As Congress searches for ways to control health care costs, a new report provides a sizable target: obesity.
Americans who are 30 or more pounds over a healthy weight cost the country an estimated $147 billion in weight-related medical bills in 2008, double the amount a decade ago, according to a study by government scientists and the non-profit research group RTI International.

Obesity now accounts for 9.1% of all medical spending, up from 6.5% in 1998. Overall, an obese patient has $4,871 in medical bills a year compared with $3,442 for a patient at a healthy weight.
"Obesity is the single biggest reason for the increase in health care costs," says Eric Finkelstein, a health economist with RTI and lead researcher on the new study. "If you really want to rein in health care dollars, you have to get people dieting, exercising and living a healthier lifestyle. Otherwise somebody is going to be paying for treating these weight-related illnesses."

The study was presented Monday at Weight of the Nation, a meeting sponsored by the Centers for Disease Control and Prevention (CDC) to discuss ways to reduce obesity and inactivity.

House and Senate bills to overhaul the nation's health system both include money for community programs to prevent obesity.
Obesity increases the risk of heart disease, diabetes, several types of cancer and other diseases.

About 34% of adults — more than 72 million — in the USA were obese in 2006, up from 23% in 1994, according to government data. Two-thirds of people in this country are overweight or obese.
"The average American is 23 pounds overweight," CDC Director Thomas Frieden said, "and collectively, we are 4.6 billion pounds overweight."

Former president Bill Clinton told meeting participants that changes must be made in "what goes on at home, in the neighborhood, in the schools and in the community" to confront the obesity problem. "We are trying to turn the Titanic around before it hits the iceberg."

For the study, Finkelstein and other obesity experts analyzed medical expenditure data, including direct medical costs related to extra weight, such as prescription medications, visits to doctors' offices and other outpatient and inpatient (hospital) services — but not indirect costs such as time off work.

Among findings:

Taxpayers picked up about half the $147 billion tab in 2008 through Medicare and Medicaid.

Obese patients on Medicare spent about $600 a year more in prescription medications than patients at a healthy weight.
"Obesity is not a problem that is going to respond to a silver bullet or single solution," says William Dietz, director of the CDC's Division of Nutrition, Physical Activity and Obesity. "Comprehensive policy and environmental changes are needed."

The study is published online in Health Affairs.

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