We all pay by the pound

Philip J. Goscienski, M.D.

October 2006

From stronger obstetric beds to larger caskets, obesity is driving up the cost of everything from birthing to dying. The Centers for Disease Control and Prevention tells us that obesity increases health care costs by 117 billion dollars a year but that doesn't include the extra cash that we all contribute to this new growth industry.

The nation passed new child safety laws when the average pre-schooler was a lot smaller. As childhood obesity has quadrupled, children's car seats have had to be made heavier and wider — the "husky" model — and more expensive.

If you and that youngster are heading out to visit Grandma by plane you might not notice that the average passenger has put on weight but the airlines have. In 2000 they spent $275 million dollars for the additional fuel that it took to get an extra 10 pounds per passenger into the air and to keep them there. Of course, that was when the price of oil was a mere $50 a barrel. One manufacturer of bathroom fixtures claims that airline fuel surcharges added $1 million to their operating costs for a single month. Customers will ultimately pay those costs.

When Yankee Stadium underwent a face-lift in the 1970s it needed a bottom-lift, too. The builders added 5 inches to the width of the seats to accommodate fan-fanny spread. The wider seats took up more room, of course, and the new stadium has about 20,000 fewer seats than the original one. Ticket prices went up to make up for the difference — an unnoticed cost of obesity.

It takes more cloth to cover bigger bodies and the current trend toward naked tummies won't provide it. Retailers have added plus-size garments to their lines and some have even made dressing rooms bigger. Plus-sized customers pay about 8 to 10 percent more for their clothing — another unnoticed cost of obesity.

If you've visited someone in the hospital in the past year or two you might have noticed that the doorways to hospital rooms are wider. That's because the patients are. Hospital staffers are learning how to move 500-pound patients — no longer a rarity — using motorized lifts to get them from oversized wheelchairs into beds that can accommodate a half-ton of human. When nature calls it's to a sturdy toilet, anchored to the floor, that can hold even more weight because wall-mounted commodes kept giving way.

Undergoing a CAT scan is not for the claustrophobic. It's not for the very obese either. Big bodies require new designs for imaging equipment, not just to accommodate the extra weight but to provide adequate results without markedly increasing radiation exposure.

Nurses need longer, stronger needles to give injections through several inches of fat. Surgical gloves have longer cuffs for the same reason.

The cost of obesity is subtle but real. So are the causes. A few more calories taken in here, a few less burned off there, hardly enough to notice. The good news is that we can reverse the trend the same way. Lean meat, whole-grain breads, sugar substitutes, lots of veggies, fruit for dessert, longer walks. It's not quite the Stone Age lifestyle but it's a start.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.