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Dec 05

Obesity and Healthcare Costs

obesityEveryone is worried about managing health care costs. This issue is a growing concern to hospitals, the health insurance industry, public health officials and doctors; it especially worries politicians. The fact is that a very large part of this problem is related to human behavior, not to any natural force like infection.

Depending on your point of reference, there are several ways of looking at health care costs. Health care payers (i.e. private medical insurance, Medicare, Medicaid, the VA and state programs) group those costs in broad, sometimes vague categories. Recently, one health industry source ranked the most expensive disease conditions in the United States. Here is how HealthPayerIntelligence.com, a leading source of news in the health payer industry, ranked healthcare expenses:

  1. CARDIOVASCULAR DISEASES
  2. SMOKING-RELATED HEALTH ISSUES
  3. ALCOHOL-RELATED HEALTH ISSUES
  4. DIABETES
  5. ALZHEIMER’S DISEASE
  6. CANCER
  7. OBESITY
  8. ARTHRITIS
  9. ASTHMA
  10. STROKE

Medical scientists and doctors will not like the way these categories were constructed, but everyone will agree that human behavior is the biggest, most costly problem facing health care. Heart disease, smoking, drinking, diabetes and obesity are all directly or indirectly related to behavior. You cannot miss the fact that obesity is at the root of many of these diseases, and therefore at the expense! It is costly to treat obesity itself, but the results of unmanaged obesity are a crippling expense. Here is what HealthPayerIntelligence.com said about the problem –

In 2006, the healthcare costs of obese patients were $1,429 higher than patients at a normal weight. Obesity is implicated in the development or worsening of many other chronic conditions, including diabetes and heart disease.”

It is now 12 years later, and those higher payments in 2006 dollars ($1,429 per patient) are almost certainly greater. How can we stop this trend?

The plain fact is that many past efforts have failed. Despite public health advertising, hospital education programs and the best advice from family physicians, the rate of obesity in the United States continues to grow. The CDC reported recently that almost 40% of all Americans (including 19% of all children and adolescents) now meet the medical definition of obese, a body mass index of 30 or more. This is about a one-third increase in the percentage of Americans who are now medically obese compared to the 1990’s

Maybe it is the time to consider a new strategy!  Not that long ago, weight loss surgery did not exist as a recognized medical procedure. Losing weight was considered a side effect of some operations, but bariatric surgery, intended to result in safe weight loss, did not exist. Today, weight loss surgery is recognized as the most successful treatment for morbid obesity and as a practical alternative for obese patients who have failed on other programs.

In October, the Journal of the American Medical Association (JAMA) published some especially convincing numbers. It was so impressive partly because of the number of patients studied – 5,301 who underwent bariatric surgery and 14,934 control patients without surgery. Doctors like studies with large numbers of patients; bigger sample groups will produce more reliable results. The total of over 20,000 patients observed in this study gives the results great credibility. Weight loss surgery worked!

In this study, bariatric surgery (weight loss surgery) reduced the chance of heart attack and stroke in people with diabetes by 40 percent over the course of five years compared to those who received the standard medical care for diabetes. Remember that heart attack and stroke are two of the top ten expenses to the healthcare system listed above. Saving the medical expense is important, but the improved quality of life, greater life expectancy and increased personal economic production is probably greater.

We cannot take the results of this one study and apply them “across-the-board” to all obese patients. However, the evidence is mounting that weight loss surgery procedures like gastric sleeve surgery and gastric bypass surgery are safe, medically effective and cost saving. If you have struggled with diets, exercise and other weight loss regimens, but have not been successful, bariatric surgery may be an option. At least, take the time to investigate.

If you have any question about bariatric surgery or any other area included in general surgery, please contact our office. You may use Contact Dr Birkedal or phone us at (386) 210-9794. Our offices, located in Daytona, New Smyrna and Palm coast are all part of the Florida Hospital Network

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