49 (3) ◽  
pp. 810-823 ◽  
Author(s):  
Youfa Wang ◽  
May A Beydoun ◽  
Jungwon Min ◽  
Hong Xue ◽  
Leonard A Kaminsky ◽  
...  
Keyword(s):  
United States ◽  
Central Obesity ◽  
The United States ◽  
Obesity Prevalence ◽  
Obesity Epidemic ◽  
Geographical Regions ◽  
Future Situation ◽  
Meta Regression Analysis ◽  
National Databases ◽  
Analysis Models

Abstract Background Obesity (OB) is a serious epidemic in the United States. Methods We examined OB patterns and time trends across socio-economic and geographic parameters and projected the future situation. Large national databases were used. Overweight (OW), OB and severe obesity (SOB) were defined using body mass index cut-points/percentiles; central obesity (CO), waist circumference cut-point in adults and waist:height ratio cutoff in youth. Various meta-regression analysis models were fit for projection analyses. Results OB prevalence had consistently risen since 1999 and considerable differences existed across groups and regions. Among adults, men’s OB (33.7%) and OW (71.6%) levelled off in 2009–2012, resuming the increase to 38.0 and 74.7% in 2015–2016, respectively. Women showed an uninterrupted increase in OB/OW prevalence since 1999, reaching 41.5% (OB) and 68.9% (OW) in 2015–2016. SOB levelled off in 2013–2016 (men: 5.5–5.6%; women: 9.7–9.5%), after annual increases of 0.2% between 1999 and 2012. Non-Hispanic Blacks had the highest prevalence in women’s OB/SOB and men’s SOB. OB prevalence in boys rose continuously to 20.6% and SOB to 7.5% in 2015–2016, but not in girls. By 2030, most Americans will be OB/OW and nearly 50% of adults OB, whereas ∼33% of children aged 6–11 and ∼50% of adolescents aged 12–19 will be OB/OW. Since 1999, CO has risen steadily, and by 2030 is projected to reach 55.6% in men, 80.0% in women, 47.6% among girls and 38.9% among boys. Regional differences exist in adult OB prevalence (2011–2016) and across ethnicities; South (32.0%) and Midwest (31.4%) had the highest rates. Conclusions US obesity prevalence has been rising, despite a temporary pause in 2009–2012. Wide disparities across groups and geographical regions persist. Effective, sustainable, culturally-tailored interventions are needed.

scholarly journals OBESITY AND TIME PREFERENCE: THE HEALTH CONSEQUENCES OF DISCOUNTING THE FUTURE

2008 ◽  
Vol 40 (1) ◽  
pp. 97-113 ◽  
Author(s):  
LEI ZHANG ◽  
INAS RASHAD
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Time Preference ◽  
Positive Association ◽  
The United States ◽  
The Body ◽  
Self Control ◽  
Policy Implications ◽  
Obesity Epidemic ◽  
Commitment Devices

SummaryMuch focus has been placed on the obesity epidemic due to its high prevalence and the costs it imposes on society. Using 2004 data from the Roper Center, complemented with 2003 data from the Behavioural Risk Factor Surveillance System, this study analyses the possible effect that time preference has on health in the United States, as measured by the body mass index. After controlling for a variety of covariates and correcting for potential selectivity, some evidence of a positive association between time preference for the present and the body mass index can be found, particularly for males. Research in this area has policy implications in terms of creating incentives for those who lack self-control through the use of pre-commitment devices. Measures addressing self-control issues may be more effective in reducing the rising obesity rates across the world.

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