Obesity

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Charles Barkley and the Nanny State

May 27, 2010 in Obesity | 2 comments

Michelle Obama’s is deeply involved in her recently involved in fight against childhood obesity.  Eating healthy and exercising more is a laudable goal.  But do we want the government operatives taking the role of a Biggest Loser Drill Sergent?  Could government weight monitoring become a reality?

Maybe. In an interview with Marv Albert, President Barack Obama had a question for Charles Barkley:

“I know you say you’re not a role model, but the first lady has been working on this childhood obesity thing and she wants to know if you are setting a good example by getting your exercise and eating right.  If you could give an honest response, because I have ways of checking up. I’ve got a lot of intelligence operations around. We’ve got hidden cameras everywhere. Let us know, are you, in fact, sticking to your diet?”

Although the President’s comments should be taken lightheartedly, the government does face a conundrum.  Obesity reduction efforts that implore individuals to lose weight likely won’t have any teeth (pun-intended).  Just saying ‘pretty please’ or trying to make people feel guilty about being fat will only have a moderate effect on weight loss and could even increase the incidence of eating disorders.  On the other hand, the government could impose penalties (e.g., higher premiums) for overweight individuals who receive government-run healthcare (e.g., Medicare and Medicaid).

In this case, the President’s threats may not be a laughing matter.

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Women with a Partner Gain Weight

January 21, 2010 in My Papers, Obesity | 1 comment

Most women gain weight after marriage.  However, this may not just be do to having a child.

The New York Times reports on a recent study by Annette Dobson in the American Journal of Preventive Medicine.  They find that “[a]fter adjusting for other variables, the 10-year weight gain for an average 140-pound woman was 20 pounds if she had a baby and a partner, 15 if she had a partner but no baby, and only 11 pounds if she was childless with no partner. The number of women with a baby but no partner was too small to draw statistically significant conclusions.”

The study does a good job of documenting the weight gain, but does not fully explain why this is occurring.  One of my previous studies looks at just this question.  My co-author and I hypothesize that married individuals have less of an incentive to maintain their weight, because they are not in the dating market.  In fact, the study finds evidence that women who begin cohabitating with their mate gain less weight than if they had gotten married.   Since in both cases the women live with their partner, the weight gain cannot be due to simply moving in with one’s significant other.  We find evidence that the probability a couple will separate (based on marital status and other factors), directly affects weight.  Women in more stable relationships gain more weight then women in less stable relationships, likely because the women in less stable relationships know they may soon re-enter the dating market.

However, the effect of the “dating market” on weight is only 2.4 kg (about 5 lb).  Thus, this effect doesn’t cause one to be obese, but can explain some of the weight gain after marriage.  Marriage does have many other salubrious effects, and one should not avoid marriage simply to avoid a minimal weight gain.

Should Uncle Sam feed Seniors cheesesteaks or cantaloupe?

August 17, 2009 in Obesity | 1 comment

Obesity is  growing problem in the United States.  As more people become increasingly obese, mortality rates will increase (or at least decrease less slowly than would have otherwise been the case).  However, increased mortality may be a blessing for Uncle Sam.  As more elderly die earlier from obesity-related diseases, the government will be able to reduce its fiscal responsibility to pay for health care for these individuals.  In an earlier post, I cited a study that found that a rise in obesity can save governments money.

Another study by Michaud et al. (2009) has contradicted this finding.  While obese individuals will have shorter life expectancies, they do have higher health care costs in each year in which they live.  Taking into account a variety of trends that affect life expectancy–such as obesity and diabetes–Michaud and co-authors find that “Together, the reduction in smoking and the rise in obesity have increased net public-sector liabilities by $430bn, or approximately 4% of the current debt burden. Larger effects are observed for specific public programs: annual spending is 10% higher in the Medicaid program, and 7% higher for Medicare.”

It seems like it pays for Uncle Sam to feed grandma cantaloupe and not cheesesteaks.

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Health Insurance Makes You Fat

July 22, 2009 in Obesity | 4 comments

In my own research, I have examined the relationship to marriage and weight gain.  

A study by Jay Bhattacharya, Kate Bundorf, Noemi Pace and Neeraj Sood found that health insurance may actually increase body mass.  According to the authors: “We find weak evidence that more generous insurance coverage increases body mass index. We find stronger evidence that being insured increases body mass index and obesity.”

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Spend more time eating, Weigh Less

May 6, 2009 in Obesity | No comments

According to Economix, countries whose people spend more time eating have a lower obesity rates.

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Overweight Children: Rural vs. Urban

April 2, 2009 in Obesity | No comments

Rural children are more likely to be overweight than urban children, despite the fact that children living in urban areas engage in less physical activity.

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5 Health Care Myths

January 12, 2009 in Healthcare IT, Obesity, Physician Compensation | No comments

Bob Laszewski has a great posts on 5 false  “solutions” to reduce health care costs.  These are:

  • EMR: Making electronic medical records universal will greatly improve health care quality, but the impact on cost will be minor.  Better quality care can reduce iatrogenic injuries and reduce cost, but the cost reduction–if any–will likely be small in magnitude.
  • Prevention.  From the CBO: any gains from reducing obesity would be concentrated in the short and intermediate period “because some of the savings will be offset by increased longevity and the cost of disease that are most prevalent during old age.”
  • Outcomes Research:  Laszewski claims that “inefficient use of technology is the key driver in health care spending accounting for an estimated 38% to 65% of spending growth.  The problem…with the suggestions that more outcomes research will save us money is that more than twenty years of outstanding outcomes research, Dartmouth for example, has not kept our health care costs under control.”  Outcomes research is important; it is imperative for physicians to prescribe cost effective treatment.  However, I agree with Laszewski that if financial incentives are not aligned to promote physician use of evidence-based medicine, then health outcomes research will have little impact.
  • P4P: Laszewski doesn’t like pay-for-performance because in order for it to save money, it must lead to a reduction in physician payment on average.  Another reason why P4P won’t work is that paying individuals to check a diabetic’s A1C level may increase the frequency the physician monitors this metric, but it also may compel the physician to substitute their time away from other necessary medical services.
  • Universal Coverage.  Universal coverage should reduce the percentage of individual who go to the emergency room for primary care needs;.  Nevertheless, providing universal health insurance coverage will certainly increase healthcare spending due to the moral hazard problem as well as supplier-induced demand.

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Cigarette taxes are bad for your health?

January 5, 2009 in Obesity, Taxes | No comments

Many economists and public plicy researchers have found that cigarette taxes reduce smoking.  This means that cigarette taxes must be good for your health…right?

A study by Baum (2009) claims that cigarette taxes may improve health, but not by as much as previously thought.  The paper finds that increasing the cigarette tax decreases smoking, but decreased smoking–an appetite suprressant–increases obesity.  Thus Baum finds that the health benefits of cigarette taxes may be overstated.

Disclaimer: Baum does state that “this research in no way concludes that [cigarette taxes] should be decreased to prompt weight loss.”

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Marriage and weight gain

November 17, 2008 in Obesity | No comments

Do people gain weight after marriage?  A paper by Jeffrey and Rick (2002) says yes.  Using data collected from 2528 workers over a 2 year period, the authors estimated the effect of marriage and divorce on weight gain.  They found the following:

Getting married increases BMI by 0.70 for men and 0.96 for women.  For the average American male and female, this translates into a 4.8 pound increase for men and a 5.6 pound increase for women.  

Getting divorced actually decreases BMI.  The coefficients estimated were -0.27 for men and -0.63 for women; this translates into weight losses of 1.8 pounds for men and 3.7 pounds for women.  

The authors also found that “spouses tend to become more similar in body weight over time, indicating that environmental influences are an important cause of spouse weight similarity.”

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Wal-Mart reduces obesity

September 10, 2008 in Obesity | Permalink

Wal-Mart increases real incomes by lowering prices.  The purchasing power increase makes buying fresh fruit and vegetables more affordable for the average consumer.  At least this is what Charles Courtemanche and Art Carden found.

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