The Bulging Costs Of America's Obesity Epidemic

Tyler Durden's picture

A month ago we chronicled what we consider one of the biggest problems for America's long-term viability in "No Country For Thin Men: 75% Of Americans To Be Obese By 2020" which goes straight to the heart of the biggest shortfall in America's balance sheet: the net present value of future spending associated with Medicare and various other healthcare related programs, which will sadly only rise as more and more Americans become morbidly obese, and demand more expensive health service out of the piggy bank that even now has tens of trillions in unfunded liabilities. And while the future is certainly not bright, the past and present are just as bleak. A Reuters report focuses on just how it is that America got to where it is today (most likely sitting in front a computer, eating potato chips and drinking sugar-laden soda): "The percentage of Americans who are obese (with a BMI of 30 or higher) has tripled since 1960, to 34 percent, while the incidence of extreme or "morbid" obesity (BMI above 40) has risen sixfold, to 6 percent. The percentage of overweight Americans (BMI of 25 to 29.9) has held steady: It was 34 percent in 2008 and 32 percent in 1961. What seems to have happened is that for every healthy-weight person who "graduated" into overweight, an overweight person graduated into obesity." Which is not surprising: with pink and white slime food substitutes (as an example) allowing more and more low income individuals to drown their sorrows in fat (aka high calorie dollar meals) it was only a matter of time. Sadly, there is nothing in the equation that indicates this is set to change any time soon, even as the all too real costs, to both the individual and to society, mount in an exponential manner.

Here is a sample of how America's obesity epidemic is causing not just the average circumference of Americans to explode, but also how it is sending private and public sector costs and expenses through the stratosphere:

  • U.S. hospitals are ripping out wall-mounted toilets and replacing them with floor models to better support obese patients.
  • The Federal Transit Administration wants buses to be tested for the impact of heavier riders on steering and braking.
  • Cars are burning nearly a billion gallons of gasoline more a year than if passengers weighed what they did in 1960.
  • Because obesity raises the risk of a host of medical conditions, from heart disease to chronic pain, the obese are absent from work more often than people of healthy weight. The most obese men take 5.9 more sick days a year; the most obese women, 9.4 days more. Obesity-related absenteeism costs employers as much as $6.4 billion a year, health economists led by Eric Finkelstein of Duke University calculated.
  • The very obese lose one month of productive work per year, costing employers an average of $3,792 per very obese male worker and $3,037 per female. Total annual cost of presenteeism due to obesity: $30 billion.
    • Obese men rack up an additional $1,152 a year in medical spending, especially for hospitalizations and prescription drugs, Cawley and Chad Meyerhoefer of Lehigh University reported in January in the Journal of Health Economics.
    • Obese women account for an extra $3,613 a year. Using data from 9,852 men (average BMI: 28) and 13,837 women (average BMI: 27) ages 20 to 64, among whom 28 percent were obese, the researchers found even higher costs among the uninsured: annual medical spending for an obese person was $3,271 compared with $512 for the non-obese.
  • Nationally, that comes to $190 billion a year in additional medical spending as a result of obesity, calculated Cawley, or 20.6 percent of U.S. health care expenditures.

And guess who ends up eating (no pun intended) the shortfall? You:

  • Those extra medical costs are partly born by the
    non-obese, in the form of higher taxes to support Medicaid and higher
    health insurance premiums. Obese women raise such "third party"
    expenditures $3,220 a year each; obese men, $967 a year, Cawley and
    Meyerhoefer found.

That is only the beginning:

The startling economic costs of obesity, often borne by the non-obese, could become the epidemic's second-hand smoke. Only when scientists discovered that nonsmokers were developing lung cancer and other diseases from breathing smoke-filled air did policymakers get serious about fighting the habit, in particular by establishing nonsmoking zones. The costs that smoking added to Medicaid also spurred action. Now, as economists put a price tag on sky-high body mass indexes (BMIs), policymakers as well as the private sector are mobilizing to find solutions to the obesity epidemic.

The private sector is starting to take steps to trim America's fat, so to say, with negative reinforcement:

The U.S. health care reform law of 2010 allows employers to charge obese workers 30 percent to 50 percent more for health insurance if they decline to participate in a qualified wellness program. The law also includes carrots and celery sticks, so to speak, to persuade Medicare and Medicaid enrollees to see a primary care physician about losing weight, and funds community demonstration programs for weight loss.

Naturally, in a country which loathes negative reinforcement more than anything (as it involved work to undo retroactive shortfalls), cries of discrimination against fat people are reaching fever pitch:

Such measures do not sit well with all obese Americans. Advocacy groups formed to "end size discrimination" argue that it is possible to be healthy "at every size," taking issue with the findings that obesity necessarily comes with added medical costs.

Oddly enough, nobody had a problem with smokers being stigmatized: after all while eating is optional, even stuffing your mouth with the worst filth imaginable, it is simply unamerican to blame someone for eating. Smoking is a different matter entirely. Yet when one cuts to the chase, smoking is a far lower financial drag on society than fatness (sic):

One recent surprise is the discovery that the costs of obesity exceed those of smoking. In a paper published in March, scientists at the Mayo Clinic toted up the exact medical costs of 30,529 Mayo employees, adult dependents, and retirees over several years.


"Smoking added about 20 percent a year to medical costs," said Mayo's James Naessens. "Obesity was similar, but morbid obesity increased those costs by 50 percent a year. There really is an economic justification for employers to offer programs to help the very obese lose weight."

And here we get into some rather Mengelian demographic reverse eugenics:

For years researchers suspected that the higher medical costs of obesity might be offset by the possibility that the obese would die young, and thus never rack up spending for nursing homes, Alzheimer's care, and other pricey items.


That's what happens to smokers. While they do incur higher medical costs than nonsmokers in any given year, their lifetime drain on public and private dollars is less because they die sooner. "Smokers die early enough that they save Social Security, private pensions, and Medicare" trillions of dollars, said Duke's Finkelstein. "But mortality isn't that much higher among the obese."

In other words, those damn fat people just refuse to die. One is unsure whether to laugh or cry that this is the kind of prudent financial analysis that would carry tens, if not hundreds of trillions in unfunded medical costs. And yet, that's precisely what it is.

Where one does have to laugh is when extrpolating physical events as a result of obesity. Such as gas prices.

Some costs of obesity reflect basic physics. It requires twice as much energy to move 250 pounds than 125 pounds. As a result, a vehicle burns more gasoline carrying heavier passengers than lighter ones.


"Growing obesity rates increase fuel consumption," said engineer Sheldon Jacobson of the University of Illinois. How much? An additional 938 million gallons of gasoline each year due to overweight and obesity in the United States, or 0.8 percent, he calculated. That's $4 billion extra.

It gets better:

The built environment generally is changing to accommodate larger Americans. New York's commuter trains are considering new cars with seats able to hold 400 pounds. Blue Bird is widening the front doors on its school buses so wider kids can fit. And at both the new Yankee Stadium and Citi Field, home of the New York Mets, seats are wider than their predecessors by 1 to 2 inches.


The new performance testing proposed by transit officials for buses, assuming an average passenger weight of 175 instead of 150 pounds, arise from concerns that heavier passengers might pose a safety threat. If too much weight is behind the rear axle, a bus can lose steering. And every additional pound increases a moving vehicle's momentum, requiring more force to stop and thereby putting greater demands on brakes. Manufacturers have told the FTA the proposal will require them to upgrade several components.

Leave it to Keynesians to justify away fatness:

"Yes, a heart attack will generate economic activity, since the surgeon and hospital get paid, but not in a good way," said Murray Ross, vice president of Kaiser Permanente's Institute for Health Policy. "If we avoided that heart attack we could have put the money to better use, such as in education or investments in clean energy."

From Broken Window to Busted Ticker falacy. Brilliant.

The best news, however, is that at least the fat are as docile as Hindu cows (just before they are eaten in the local McDonalds):

The books on obesity remain open. The latest entry: An obese man is 64 percent less likely to be arrested for a crime than a healthy man. Researchers have yet to run the numbers on what that might save.

And so it goes on.

As noted, while we are unsure whether to laugh or cry, the sad conclusion sticks out like an overflowing midsection: spending related to America's obesity epidemic will merely continue to rise. One can argue about the behvioral reasons for this propensity of Americans to chew the fat until one is blue in the face, but the truth is that until cheap, low quality food is easily accessible, as long as a sedentary lifestyle is dominant (and with more and more working in front of a computer all day long this won't change any time soon), and as long as healthcare is supposedly prefunded and exists to everyone, the problem will only get worse.

So go out, have that $0.99 cent meal, and enjoy life. Because a stray heart attack is only a few cholesterol molecules away.

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cossack55's picture

Damnit. I had to actually put down my Big Mac in order to type this stupid comment.

Seorse Gorog from that Quantum Entanglement Fund. alright_.-'s picture

You're wasting precious chewing energy. Back to work, son.

bigdumbnugly's picture

dam they cut off the head in that photo.

i'm betting it's hillary.

5880's picture

could I get her #? Please?

Clueless Economist's picture

She is a fine example of the newly discovered species...Obestius Americanus

The Big Ching-aso's picture



"Fat in eye of defolder."


Bicycle Repairman's picture

Yaaaaay, blame the fatties.  Get them!!!!!

"But mortality isn't that much higher among the obese."

Then it's clear what must be done.  Yaaaaayyyy!!!!!!

mophead's picture

If we avoided that heart attack we could have put the money to better use, such as in education or investments in clean energy.

What if the education system doesn't need anymore money and if global warming is a fraud, will the Keynesians openly proclaim that heart attacks are good for the economy? Will they finally admit that they're evil sons of bitches?

The books on obesity remain open. The latest entry: An obese man is 64 percent less likely to be arrested for a crime than a healthy man. Researchers have yet to run the numbers on what that might save.

If you think about it, masturbation is likely linked to lower rape crimes. Tax credit for masturbating US citizens?

AldousHuxley's picture

no healthcare for

  • obese
  • smokers
  • alcoholics
  • drug addicts
  • school drop outs
prole's picture

How about just "no free healthcare?"

Solves the entire problem before it can get started. This little article is meaningless outside a Communist system. It veritably assumes Collectivism. Kind of like all your posts "Aldo"

pods's picture

So you are in favor of making decisions denying what two private individuals may contract to?

Point noted.


fockewulf190's picture

It isn't just happening in the US. Germans are also turning into blobs at ever increasing rates. If you go into a typical grocery store such as Aldi, Norma or Lidl, damn near everything for sale has sugar added to it. Do you really need to add sugar to sliced pineapples in a can? Corn too?

A few other certainties. The airlines are doomed. 2XL and 3XL will be normal sizes. Medicare and Medicaid will collapse sooner than anyone is currently forcasting. Pet obesity will also explode. The sizes of western military armies will shrink alarmingly as physically suitable recruits become harder and harder to find (already a big problem for the US Army).

mophead's picture

The startling economic costs of obesity, often borne by the non-obese, could become the epidemic's second-hand smoke. Only when scientists discovered that nonsmokers were developing lung cancer and other diseases from breathing smoke-filled

Smoking causes lung cancer?? Haaaaaahaha...


The Big Ching-aso's picture



In a fat enough timeline we all end up bone-white thin.

Bicycle Repairman's picture

Yes.  The diet doc diet.  Herman Tarnower now 30 lbs AND LOSING!!!!!!!!!!!!!

BeetleBailey's picture

Related to the


Adiposius OhMyGawdous

and the

Lardorumptus Thunderthighus


FeralSerf's picture

The number of that beast is 666.

Dr. Engali's picture

Too small  and not butch enough  for Hillary.

The Big Ching-aso's picture



Meals on Wheels will soon be 3x a day wheelbarrows to your doorstep.

Badabing's picture

We get fed pink slime and then they wonder why we’re fat.

Grind all the fat people into pink slime!!

t_kAyk's picture

Then you just have pink slime eating pink slime, the same way that mad cow disease started. 


odatruf's picture

Don't be a victim. No one is shoving that shit down your or anyone else's throat. The fat fucking fucks gobble it up willingly.

Sgt.Sausage's picture

Correction: You CHOOSE 'Pink Slime'.

There are plenty of alternatives to choose from. Choose wisely, young Grasshopper, and some day you may leave the Temple.



francis_sawyer's picture

A new study testing the limits of what people will eat...


Summary: 'Anything... with melted cheese on it'...

duo's picture

unfortunately, once you've given yourself diabeties or metabolic syndrome, and screwed up your endocrine system with HFCS and GMO foods, you can't undo most of the damage, and purging the toxins and their effects usually requires effort, discomfort, and possibly sweating.

The food industry and Monsanto have created a health crisis.  Why you would want to poison your "customers" (read: slaves) is beyond me, but it seems to be a profitable business model with the government's help.

mophead's picture

That's not why it's profitable. It's profitable because people are stupid enough to believe that eating the "wrong" kinds of foods will lead to disease.

smiler03's picture

As much as I hate Monsanto I wouldn't blame them (except for corn). The whole world has an obesity epidemic, including China but most European countries ban GM foods.

George Washington posted an interesting article on ZH a while back regarding toxic chemicals linked to fat pets and 6 month old infants. I can't find the ZH link but GWs blog has it:

TBT or not TBT's picture

The main correlation of interest is between simple/refined carbohydrate consumption, and just about every major degenerative disease, including the obvious outward symptom, obesity.     

The GMO's are just an additional twist of the same deadly screw:  cheap carbohydrates.  

Matt's picture

High Fructose Corn Syrup is a big one. Cane sugar has been around for quite some time, but the epidemic levels of obesity are much more recent.

Glucose-Fructose does not digest the same as sugar at all; it suppresses the signals that tell you that you are full, scars the liver, and some of it converts directly into fat inside the liver.

Best of all, it is in nearly everything.

short 1 minute version:

Long 80 minute version:

mophead's picture

Five thumbs down and not a single person can post a link showing that eating certain foods causes disease.

Where are the studies? Where is the scientific proof?

Answer: there are no studies that show scientific proof of any kind. It's another BIG LIE.

Food does not cause disease, no matter how bad it is, no matter how often you've consumed it. That is a fact. 100% scientifically provable.

dolly madison's picture

Here ya go:

Any form of free glutamate will do, not just MSG.  Here's a list of the ingredients used to increase free glutamate levels while maintaining a clean label:

mophead's picture

I see no references to scientific studies relating to human disease, only mice. Sigh. And the second link doesn't even contain the word "disease".

Studies...anyone? Scientific??? Any takers?

Harbanger's picture

How often do you get fed?

tempo's picture

When your bored and don't work, what else is there to do except eat comfort cheap junk food. Its the only way to escape from reality.

Hippocratic Oaf's picture

Its the only way to escape from reality.


Apparently you have never heard of weed.

prole's picture

When your bored and don't work, what else is there to do except eat comfort cheap junk food. Its the only way to escape from reality.

You talking to me? Are you talking to me?

That comment should only apply to the shifless and useless. Ever heard of working out? Ever heard of cooking your own healthy food?

Max Fischer

Civis Obesitus

Harbanger's picture

I wouldn't be surprised if she's on Food Stamps.

Miffed Microbiologist's picture

True. However if this were a picture of an individual at the turn of the century you would have assumed this was someone very wealthy. Speaking as an person who 5 years ago was on my way towards this shape I can attest to the fact my food bill was much cheaper at that time. Even taking inflation into account, I pay more than double for our non processed, home cooked, mostly organic food. At least giving up all my medications makes up for some part of the monthy expense and being in better health at 51 than I was at 25 certainly is a perk. Being healthy today,unfortunately, is just very expensive.


Harbanger's picture

I think what you're experiencing is price inflation in food.  There's no way (apples to apples) home cooked food is more expensive than buying prepared food.  Organic or not.

TBT or not TBT's picture

And simple carbs are cheaper than fats or protein, which is why poorer people tend to be fatter people.  

Wealthier people choose more fat and protein, and less refined carbs and sugar, and are healthier for it.

TBT or not TBT's picture

No, since the advent of mass manufactured sugar and refined flour, obesity has been associated with poverty.    Sugar and flour product dates back a couple centuries in developed/western countries.   

Over the centuries, each human group that adopted these easy to store and ship, addictive, carbohydrate loaded foods developed "diseases of civilisation" that is to say diabetes, cancer, obesity, heart disease, high blood pressure, and so on.   


Each of us can experience what the days before civilisation were like by dropping carbs almost entirely from our diet for just a few weeks.

Steaming_Wookie_Doo's picture

As someone who also went from the obese to normal weight in 1 yr, yeah it may cost a bit more in terms of food cost (not eating cheap carbs all the time), but in terms of my ability to do more and feel really good all the time, such costs are minor. Plus the long term costs of avoiding diabetes, etc are savings I get to bank in the future.

And I can't avoid commenting on this bit:

"The books on obesity remain open. The latest entry: An obese man is 64 percent less likely to be arrested for a crime than a healthy man. Researchers have yet to run the numbers on what that might save."

So in order to empty out prisons, all we really need to do is get them completely hooked on supersized Cokes, double cheeseburgers, etc. Maybe even have fountain drink dispensers in their cells--they'll balloon up in no time. You're too fat to run from the cops, or even figure it's worth the effort to get up off the couch to even *try* to commit some mayhem. And, as a fat ex-felon, you'll be embraced by the rest of your fat community and the broader society. Everyone wins!

TBT or not TBT's picture

Cheap carbs are the principal problem here.

smiler03's picture

I cannot source this story as I can't find it but I believe it's true:

There is an American food agency that is succeeding in persuading more people to use skimmed and semi-skimmed milk. A positive thing for fighting obesity, you'd think. But..

There is another American food agency that promotes the consumption of dairy products. They found that farmers were being left with excess milk fat which they couldn't sell. This agency assists those farmers by helping them to make and sell more cheese.

I'm not sure what my point is but maybe there are too many government agencies interfering with Agriculture?