August 10th, 2009
03:15 PM ET

Obesity, smoking add immense burdens to health care costs

By David S. Martin
CNN Senior Medical Producer

An orthopedic surgeon told me the story recently about a 300-plus pound man whose feet gradually failed under his immense weight - until he walked on the inside of his ankles.

He required complicated surgery on each foot and ankle – 3 ½ hours in the OR, a night in the hospital and months of rehab each time. The bill ran into the tens of thousands of dollars for a problem largely attributable to his weight.

“Bones aren’t any bigger than they were thousands of years ago,” the surgeon told me. Unfortunately, we are. And bones and tendons don’t grow to accommodate body weight.

The debate about health care is largely about dollar figures. How much will it cost? How will it affect the deficit? How much will it raise our taxes?

There are a couple of figures that don’t often make the debate, and they may pose an even greater challenge. I’m talking about the obesity rate and the percentage of Americans who continue to smoke.

A government-sponsored study recently estimated that medical spending for obesity reached $147 billion in 2008, almost doubling in the past decade. It’s not surprising. About 32 percent of American adults are obese, a condition linked to diabetes, heart disease, even cancer. As the story above illustrates, obesity can also do a number on your bones and joints.

If you want an idea of how big $147 billion is, it’s roughly 6 percent of all health care spending in the United States.

How about smoking? Almost 21 percent of American adults are addicted to cigarettes, according to the Centers for Disease Control and Prevention. That’s more than 45 million people. The estimated health care costs pegged to smoking: $96 billion.

It’s virtually impossible to live in the United States and not be aware of the health risks associated with smoking, yet the addictive habit continues – with tragic consequences for smokers and an immense burden on the health care system.

The Congressional Budget Office caused an uproar when it projected that Obama-backed changes in the health care would add $239 billion to the deficit over 10 years.

That’s nothing compared with the cost of obesity and cigarettes. Over 10 years, those costs top $2.4 trillion.

And that leads to the obvious question: How would you get Americans to lose weight and quit smoking?

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Filed under: Health & Politics • Smoking • Weight loss

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