Obesity and Health Tips

The effects of obesity on the number of chronic conditions are
larger than those of current or past smoking or problem drinking

Smoking status is classified into ever smoking, daily smoking, and never smoking; problem drinking was assessed using the Alcohol Use Disorders Identification Test (AUDIT); and age is measured as a continuous variable.8 Other explanatory variables include gender, race, household income, and education.

Obesity prevalence:

According to the HCC survey, 36 percent of the population in 1998 was overweight but not obese, and 23 percent was obese. There is a tendency toward underreporting of
weight and overreporting of height; these numbers are therefore
almost identical to the earlier third National Health and Nutrition
Examination Survey which measured height and weight objectively.
Both surveys give slightly higher estimates than the Behavioral Risk Factor Surveillance System (BRFSS) fielded at the same time as the HCC survey, which also uses self-reporting.

Dependent variables.

The main dependent variables are two measures of health status and two measures of health care use.

The first measure of service use is spending on inpatient and
ambulatory care, based on the number of reported hospital stays and ambulatory visits and multiplied by unit costs from the Medical Expenditure Panel Survey (MEPS). The overall HCC numbers are very similar to MEPS estimates. For example, average inpatient and outpatient spending for adults ages 18–64 are $1,494 in HCC and $1,377 in MEPS.12 The second measure is medication use based on survey questions about regularly used medication, mapped to insurance claims (for prescription drugs) or wholesale prices (others) to obtain spending estimates.13 The usual limitations of this approach apply, especially the underreporting in self-reports and incomplete assessment of services. Even after scope of coverage is adjusted for,MEPS estimates are lower than estimates from the National Health Accounts. Relative effects may be less biased than absolute numbers are, and I therefore show percentage changes based on the ratio of predicted costs for the population with and without the risk factor.

Weight control as a national priority.

Is it likely that making weight control a higher national priority would lead to weight loss and improved health?
Achieving lasting health behavioral change is difficult and rarely achieved by exhorting individuals to exercise more, eat healthier foods, stop smoking, or drink responsibly. Car friendly (and bike/pedestrian-hostile) urban developments; desk
jobs; television; and relatively cheap, calorie-dense foods are some of the recent environmental changes that have changed relative prices in favor of less physical activity without a corresponding decreased caloric intake. In contrast, taxation and access control on tobacco (indoor smoking bans) and alcohol products are environmental interventions (or relative price changes) that have reduced smoking rates and some alcohol problems.