Everyone's Health

Just how much is fat costing you?

Fat's cost: Obesity may be hazardous to your wealth

Damon Darlin

As you snatch a couple more Christmas cookies or down another eggnog, you might be thinking about what those extra calories will do to your health.

But have you considered what they will do to your wealth?

Being fat costs money – tens of thousands of dollars over a lifetime.

Findings Eating up wealth: Obese people have higher life insurance premiums, higher medical expenses, and they tend to make less money and accumulate less wealth in their shortened lifetimes.

Heavy people do not spend more than normal-size people on food itself, but their life insurance premiums are two to four times as large. They can expect higher medical expenses, and they tend to make less money and accumulate less wealth in their shortened lifetimes. They can have a harder time being hired and, once on the job, a harder time winning plum assignments and promotions.

We're not talking here about people who are merely chubby or carrying a few extra pounds. People carrying an extra 30 to 40 pounds can be affected.

“Being overweight can be dangerous to your wealth,” said Jay Zagorsky, an economist at Ohio State University who has looked at the relationship between various economic and sociological factors and a measure of obesity called the body mass index. Doctors use the BMI index to determine whether a person is merely overweight or dangerously obese.

Academics have struggled to place a price tag on the cost of treating those carrying around too much weight. The obese suffer from heart disease, diabetes, depression, arthritis and joint problems, liver disease, sleep apnea and a shortened life span.

Complications from obesity, particularly diabetes, which afflicts 21 million Americans, boost the bill: $44,000 for a heart attack, $40,200 for a stroke or $37,000 for end-state kidney disease, estimates Judith O'Brien, the director of cost research at the Caro Research Institute, a health costs consulting firm. Amputating just a toe, a not-uncommon consequence of untreated diabetes, averages $15,000.

Academics have not spent much time calculating what that care costs the overweight individual. Instead, they look at what obesity costs society or insurers. The sum usually arrived at is about $80 billion a year and steadily growing. The government or insurers pay about 85 percent of that. In other words, the fit and the fat pay for it indirectly through taxes or higher health insurance premiums.

Furthermore, routine care for obese people can put a dent in finances. Doctor visits and prescriptions for medicines to manage diabetes, high cholesterol, back pain and depression can reach $7,000 in annual out-of-pocket expenses for someone covered by an employer's health insurance, according to an online health care plan cost estimator that United HealthGroup provides to its customers.

While the health problems can ravage savings, an overweight person may have difficulty accumulating a nest egg in the first place. One of the earliest sociological studies of the overweight, in 1966, found that the heaviest students had a harder time getting into top colleges.

More recent studies have found that the obese, particularly white women, are paid less. A study by John Cawley, an associate professor of human ecology at Cornell University, found that an increase in weight of 64 pounds above the average for white women was associated with 9 percent lower wages.

Evidence from decades of discrimination studies has led Mark Roehling, an associate professor at the School of Labor and Industrial Relations at Michigan State University, to the conclusion that there is “consistent evidence of weight discrimination.”

One factor is that some employers do not want to be burdened with higher health insurance costs. Other times it is a matter of appearances or a belief that “people of size,” as Roehling terms the obese, are lazy, weak-willed or considered too unattractive to interact with customers. He has found that some employers are upfront about it, even in Michigan, which is the only state that outlaws weight discrimination.

Sociologists have long noted that in developed countries, the higher-status people tend to be thin and the lower-status ones are fat. “That heavier people have a harder time getting married is pretty well supported,” said Jeffery Sobal, a professor at Cornell University who has studied obesity. Marriage can be crucial in wealth creation, especially when a person “marries up” to someone with money or a higher education. That may be a rarer occurrence for the obese.

“There is a stigma against the overweight that plays out in the social class world,” Sobal said.

The end result? The obese accumulate only about half the assets of the normal-size American, said Zagorsky, the Ohio State University research scientist. He matched BMI and wealth data and found that for every one-point increase in the index, net worth dropped by $1,000. The typical female baby boomer, he said, earned $313.70 less annually for every one-point increase in her BMI, while the typical male earned $161.30 less for every point.

Zagorsky's data also revealed an odd finding about inheritances. Thin people tend to receive bigger inheritances. He is not sure why, but he thought it could be because people with low BMIs live longer and their parents tend to live longer, so wealth has a longer time to accumulate before it is transferred.

What happens to a person who loses weight? Zagorsky says a drastic drop in weight corresponds to an increase in wealth. A baby boomer whose BMI drops from 27.5, the middle of the overweight category, to 21.7, the middle of the normal category, sees an increase in wealth of $4,085.

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