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Obesity Fight Hits Taxpayers

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Obesity in the United States --- which affects nearly one-third of adults --- costs $75 billion a year in medical expenses, half of it funded by taxpayers through Medicare and Medicaid, a new study says.

Treatment of obesity, ranging from clinic visits to gastric bypass surgeries, amounts to $350 a year for each adult, according to the study released Wednesday by the Centers for Disease Control and Prevention in Atlanta and RTI International, a nonprofit research firm in North Carolina.

The percentage of American adults considered obese has doubled in the last 25 years, fueling a rise in chronic diseases such as diabetes and heart disease, the CDC said.

"Obesity has become a crucial health problem for our nation, and these findings show that the medical costs alone reflect the significance of the challenge," said Health and Human Services Secretary Tommy Thompson. "We must take responsibility both as individuals and working together to reduce the health toll associated with obesity."

Both Thompson and Dr. Julie Gerberding, CDC director, have declared obesity a major health concern.

The new study --- which doesn't include children, whose obesity rates are soaring --- found that 5.7 percent of the nation's health care expenses are for treatment of obesity. That is roughly the same percentage spent on treatment for the effects of smoking.

The burden is greater for taxpayer-funded programs: 6.8 percent of Medicare costs and 10.6 percent of Medicaid costs are spent on treatment of obesity.

Medicare is a federal program for seniors and the disabled, and Medicaid is a federal and state program for the poor.

The study, the first to break down obesity costs by state, focuses on all medical expenses incurred by obese people that exceed the medical expenses of the non-obese. This included all costs for all medical treatment, whether paid by private insurance or public programs. Indirect costs, such as lost productivity and time away from work, were not considered.

California spends the most on obesity overall --- $7.7 billion a year --- and through Medicare --- $1.7 billion. New York tops the list in obesity-related Medicaid expenses at $3.5 billion. Alaska and the District of Columbia spend the largest share of medical expenses on obesity --- 6.7 percent.

Wyoming spends the least treating obesity each year, at $87 million. Arizona spends the smallest share of its health care dollars on obesity, at 4 percent.

A state's obesity costs are influenced by its obesity rate, its population, the amount of managed care and the extent to which public programs pay for medical expenses. High costs can result from generous health care programs as well as a high incidence of obesity.

"This allows each state to see how much they spend on obesity," said Eric Finkelstein, an RTI researcher. "It should encourage states and employers to figure out how to reduce these costs."

States can support nutrition and fitness programs to reduce obesity costs in future years, Finkelstein said. Some employers offer perks to workers who enroll in exercise programs or otherwise keep health care costs down. Georgia's obesity rate is 23.5 percent, compared with the national average of 22.1 percent, according to a CDC survey that relies on self-reporting by participants. A more robust CDC study, not broken down by state, puts the national rate at 31 percent. 

In the new study, Georgia comes in slightly higher than the national average on obesity costs. The state spends $2.1 billion treating obesity, or 6 percent of its overall health care costs. Obesity accounts for $405,000, or 7.1 percent, of Medicare spending and $385,000, or 10.1 percent, of Medicaid spending in Georgia. Gov. Sonny Perdue's budget for next year calls for greater cuts in public health spending than the 5 percent reduction across the board in spending by state agency. But that doesn't mean obesity isn't an important issue, Perdue spokesman Dan McLagan said.

"The governor's focus is on children, education and job creation," he said. "Sadly, everything can't be funded." ON AJC.COM > Join our forum and update us on your diet and fitness progress.

Copyright 2004 The Atlanta Journal-Constitution

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