Greg Brown's Weekend Reading and Other Things.. 04/16/2017
DEAR FRIEND.....
Obesity's hefty price tag
America's heaviest city grapples with costs from weight-loss surgery to extra-wide hospital beds.
In a recent article in Politico Magazine by Beth Baker she describes the operation above of a 30 year-old 330 pound female patient considered "morbidly obese" with two gaping hernias holes torn in the abdominal sac that holds the body's major organs, as "The belly wall is not designed to hold this much weight," said by her Baptist Memphis Hospital, surgeon George Woodman.
By the operation's end, most of the patient's stomach was trimmed away, leaving a much smaller "gastric sleeve" that will allow her to feel full after eating only small amounts of food. Removing a portion of the stomach also suppresses the hormones that stimulate hunger. The operation (known as a laparoscopic sleeve gastrectomy) is now the most common type of weight-loss surgery performed in the U.S. Woodman has conducted 6,000 gastric sleeve operations, and did three more that morning. Memphis is the heaviest metropolitan city in the country, with an adult obesity rate of about 36 percent — approaching the rate of more than 40 percent that researchers say we will reach by 2030, if current trends continue.
"There is an unlimited number of patients," he said.
Memphis may be the heaviest city in the country, but it isn't much of an outlier. From the trimmest state, Colorado, to the most obese, Mississippi, the entire nation has been on a perilous—and costly—upward track when it comes to extreme weight gain. Severe obesity (a BMI of 40 or more) — the kind most harmful to individual well-being and expensive to society — is rising at an alarming rate and may affect 11 percent of U.S. adults by 2030.
Dieting and exercise are the prescription for most Americans who want to lose weight, but only a minority succeed. Woodman estimates that just 3 percent of his morbidly obese patients could lose their excess weight on their own, so for most, bariatric surgery is a last-resort option. With luck, this patient will lose about 75 percent of her excess weight, putting her on track to a healthier future. "People say that obesity is self-induced," Woodman said. "But it doesn't matter. We have to do something about it."
Every five days, Woodman holds a seminar for prospective patients. On a recent Saturday, 60 people showed up. Perhaps one-third would follow through with surgery. For some, Medicare, Medicaid, or private insurers will pay, calculating that the price of the surgery is less than the cost of a lifetime of chronic disease. At Baptist Memphis, the operation costs $14,000 — the cost is often higher elsewhere, $25,000 or more. That may seem expensive, but it could be a bargain compared with the estimated $200,000 in excess medical costs obese Americans can rack up over their lifetimes.
Memphis has the highest obesity rate among U.S. cities, and its appetite for unhealthy food is part of the reason.
Pedestrians on Beale Street take in the sights, including the day's menu at B.B. King's famous blues club. At right, spectators wait for the city's famous Mardi Gras parade to pass by.
As American waistbands continue to expand, researchers and policymakers are trying to figure out just what the obesity epidemic is going to cost the nation. There are the direct medical costs of treating obesity-related diseases including Type 2 diabetes, heart disease and stroke, high blood pressure, arthritis, and related cancers, among others. And then there are the indirect costs: lost productivity, more illness, extra infrastructure to handle heavier patients and residents.
These bills are already coming due in Memphis. Last year, extra health care costs from obesity were $538 million — more than half the budget of the city's public school system, according to Gallup Healthways Well-Being Index. For the state of Tennessee, the annual excess health costs of obesity were $2.29 billion — equivalent to more than 6 percent of the entire state budget. No matter how many surgeries Woodman conducts, he won't make a dent; many more Americans are tipping the scales into the obese range each year.