Margaret Aker and Brandel France de Bravo, MPH
By now nearly everyone knows that being obese is bad for your health, but did you know that it is also bad for your wallet? This is especially true for women.
Obesity is usually defined as being 20% over ideal weight or as having a body mass index of 30 or higher (body mass index or BMI is calculated using height and weight). Obese people are more likely to suffer from chronic health problems, such as diabetes and heart disease, and they don’t usually live as long as people who are not overweight. The latest research indicates that obese men and women are at higher risk of colon cancer, and obese women are also more likely to get breast cancer and endometrial cancer (cancer of the womb). Obese people also experience a diminished quality of life because of physical difficulties and discrimination. While many reports have discussed the “cost to society” of obesity, none have looked at the additional costs in dollars for an obese woman or man.
A recent study by Avi Dor and his colleagues at the School of Public Health at George Washington University found that it costs an obese woman $4,870 more per year to live in America than a woman of healthy weight. Obesity costs less for men-an additional $2,646 per year. Some of those costs are paid directly by the obese person and part by employers and the government.
How did the researchers come up with those figures?
They looked at all the data available on direct medical costs, work-related costs, and personal costs. Direct medical costs include out-of-pocket as well as insurance-covered expenses related to doctor visits, hospital care, and medications; work-related costs include differences in wages, missed work days and disability payments. Personal costs refer to the yearly dollar amount spent on transportation and life insurance.
The researchers believe that their estimates are on the low side because they did not take into account other expenses that typically are higher for obese people, such as clothing, air travel, or furniture.
Most surprising, the researchers discovered that obese women do not earn as much as normal-weight female employees. No such wage differential was found for obese men who earn the same as normal-weight men. While no one knows for sure why it is that obese women have lower wages, one likely explanation is a double standard that places greater emphasis on women’s physical appearance than men’s. If obese women’s lower wages were the result of something else, like lower productivity or more missed days of work, wouldn’t that be true for obese men as well?
The chart below shows the breakdown in obesity costs for men and women. For men, direct medical costs account for over half of their additional “cost of living,” whereas for women, reduced wages are the biggest contributor.
Total Cost of Obesity for an Individual
Overweight vs. Obese. Do costs go down when weight goes down?
This study also found that there is an added cost for being overweight (BMI of 25 to 29.9), although not as high as for being obese. It costs an overweight woman an extra $524 per year to live in the United States, compared to $432 extra per year for men. So, how overweight you are matters. If a person is only overweight by a few pounds, losing those pounds could potentially save quite a bit.
The economic downturn has affected nearly all of us in one way or another, but this study reveals that its impact may be even greater for people who are overweight or obese. If health concerns aren’t enough incentive to change eating and exercise habits, knowing the economic costs might be.
Lastly, while many of us need to lose weight, all of us should be finding ways to fight discrimination. This study draws needed attention to another way obese people-particularly women-are discriminated against.
 Dor, A., Ferguson, C., Langwith, C., Tan, E.: A Heavy Burdern: The Individual Costs of Being Overweight and Obese in the United States. The George Washington University School of Public Health and Health Services 2010.