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Children's Health

Expanding Waistlines Drive Increases in Obesity Rate

A new report looks a the rapidly increasing rate of obese people in North Carolina, and calculates the stunning cost of doing nothing.

By Rose Hoban

$17.6 billion.

It’s a number that always makes Ruth Peterson go back and check it before she talks about it – this estimate of the annual cost to North Carolina as a result of people just carrying around too much weight.

Obese couple

The Trust for America’s Health estimates that 58 percent of North Carolinians will be obese by 2030 if current trends continue. Photo courtesy Tobyotter, Flickr Creative Commons

And that doesn’t take into account the costs of people being out of shape or poor nutrition, which together add an additional $10 billion to that tab.

“Those numbers are so large that I don’t trust my memory whenever I need to talk about it,” said Peterson, who is the chief of the chronic disease and injury section of North Carolina’s Division of Public Health.

Right now, 29.1 percent of people in the state are obese, but that number is due to rise, according to a new report out Tuesday.

Projections done by the Trust for America’s Health, estimate that about 58 percent of North Carolina residents will be obese by 2030 if current trends continue.

And that would cost a lot more money than it does now, according to the report.

Numbers tell the tale

A combination of factors of modern American life – lack of exercise, fast food and the layout of suburban housing – has created a “perfect storm” that has resulted in the current rates of excessive weight in the U.S., according to Michelle Larkin from the Robert Wood Johnson Foundation, which funded the TFAH study.

The extra weight being carried around by North Carolinians results in a host of additional health problems, adding cost to the health care system and lost dollars in the form of reduced productivity and absenteeism.

If trends in north Carolina continue, by 2030, the state could have:
new cases of Type 2 Diabetes 1,217,093
new cases of Heart Disease & Stroke 2,572,272
new cases of High Blood Pressure 2,413,521
new cases of Arthritis 1,572,931
new cases of Cancer 362,984
as a result of increased rates of obesity. Data, TFAH

The report estimated that if obese people lowered their body mass index (a calculation that combines weight and height) by 5 percent, it could save billions in health care spending.For example, a 250-pound, six-foot-tall man would only need to lose 13 pounds to reduce his BMI by 5 percent. A BMI of 30 is considered the threshold for obesity; “normal” BMI is between 18 and 25.

“We’re not talking about huge changes, but small changes that produce big outcomes,” said TFAH head Jeffrey Levi during a conference call for reporters.

Getting kids moving

A big portion of the TFAH report focused on helping kids get to and stay at healthier weights. In 1980, only 6.5 percent of children under 18 were obese. Now that rate is more than 19 percent.

CDC Obesity Map - 2004 - 2009

Map/ data courtesy of the Centers for Disease Control and Prevention

The report also calculated that health care costs could decrease by more than $21 billion over the next 20 years if people in North Carolina reduced their BMI by 5 percent.

Levi said that a combination of factors has contributed to childhood obesity, including fewer minutes of physical education in schools, fewer opportunities for children to walk to school and increased consumption of sugary sodas.

“Preventing obesity in kids is going to have the biggest payoff,” Levi said, noting that it’s cheaper to prevent children from becoming fat than to treat those who are.

But Levi admitted it can be a hard sell in a down economy.

In North Carolina, the General Assembly reduced dollars for obesity prevention in last year’s budget. And funds for prevention took another big hit in this year’s budget.

“Where we’re seeing the greatest success is where states and communities are trying things together, things like making it easier for children to walk to school, creating places to exercise and be physically active [and] have access to healthy and affordable foods,” Michelle Larkin said.

Combination of fixes

“The thing that resonates for me is that there’s no silver bullet to resolving the problem of obesity,” Larkin said.

That sentiment was echoed by Ruth Peterson, who said North Carolina is taking a multi-pronged approach to tackling obesity.

Peterson said the Division of Public Health has been doing a lot of work with several state departments, including Transportation, Environment and Natural Resources, Commerce and Public Instruction.

“There’s a clear strategic plan that all these agencies have to try to change the local environments,” she said. “I know it sounds so hokey, but we have to make access to physical activity and better nutrition the de facto choice.”

For example, Peterson said her department has been working with the Department of Transportation on a bike and pedestrian plan to place bike paths and greenways close to neighborhoods where the obesity problem is the worst.

“Commerce wants the state to build worksites near greenways, because employers want to put their offices where it will be easier to keep their employees healthy,” she said. “And the DOT just added the word ‘health’ to their mission statement.”

Peterson cited research from Charlotte showing that people who live near the new light-rail system are doing more walking, and even losing weight, by having exercise integrated into their daily routines.

But she said it’s difficult to convince lawmakers – who usually work on two-year budget cycles – to make investments in pricey infrastructure projects that pay dividends only after 10 or 20 years.

“But if we don’t do something, and soon, the health care cost of having 58 percent of North Carolinians being obese will bring the state’s budget to its knees,” Peterson said. “We could pay for bike paths 10 times over with the savings if we would just put the money up front.”

If North Carolinians reduced their BMI by 5 percent by 2030 the state would have:
fewer cases type 2 diabetes 261,785
fewer cases of coronary heart disease and stroke 213,310
fewer cases of hypertension 195,735
fewer cases of arthritis 115,491
fewer cases of obesity-related cancer 17,382
Data, TFAH.

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