intellectual vanities… about close to everything

Let Us Eat And Drink; For To Morrow We Shall Die.

with 4 comments

At least Isaiah xxii. 13 (AV) has it like this. he did not know that overweight smokers are an even less financial burden for public health. They simply die soonest, causing the least cost in health care systems.

A new research paper suggests that preventing obesity might result in increased public spending on medical care. Many countries are currently developing policies aimed at reducing obesity in the population. However, it is not currently clear whether successfully reducing obesity will also reduce national healthcare spending or not. Pieter van Baal and colleagues, from the National Institute for Public Health and the Environment in the Netherlands, created a mathematical model to try to answer this question.

In their study, van Baal and his co-workers created three hypothetical populations of 1000 men and women, all aged 20 years at the start: a group of obese, never-smoking individuals; a group of healthy-never smoking individuals of normal weight; and a group of smokers of normal weight. The model produced an estimate of the likely proportion of each group who would encounter certain long term (chronic) diseases, and then estimated what the approximate cost of medical care associated with each disease was likely to be. The researchers found that the group of healthy, never-smoking individuals had the highest lifetime healthcare costs, because they lived the longest and developed diseases associated with aging; healthcare costs were lowest for the smokers, and intermediate for the group of obese never-smokers.

However, the authors argue that although obesity prevention may not be a cure for increasing expenditures, it may well be a cost-effective cure for much morbidity and mortality and importantly contribute to the health of nations.

Should Isaiah’s biblical ammendment be then. “Eat, drink, smoke and be merry, for tomorrow we diet”? Mind, this is a mathematical model comparing life-time-health-costs. Main target of medicine is not keeping public health cheap but people healthy until old age! A Perspective by Klim McPherson, from Oxford University in the UK, who was not involved in the study, discusses the implications of these findings and comments that “it would be wrong to interpret the findings as meaning that public-health prevention (e.g., to prevent obesity) has no benefits”; the quality of life experienced by individuals, and other factors, must also be taken into account when planning interventions aimed at improving public health.

van Baal PHM, Polder JJ, de Wit GA, Hoogenveen RT, Feenstra TL, et al. (2008)

Lifetime medical costs of obesity: Prevention no cure for increasing health expenditure.

PLoS Med 5(2): e29. doi:10.1371/journal.pmed.0050029

BackgroundObesity is a major cause of morbidity and mortality and is associated with high medical expenditures. It has been suggested that obesity prevention could result in cost savings. The objective of this study was to estimate the annual and lifetime medical costs attributable to obesity, to compare those to similar costs attributable to smoking, and to discuss the implications for prevention.

Methods and Findings

With a simulation model, lifetime health-care costs were estimated for a cohort of obese people aged 20 y at baseline. To assess the impact of obesity, comparisons were made with similar cohorts of smokers and “healthy-living” persons (defined as nonsmokers with a body mass index between 18.5 and 25). Except for relative risk values, all input parameters of the simulation model were based on data from The Netherlands. In sensitivity analyses the effects of epidemiologic parameters and cost definitions were assessed. Until age 56 y, annual health expenditure was highest for obese people. At older ages, smokers incurred higher costs. Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position. Alternative values of epidemiologic parameters and cost definitions did not alter these conclusions.


Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures.

Written by huehueteotl

February 7, 2008 at 4:23 pm

4 Responses

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  1. Wow, funny coincidence… I used the same study to prove the exact same point in my blog.

    Studies like these should get more attention than they’re getting, unfortunately, though I can easily see why they don’t.

    Ironically, the findings make sense in a ‘common sense’ kind of way, so it’s sad to see that more people don’t come to a similar conclusion of their own accord.


    December 7, 2008 at 7:33 am

    • … perhaps many people do. it is seldom reason alone that drives politics. “It’s the economy, stupid.” 😉


      December 7, 2008 at 10:56 am

  2. Yeah exactly. The saddest thing about our society is that people who have the say are finessed and / or forced to choose the more profitable decision over the morally correct one most of the time.

    One of the worst parts of that is that the decisions a few make out of greed are sold as the truth and become the people’s new morality. A crying shame.


    December 8, 2008 at 1:47 am

  3. However true or credible it may be, the fundamental truth is you can’t eat your cake & still have it. So I think the buttom line is we either let people die from obesity & its related illnesses & save the money OR we use the money to help people live longer through obesity prevention programmes and also treat/ manage diseases associated with ageing. With that said I hold the view that knowledge, wisdom, power & wealth are all needed because we need to protect & save lives. So I the current spendinp on obesity prevention programs is absolutely the right way to go and in fact more resources need to be directed this area.

    Sam Fos

    November 24, 2010 at 5:50 pm

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