Everything You Know Is Wrong, Part 5

Health Month Starts

Really, is there solid ground anywhere? Every time you turn around, researchers are casting doubt on what other researchers have pretty well established as fact. Take monosodium glutamate (MSG), for instance. It has starred in the role of the obesity villain for many years.

Yet, the Glutamate Association still holds that a “great deal of scientific research” has shown that there is no problem, and certainly no relationship to obesity. They mainly cite the 2010 Jiangsu Nutrition Study from China, and state unequivocally,

This research, which has been reviewed by scientists and regulators around the world, demonstrates that monosodium glutamate (MSG) is safe for everyone.

Whenever the childhood obesity epidemic is mentioned, the dollar cost is mentioned too, and, especially, the eventual cumulative cost. For example, this source tells us that obesity accounts for nearly 6% of all American health expenditure, and the cost of managing obesity (PDF) in the U.S. is about $100 billion per year (of which $52 billion represents direct costs).

The Brookings Institute explains why it is so difficult to know the exact price tag for obesity-related diseases:

Numerous studies estimate these costs, using a variety of methodologies including: cohort studies, case studies, dynamic models, nationwide representative surveys, regression analyses, and simulation forecasting. There is widespread agreement across this literature that the medical costs associated with obesity are substantial; however, there are important differences between the studies.

Therefore, different people arrive at different estimates of how many billions of dollars America will pay for obesity in five years, 10 years, and so on. Various numbers are put forth, but as to whether obesity costs will totally overwhelm whatever may remain of the health care system, that notion is taken for granted, a truism.

And then you run up against a research article like this one, published in 2008, which inspired John Sexton of the website Verum Serum to compose the headline “Tell Michelle: Fat People Have Lower Lifetime Medical Costs.” The research article concludes,

Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures.

In other words, the contention here is that obesity does not increase medical spending overall because, while obesity-related diseases are costly during the lifespans of the obese, they tend to die younger, and cost the health care system less in the long run.

Dr. Pretlow says,

I believe this may actually be the reason why Medicare, and other insurers, don’t want to reimburse for obesity treatment. I once organized a VIP panel at MedNet 2006 to look at why Medicare and other insurers aren’t interested in paying for Internet home monitoring, e.g. home blood pressure monitoring.

I was told by a physician manager of a large insurance consortium that insurers in Germany aren’t interested in home blood pressure monitoring because it will make people live longer, which will cost insurers more money. Separately, I was told exactly the same thing in regard to Medicare by the President of the National Patient Advocate Foundation.

Your responses and feedback are welcome!

Source: “MSG Basics,” MSG Facts
Source: “Background,” Medscape
Source: “The economic impact of obesity in the United States” (PDF), Brookings.edu, 08/17/10
Source: “Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure,” PLoS Medicine, 02/05/08
Image by Buster Benson, used under its Creative Commons license.


  1. I must say that I get frustrated with all the conflicting reports that contradict each other.

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Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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