Smart Beds — for Bariatric and Other Reasons

In the field of bariatrics, it seems obvious that heavy people face physical challenges and restrictions that can require some pretty elaborate equipment. It is also apparent that ever more complicated hardware must and will inexorably raise the total cost of healthcare. But obese people should not be assigned the whole blame. Increasingly, medical equipment related to weight is for everyone.

We spoke of the transfer safety factor, with an uncomfortable number of mishaps, resulting in what are somewhat euphemistically called “delays in care.” Moreover, for hospital inpatients of many sorts, continuous weight monitoring is increasingly seen as essential.

A company called SonderCare explains why:

A bed equipped with load sensors provides real-time information that derives from, and in turn affects, the patient. Treatment options can change minute-by-minute, rather [than] according to orders tied to an 8-hour shift.

Despite the best intentions of staff members, the big danger point connected with patient injuries is movement from place to place. If the patient can just stay right there in bed and be weighed, so much the better, because a potential cause of injury has been eliminated.

In this style of bed, load sensors convert the pressure they feel into electrical signals for crucial weight monitoring, while other technology includes keeping track of the patient’s vital signs. A sudden weight change, either up or down, may indicate a problem with the heart or kidneys, and can be quickly investigated.

In some conditions, fluid buildup may be detected before it causes serious damage. Overall, continuous weight monitoring, without the need for actual transfer of the body, greatly reduces injuries.

According to SonderCare,

Advances in bed technology include vital signs monitoring and alerts to prevent pressure ulcers, increasing safety and comfort for patients. Future innovations will incorporate smart fabrics and touch-sensitive sensors that offer real-time health updates directly into electronic medical records.

But wait, there is more…

Another entire area in which very large people can be particularly vulnerable is medication dosage. We are accustomed to the idea of child-size doses, to ensure that the young and vulnerable don’t get too much. But we think less often about the need for accurate measurement in the ratio of medication to body weight, in the case of an extremely large adult.

Both insufficient dosage and overdosage would be problematic. GoodRx.com says,

Some medication dosages are weight-based because your body weight or body composition could affect their absorption, distribution, metabolism, or elimination. These four factors predict how a medication will behave in your body. Drug toxicity can also play a role.

Changing any one of these factors can potentially make a medication more or less active in your body. In turn, this can lead to unwanted side effects or a less effective treatment.

Another paper points out that “the weight effect may be minimal or dosage can be affected only when weight is combined with other factors. Findings of sporadic studies in recent years indicated that fixed dosing was more advantageous than weight-based dosing in some cases…” It stresses that the medical facility needs to establish good processes for both weighing and documentation, and to ensure “sufficient and convenient availability of appropriate and properly functioning equipment for patient weighing and medication delivery.”

Insulin, antibiotics, and anesthetics are some of the drug types that need very careful consideration when prescribed. In the overall cost of obesity, this factor is not very large. Although considering it over and over again in each case certainly takes time, which adds up. But just one case that goes to court because a patient was under-treated or died from an overdose can become very expensive.

Any reader of this piece who treats lightly the matter of dosage calculation might take a look at this website, “How To Calculate Drug Dosage By Weight | Essential Guide.” This excerpt is just a tiny sample:

\[
\text{Required Volume} = \frac{\text{Total Dose}}{\text{Available Concentration}} = \frac{700 \text{ mg}}{250 \text{ mg/mL}} = 2.8 \text{ mL}
\]

Got that? This is why medical school is so expensive, and why physicians are so well-compensated. The matters discussed here are relevant not only to the status of obese children as they exist now. The whole area of concern involves viewing children not just as young people per se, but as precursors of the adults they will grow into.

We strive to avoid these very costly problems, both for the sake of each individual child and for the sake of the economy, as they will grow up to impact with their ever-increasing number of expensive obesity-related issues.

Your responses and feedback are welcome!

Source: “Do Hospital Beds Weigh You?,” SonderCare.com, 06/27/24
Source: “Weight-Based Dosing: What to Know About Medication Dosages and Body Weight,” GoodRx.com, 02/09/23
Source: “Weight-based dosing in medication use: what should we know?,” NIH.gov, April 2016
Source: “How To Calculate Drug Dosage By Weight | Essential Guide,” Wellwisp.com, undated
Image by [name not given]/Pixabay

Weight Loss Without the Nausea?

Weight loss and diabetes drugs currently available, such as Ozempic and Zepbound, often fail to provide lasting results. While GLP-1 drugs work by targeting brain neurons that regulate appetite, they frequently cause unpleasant side effects. According to researchers, nausea and vomiting force 70% of patients to stop treatment within a year.

Now, a Syracuse University-led research team believes they’ve found a new approach that could offer weight loss without the gastrointestinal distress that derails so many patients.

Dr. Robert Doyle, a medicinal chemist and the Jack and Laura H. Milton Professor of Chemistry in the College of Arts and Sciences at Syracuse University, is leading the effort. Dr. Doyle is also a professor of pharmacology and medicine at SUNY Upstate Medical University. He and his colleagues have identified a different brain target — one that focuses on cells supporting neurons rather than the neurons themselves. This breakthrough could help treat both obesity and diabetes in a safer, more tolerable way.

Looking beyond neurons

For decades, neurons have been the most obvious and well-studied targets for brain-related drug development. GLP-1 medications, for example, zero in on neurons in the hindbrain that control appetite. But Dr. Doyle’s team is taking a different route, exploring the role of “support” cells, including glia and astrocytes, which may also influence hunger and metabolism.

A recent collaborative research effort has found that these support cells play a role in reducing feelings of hunger, although this process has received far less attention in the scientific literature. Dr. Doyle explains:

We wanted to know whether support cells might produce new peptides or new signaling molecules that might be critical in body weight reduction.

How it works

To visualize the difference between neurons and their support cells, Dr. Doyle offers a simple analogy:

Think of each brain neuron as a light bulb and support cells as the components that allow the light bulb to brighten, including the wiring, switch and filament. All of those supporting parts beyond the light bulb play a role in making the light shine.

In their research, the team discovered that certain support cells in the hindbrain naturally produce a molecule called octadecaneuropeptide (ODN), which can suppress appetite. In lab experiments, when ODN was injected directly into the brains of rats, the animals lost weight and improved their glucose processing, an important factor for managing diabetes.

However, injecting substances directly into the brain isn’t a realistic option for human treatment. To solve this, the researchers engineered a new version of the molecule, tridecaneuropeptide (TDN), that could be administered via regular subcutaneous injections, much like existing GLP-1 treatments.

When tested in obese mice and musk shrews, TDN led to weight loss and improved insulin sensitivity without triggering the nausea and vomiting commonly seen with GLP-1 drugs.

A shortcut to appetite control

One of the team’s key objectives is to develop weight loss therapies that avoid stimulating neurons directly. TDN accomplishes this by bypassing neurons and targeting the downstream support cells responsible for appetite suppression.

Dr. Doyle likens the process to starting a race partway through rather than at the very beginning. He says:

Instead of running a marathon from the very beginning like current drugs do, our targeting downstream pathways in support cells is like starting the race halfway through, reducing the unpleasant side effects many people experience… If we could hit that downstream process directly, then potentially we wouldn’t have to use GLP-1 drugs with their side effects.

Or we could reduce their dose, improving the toleration of these drugs. We could trigger weight loss signals that happen later in the pathway more directly.

This “shortcut” approach could have major implications for the millions struggling with obesity or type 2 diabetes, particularly those who cannot tolerate current treatments.

From lab to clinic

To turn this scientific discovery into a practical therapy, a new company called CoronationBio has been launched. The company has licensed intellectual property related to ODN derivatives for treating obesity and cardio-metabolic disease from both Syracuse University and the University of Pennsylvania.

CoronationBio’s mission is to move promising candidates like TDN from the lab into clinical trials. They are collaborating with other companies in the biotech and pharmaceutical sectors to accelerate development, with hopes of starting human trials as early as 2026 or 2027.

If successful, the new treatment could address one of the biggest barriers in obesity care: Keeping patients on their medication long enough to see lasting benefits.

The future of appetite control

While the research is still in early stages, Dr. Doyle’s team is optimistic about the potential impact. By shifting the focus from neurons to their support cells, they hope to change how scientists and clinicians approach weight management and metabolic disease.

The concept isn’t just about creating a new drug; it’s about rethinking the biology behind appetite regulation. Support cells, once considered secondary players in brain function, may hold the key to more tolerable and effective treatments for chronic conditions that affect millions worldwide.

As Dr. Doyle and his colleagues continue refining TDN and preparing for clinical testing, the hope is that this line of research will not only expand treatment options but also offer relief to patients who have long struggled with both their weight and the side effects of current medications.

If their theory holds true in human trials, this could mark the beginning of a new era in weight loss medicine — one where the body’s own support systems are harnessed to promote health, without the misery that forces so many to give up on treatment.

Your responses and feedback are welcome!

Source: “Scientists uncover hidden brain shortcut to weight loss without the nausea,” ScienceDaily, 8/10/25
Source: “Shortcut to Weight Loss: No Nausea Required,” Syracuse University, 7/30/25
Source: “Hindbrain octadecaneuropeptide gliotransmission as a therapeutic target for energy balance control without nausea or emesis,” Science Translational Medicine, 7/23/25
Image by Amel Uzunovic/Pexels

Bariatric Hardware By the Numbers

In this series concerning the costs of obesity, today’s post is about equipment. We mention some specifics of why the issue is an ongoing and ever-growing problem for patients, family members, and/or caregivers, medical professionals, other hospital personnel, insurers, and basically the American public at large.

“Bariatric” is a term that refers not only to weight reduction surgery but to the entire field of obesity treatment. Let us confront the issue of equipment — first, by looking at some available devices. Several sources were consulted for bits and pieces of information; a typical website of this genre describes items designed for patients in their everyday lives at home and out in public.

Crutches can be found for people who weigh up to 650 pounds and maybe even heavier. There are canes guaranteed to support 500 pounds. Specialized companies make extra-wide, super-strong walkers. A combination walker and seat called a rollator will support up to 500 pounds and run you $800 or more.

An extra-wide wheelchair that supports up to 850 pounds can be had for just under $1,000, while a less sturdy model might go for half that price. And who would have guessed that a “transport chair” is a whole different category of item?

Other locales

For the home, a furniture company has designed a super-strong lounge chair that can be had for around $2,500, and a scooter available for approximately $3,750. A special bed for home use can serve a person of up to 450 pounds (or even heavier), but the basic horizontal structure itself is only the beginning. The side rails, for instance, may represent a separate, additional expense.

A home bed may cost around $3,000, but quite possibly might add up to more. In a hospital, a high-tech, specialized bariatric care bed could run for 10 times as much. A mattress particularly designed for very obese individuals is composed of different materials from the standard hospital mattress, and may cost as much as $4,000.

In either case, the patient will probably need a trapeze (around $1,000) to lift himself or herself off the bed’s surface and change the body position. For patients who need help when in physical therapy recapturing their ability to walk, there are ceiling lifts.

Similar devices are able to lift a very large person from the floor onto an exam table or bed. Although modern hospitals are designed from scratch with such contingencies in mind, the structure of a typical home might need some expensive refurbishment to handle a suspended load of this kind.

Different strokes for different folks

For more intimate needs in the individual’s bedroom and/or bathroom, there are transfer benches to help get a person on the toilet; bedside commodes (starting at around $200), shower chairs, raised toilet seats, toilet safety rails, and other beefed-up versions of standard items, and they all cost more if a lot of poundage is involved.

Equipment that will probably be found only inside a medical institution includes an extra-sturdy exam table that sells for around $2,000. For the use of the bariatric surgeon, special stapling equipment is available in the $4,000 – $5,000 range. But this begins to impinge on a whole different, related area.

Let’s take a moment to scope out an article about patient safety, with a long and explicatory title: “How Safety Is Compromised When Hospital Equipment Is a Poor Fit for Patients Who Are Obese.”

This assessment is five years old, but not much has changed since then:

Event reports […] indicate that some healthcare facilities do not have the necessary equipment to monitor and care for some individuals in this patient population, leading to embarrassment for patients, delays in care, and injuries to patients.

The most frequent problem situations involve imaging equipment, “especially MRI and CT scanners,” or at least events in the imaging department. Stretchers and wheelchairs are statistically implicated to a startling degree. Almost 75% of patient safety mishaps result in what is euphemistically called “a delay in care,” with most of the delays consisting not only of pausing to assess the damage, but in treating the resulting damage. Nobody wants this.

A huge field of knowledge is involved here, which mainly concerns adult patients rather than children. But this is the point we make again and again: The odds of an obese child growing into an obese adult are daunting. No parent wants to peer into the future and see this kind of picture. And looking at a bit of specialized bariatric equipment, and the associated prices, hopefully will cause some degree of a “scared straight” effect.

Your responses and feedback are welcome!

Source: “Bariatric durable medical equipment product guide,” Medline.com, undated
Source: “Bariatric and Heavy Duty Patient Lifts and Slings,” AdaptiveSpecialties.com, undated
Source: “How Safety Is Compromised When Hospital Equipment Is a Poor Fit for Patients Who Are Obese,” PatientSafety.pa.gov, March 2020
Image by dmchannelsng/Pixabay

The Growing Realization of Horror

Following along in this retrospective look at the alarming cost of obesity in the U.S. and the world, we note that a 2010 article in The Lancet had already proclaimed obesity to be, globally, a larger health problem than hunger. Soon afterward, the head of England’s National Health Service sounded an alarm, stating that “we are sleepwalking into the worst public health emergency for at least three decades.”

The World Economic Forum followed up on this shocking turn of events in 2015 (in an article which has vanished from the web), by stating that almost one-third of the Earth’s human inhabitants — in other words, 2.1 billion people — were overweight or obese. Why was this characterized as a more significant problem than hunger? Because…

That is nearly two and a half times the number of adults and children who are undernourished.

At that moment in time, obesity was deemed to be responsible for approximately 5% of the total deaths taking place among the world’s population. But well-being was not the only area of concern. The entire global economy was taking a beating:

This crisis is not just a pressing health concern; it is also a threat to the global economy. The total economic impact of obesity is about $2 trillion a year, or 2.8% of world GDP…

As World Health Organization (WHO) Director-General Margaret Chan has noted, “Not one single country has managed to turn around its obesity epidemic in all age groups.”

To make matters worse, this crisis did not, as might be reasonably expected, affect only impoverished countries — because well over half of the world’s obese people were located in developing countries, in which many people enjoyed more prosperity than they had ever been accustomed to. In places like China and India, thanks to new economic opportunities, the inhabitants of cities were ballooning up.

When previously hungry people suddenly find that food is available and that they are able to afford it, that is what they go for. Here is a painful example:

In the mid-twentieth century, for example, a boom in phosphate mining transformed the Micronesian island state of Nauru from a land of food shortages and starvation to the world’s leader in obesity and type-2 diabetes. In 2005, according to the WHO, 94% of men and 93% of women in Nauru were overweight, and more than 70% of the population was obese.

The combination of money and availability made people sent people around the bend, and who can really blame them? But casting blame was never an issue. For the authorities in charge of public health, the only issue at hand was what to do about the situation. The crisis could not even be characterized as unforeseen, because statisticians and the entire medical profession had been noticing it all along.

One unfortunate circumstance was that countries where people suddenly could afford more food than they needed did not necessarily also have the funds to provide health services that they also desperately needed. Increased disposable income perversely led to obesity that “can lock in poverty and perpetuate inequality.”

To address the crisis, the McKinsey Global Institute (MGI) identified 74 potential interventions and classified 44 of them as possessing sufficient data “to be able to measure potential impact if scaled up to a national level.” These tantalizing alleviating actions included subsidized school meals, better nutritional labeling on food products, and built environments that encouraged walking and other types of exercise.

One element in particular would prove to be increasingly crucial but also increasingly impervious to any resistance: the advertising of high-calorie food and drink. Still, undaunted by ever more alarming reality, the MGI went ahead with projections of what might, in a better world, come to pass:

If the United Kingdom, for example, were to deploy all 44 interventions, it could rein in obesity rates and help roughly 20% of its overweight and obese population return to a healthy weight within 5-10 years… Over the long term, savings from reduced health-care spending and gains from higher productivity could outweigh the investment needed to deliver interventions… In the UK, reversing obesity trends could save the National Health Service about $1.2 billion a year.

Dream on, MGI! When there are fortunes to be made selling sugar-saturated fizzy drinks to everyone from infants to geriatric patients, nobody wants to hear about interventions and alleviation and better health and blah-blah-blah. The voices of earnest experts who tried to warn of impending doom were drowned out by ever more obnoxious advertising. Throwing money at the problem did not help — because almost nobody cared to listen. The article ended by stating a dismal fact:

Today, investment in obesity research worldwide amounts to some $4 billion a year — just 0.2% of the estimated social costs of obesity.

Source: “What’s the best way of tackling obesity?,” WeForum.org, 12/15/14
Source: “Why Obesity Threatens the Global Economy,” WeForum.org, 04/07/15
Image by marlenemgm (modified)/Pixabay

U.S. Young Adults Are Eligible for GLP-1RAs, But Few Receive Them

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a relatively new and highly effective category of medications, making headlines for their role in weight loss. Now, new research from Yale reveals that approximately 17 million adolescents and young adults in the U.S. — about one in four in this age group — may qualify for GLP-1RAs, including well-known drugs like Ozempic and Wegovy.

The study aimed to define the demographic, clinical, and socioeconomic characteristics of eligible youth. Published in JAMA Pediatrics, the study’s lead author, medical student Ashwin Chetty, BS, noted that while GLP-1RAs are approved to treat obesity and Type 2 Diabetes (T2D) in pediatric populations, very few eligible young people are currently receiving these medications. Barriers such as limited healthcare access and inadequate insurance coverage are key contributors.

Chetty said:

Only a fraction of state Medicaid programs cover GLP-1RAs for weight management, but this research shows that broad anti-obesity medication coverage through Medicaid could substantially expand access to GLP-1RAs for adolescents and young adults. However, even with coverage expansion, high levels of uninsurance and lack of routine care are barriers to GLP-1RA access in this population.

The researchers also described this gap as “a barrier to identifying, treating, and preventing cardio-kidney-metabolic diseases.”

Chetty told Newsweek:

Assuming that all individuals who were appropriate candidates for these medications could receive them after shared-decision making with their clinician, we could see substantial progress made in treating and preventing obesity-related diseases in U.S. youth, such as dyslipidemia and hypertension.

This progress, he added, “could lead to the prevention of severe complications of obesity into adulthood, such as strokes and heart attacks.”

Chetty explained that the study used eligibility criteria aligned with FDA indications for medications such as semaglutide (Ozempic, Rybelsus, Wegovy), liraglutide (Saxenda, Victoza), exenatide (Bydureon BCise), dulaglutide (Trulicity), and tirzepatide (Zepbound, Mounjaro).

The research analyzed data from the National Health and Nutrition Examination Survey (NHANES) for individuals aged 12–17 (adolescents) and 18–25 (young adults). For adolescents, eligibility included a diagnosis of type 2 diabetes or obesity, defined as a BMI at or above the 95th percentile for age and sex, or a body weight over 60 kg (132 lbs.) with a BMI equivalent to 30 for adults. For young adults, criteria included type 2 diabetes, a BMI over 30, or a BMI of 27 or more accompanied by a weight-related condition like hypertension, dyslipidemia, cardiovascular disease, or T2D.

The final dataset included 572 adolescents and 590 young adults who met these criteria, representing an estimated 5.8 million adolescents and 11.1 million young adults nationwide.

Among eligible adolescents, 40.3% were covered by Medicaid, 40.5% by private insurance, and 7.2% were uninsured. For young adults, 20.8% had Medicaid, 49% had private insurance, and 19.4% were uninsured. While 92.2% of adolescents reported a regular source of healthcare, only 68.1% of young adults did, highlighting a key access gap.

The study also found that cardio-kidney-metabolic risk factors such as hypertension, prediabetes, impaired kidney function, and abnormal cholesterol levels were common across both age groups.

“Of note, some indications for young adults were fully encompassed by other indications and were not analyzed separately,” Chetty explained. For instance, individuals with type 2 diabetes may also have cardiovascular disease, which overlaps with other eligibility criteria.

Improving access to healthcare among young adults could help more eligible patients benefit from GLP-1RAs. In addition, expanding Medicaid and private insurance coverage for these medications across all age groups could make a significant impact.

James Nugent, MD, MPH, a co-author of the letter, told Newsweek,

Changes in lifestyle behaviors and structural factors like increased screen time, decreased physical activity, poor sleep, and consumption of ultra-processed foods and sugar-sweetened beverages are important contributors to obesity in youth.

Dr. Nugent emphasized that addressing pediatric obesity demands both individualized treatment and broad public health strategies. Medications like GLP-1RAs are one tool among many for managing obesity in children and teens, especially those facing severe obesity and related health complications.

Looking ahead, the authors urge greater national dialogue on how to expand access to GLP-1RAs and other evidence-based obesity interventions. “Given the size and clinical characteristics of the U.S. youth population eligible for GLP-1RAs, there should be greater discussion of how to improve access to GLP-1RAs and other anti-obesity interventions among this population,” they concluded.

Your responses and feedback are welcome!

Source: “New Research Letter Examines GLP-1 Access for Adolescents and Young Adults,” Yale School of Medicine, 8/4/25
Source: “Glucagon-Like Peptide-1 Receptor Agonist Eligibility Among US Adolescents and Young Adults,” JAMA Pediatrics, 8/4/25
Source: “Nearly 17 Million Young Americans Could Benefit From Ozempic-like Drugs,” Newsweek, 8/4/25
Image by MART  PRODUCTION/Pexels

A Painful Paradox

What has been the total financial cost extracted by childhood obesity — which almost inevitably proceeds to become the adult kind — throughout the world, throughout history, or even for a short time period? Nobody knows, but it is instructive to sample various news articles from sundry times and places, which Childhood Obesity News is in the midst of doing.

To continue by going back a little over 10 years, we look at a widely discussed report on the subject, from the Associated Press. That $2 trillion figure cited in the headline was a momentous amount, and not just because of its awesome size. The number was also identified as “nearly as much as smoking or the combined impact of armed violence, war and terrorism.” Smoking, okay, we get it — awareness of the cost of that habit was increasing day by day, and awareness of its destructiveness was spreading widely.

An eye-opening statistic

But to cost more per year than war, terrorism, and other armed violence? Who could wrap their head around a statement like that? A lot of people sat up and took notice. Just in case anyone missed the point, the figure was also identified as “2.8 percent of global gross domestic product.” A consulting firm, the McKinsey Global Institute, had done the math and brought out some other numbers, too:

The company says 2.1 billion people — about 30 percent of the global population — are overweight or obese and that about 15 percent of health care costs in developed economies are driven by it.

Sadly, the enormous amount of obesity was found to correlate with prosperity. Entire countries would rise out of abject poverty, and their people would react by piling on the pounds. Of course, no one is in favor of starvation. But it seemed like such a cruel joke, to see a higher living standard translate to a larger number of people whose obesity would cost them, and everyone else, a fortune. Folks who had never had enough to eat became folks who reacted to their improved circumstances by creating another problem — inability to fit into their clothes or to pay the medical bills that accrued as obesity caused ever more health problems.

One step forward, two steps back

Experts predicted that if things kept going in the same direction, by 2030, half the world’s adults would be overweight or obese. Nobody knew what to do, partly because, as the McKinsey organization reported, “global disagreement on how to move forward is hurting progress.”

By the time 2015 started, obesity awareness in the U.S. had notably increased, and the number of affected citizens had grown. More than one-third of adult Americans, and approximately one-fifth of the nation’s teens, were classified as obese. Kids from low-income families were heavily affected, apparently because their parents lacked the educational background to recognize the importance of avoiding extra weight, and also, obviously, because the food they could afford tended to be less costly and more calorie-laden.

In short, both prosperity and poverty are perfectly capable of contributing to the problem. What a messed-up situation.

Problems multiply

Awareness of such terms as “food desert” rose, as realization grew that many families lacked not only money, but transportation to go where fresh vegetables and fruits were available. They tended to live in areas where opportunities for healthy exercise did not exist, and where going outside more than necessary was too dangerous. For many Americans, something like a gym membership was as unaffordable as a vacation in Paris.

But the relationship between wealth and weight was also perceived as a two-way street. For a number of reasons, people (especially women) carrying extra pounds tended to earn less money. The cause was not as simple as weight bias. The Brookings Institution, a nonprofit public policy organization (aka “think tank”), among others, became very interested in how both excess weight and insufficient income are transmitted from one generation to the next, and “higher body weight predicts lower wages” became a recognized truism.

Your responses and feedback are welcome!

Source: “Report: Global obesity costs hits $2 trillion,” APNews.com, 11/20/14
Source: “Weight and social mobility: Taking the long view on childhood obesity,” Brookings.edu, 01/08/15
Image by vocablitz/Pixabay

A Crucial Cost of Obesity

The theme of “obesity versus military readiness” did not fade from public consciousness. A 2013 headline stated the case: “Food a ‘national security issue’ for America.” A message can’t get much plainer than that. Despite the exemplary phrasing, an essay penned by Jason Miks has vanished from the web, though it is referenced on social media.

In it, Anthony Bourdain is quoted:

We are eating ourselves to death. We are largely an unhealthy and increasingly obese and increasingly diabetic country. One can well make the argument that it is eroding our military readiness! And I say that only half in jest.

We are not alone

This was far from being an exclusively American problem. Studying the records of 150,000 Swedish males in their 18th year, and then comparing later information, showed that obese males earned on average (over their lifetimes) 16% less than their normal-weight counterparts.

In terms of disadvantage, this is roughly equivalent to missing out on three years of college. Obviously, many of these Scandinavian hunks would not be accepted by any self-respecting military leadership.

In the same year, financial analysis techniques were also being applied in other areas. Are we ready to explore more costs of obesity that wind up being paid by everyone, regardless of whether they signed up for it? Probably not, but that doesn’t change a thing. Those expenses are woven into the fabric of society.

A multiverse of size

In 2013, a multi-author study (presented to the Tenth International Society of Sports Nutrition Conference) compared four popular weight loss programs in terms of their cost-effectiveness. The researchers started with 129 women of sedentary habits and randomized them into five groups: the Curves Complete 90-Day Challenge; Weight Watchers Points Plus; Jenny Craig; Nutrisystem Advance Select, or no program (the control group).

During the experiment, they averaged the program costs and the food purchase costs for each group. Each participant’s weight, waist circumference, hip circumference, bone mineral content, fat mass, fat-free mass, and peak oxygen uptake were analyzed. With no further suspense, here is the conclusion:

The WW group tended to lose a lot of weight and fat mass per dollar spent, but also lost more fat-free mass resulting in a lower change in body fat percentage. The CC group tended to improve peak oxygen uptake and lose more weight and fat mass while preserving fat-free mass resulting in the greatest change in body fat percentage per dollar spent. This analysis suggests diet plus exercise is more beneficial to health and weight loss than diet alone.

In the same timeframe, a substance called Bisphenol A (commonly known as BPA) was recognized as major-league bad news. In 2014, more than a decade ago, a study conducted by Health Affairs was the first to attach a dollar value to the damage done by BPA, as follows:

Author Leo Trasande found that $2.98 billion in annual costs are attributable to BPA-associated childhood obesity and adult coronary heart disease. Of the $2.98 billion, the study identified $1.49 billion in childhood obesity costs, the first environmentally attributable costs of child obesity to be documented.

The conclusion derived from this information at the time was that the FDA should insist that manufacturers find something else to put in their products instead.

Your responses and feedback are welcome!

Source: “Food a ‘national security issue’ for America,” CNN.com 09/13/13
Source: “Being obese can cost you as much as missing three years of college ” DailyMail.co.uk, 10/09/14
Source: “Analysis of efficacy and cost effectiveness of popular weight loss and fitness programs,” JISSN.com, 12/06/13
Source: “Health Affairs Web First: First-Ever Quantitative Data About The Toll Of BPA Exposure,” HealthAffairs.org, 01/22/14
Image by anaterate/Pixabay

New Study Suggests Genetics Can Predict Obesity in Childhood

A groundbreaking international study has revealed that our DNA may hold vital clues about our risk of developing obesity — even before we hit kindergarten. Using genetic data from more than five million people, researchers have developed a new polygenic risk score (PGS) that can accurately predict an individual’s likelihood of developing obesity starting from early childhood.

This discovery opens up exciting new possibilities for targeted early intervention, offering hope in the fight against a growing global health crisis.

Unlocking obesity risk through DNA

Led by researchers from the University of Copenhagen and the University of Bristol, the study has created the most advanced genetic tool to date for predicting obesity. The polygenic risk score, built on the world’s largest and most diverse genetic dataset, assesses thousands of genetic variations that collectively influence a person’s body mass index (BMI) and appetite regulation.

Assistant Professor Roelof Smit, lead author of the study published in Nature Medicine, explains:

What makes the score so powerful is the consistency of associations between the genetic score and BMI before the age of five and through to adulthood — timing that starts well before other risk factors begin to take shape. Intervening at this point could theoretically make a huge impact.

The PGS predicts a person’s obesity risk with twice the accuracy of previous methods and accounts for nearly 17% of the variation in BMI, an unprecedented leap in the field of genetic research.

Why this matters

According to the World Obesity Federation, more than half of the global population is expected to be overweight or obese by 2035. While traditional treatment methods like diet, medication, and surgery exist, they are not universally available or effective, and they typically come after weight problems have developed.

This new research highlights the potential of genetics as a preventive tool rather than just a diagnostic one. By identifying children with a high genetic predisposition to obesity early on, public health efforts can shift focus from treatment to prevention.

Dr. Kaitlin Wade, co-author and Associate Professor in Epidemiology at the University of Bristol, underscores this point:

Obesity is a major public health issue, with many contributing factors including genetics, environment, and behavior. Some of these likely begin in childhood. This work offers an exciting opportunity to detect at-risk individuals earlier in life and intervene proactively.

How the polygenic risk score was built

To develop the PGS, researchers used data from:

  • GIANT Consortium, a large-scale genetics initiative focused on anthropometric traits
  • 23andMe, consumer DNA testing data
  • Children of the 90s study, longitudinal BMI data tracked from birth

This allowed scientists to link specific genetic markers with patterns in BMI from early childhood through adulthood. When tested on over half a million individuals, the new score outperformed all previous models, establishing itself as a reliable early predictor of obesity risk.

Not just genetics

One of the most important takeaways from the study is this: Genetics is not destiny.

While the PGS can signal risk, lifestyle interventions, such as healthy eating, physical activity, and behavioral support, still play a critical role in outcomes. Interestingly, the study also found that individuals with a higher genetic risk for obesity were more likely to respond positively to weight-loss interventions. However, they also tended to regain weight more quickly after interventions ended.

The future of obesity prevention?

This research represents a major leap forward in understanding the complex genetic underpinnings of obesity. By identifying high-risk individuals in early childhood, there’s a real possibility to prevent obesity before it takes root, rather than trying to reverse it after the fact.

If adopted widely, polygenic risk scores could become a key tool in pediatric medicine, guiding personalized lifestyle coaching and health education that could change the trajectory of a child’s life.

Your responses and feedback are welcome!

Source: “New genetic test predicts obesity before you start kindergarten,” ScienceDaily, 7/23/25
Source: “A new genetic test may be able to predict obesity in early childhood. What to know,” USA TODAY, 7/23/25
Source: “New genetic test predicts obesity risk in early childhood,” Contemporary Pediatrics, 7/22/25
Image by Artem Podrez/Pexels

The Right to Be Obese

It is actually pretty amazing how many times the alarms have sounded, just because some mathematicians practiced their trade and said, “Hey! What’s going on here?” Time and time again, experts have tried to get people to open their eyes and check their pocketbooks to see if what these highly educated individuals were saying made any sense. Why? Because the experts were saying things like, “Americans are doomed.”

Experts with advanced degrees and extensive experience in several fields, employed by universities and think tanks and medical institutions, and the government, to mention a few, have done their darnedest to try and make the public listen. Obesity is a very, very expensive condition, and the more assiduously the logisticians examine the problem, the more frightening it becomes… to anyone who is paying attention, anyway — which seems to be a vanishingly small number of folks.

Easy to ignore

Many Americans dismiss these warnings as “much ado about nothing,” but even into their resistant minds, it seems like some shards of light ought to have penetrated by now. Quite understandably, many patriots who love and praise the ideal of individual freedom have suggested that people should be left alone to pursue happiness in their own preferred manner, even if and when this includes a self-destructive lifestyle that also costs society a pretty penny.

This mindset does make a certain amount of sense, in a way. Of course an American should be allowed to eat whatever she or he prefers. On the other hand, we have rejected total acceptance of the doctrine that anyone should be allowed to drink whatever they want, whenever they want. Most jurisdictions within the United States have set age limits on who can buy, possess, and legally consume alcohol. So there actually is a rough consensus, in most states and cities, to the effect that rights are not without limits.

In fact, the law goes further, and is perfectly willing and able to prosecute people whose alcohol use brings harm to other Americans, or even just to themselves. Of course, many people experience inner conflict about this. Returning to the destruction that can be caused by careless, unheeding consumption of food — millions of Americans, whether volunteers or draftees, have fought and died for the cherished ideal of freedom.

Wakeup call?

But then, at a certain point, officials spoke up to say, “Attention! It appears that because of an epidemic of obesity, not enough Americans are fit enough to qualify to belong to the same military that is in charge of preserving our freedom.” What a paradox. What a debacle.

These are only two of the many strands that weave the tapestry of body weight disaster in our country… and nobody has finished talking about the subject. Earlier this week, Newsweek.com published ” ‘Extremely Severe’ Obesity on the Rise in US Children — Study” by Hollie Silverman. The journalist reports that…

Extremely severe obesity among American children has increased more than threefold over the past 15 years, with new research published on the JAMA Network, highlighting disturbing trends in prevalence and related health complications.

People between the ages 2 and 18 (in other words, the entirety of America’s youth) are busily increasing their obesity rates more efficiently than any other demographic. Analysis of 15 years worth of research has revealed a dismal picture. The study’s four authors use the expression “public health emergency” and also the phrase “urgent need for public health interventions against pediatric obesity.”

Silverman writes,

The sharp upswing in extremely severe obesity among children raises the risk of developing serious medical conditions — including type 2 diabetes, steatotic liver disease, also known as fatty liver disease (MASLD), metabolic syndrome, and cardiovascular disease.

And what have we been saying? Exactly — that the urgent need for public health intervention, caused by the aforementioned sharp upswing, comes at an enormous cost. Putting aside the drastically traumatic effects on the children and youth involved… and leaving aside the frustration and rejection and numerous other negative emotions experienced by these kids… and ignoring for a moment the immense physical suffering experienced by victims of the above-named diseases… all of this is horrendously expensive in sheer financial terms.

Okay, let’s get back to talking dollars:

In 2024, the CDC estimated the annual medical cost of childhood obesity at $1.3 billion…

Your responses and feedback are welcome!

Source: “’Extremely Severe’ Obesity on the Rise in US Children—Study,” Newsweek.com, 07/20/25
Images by FotoshopTofs, sedatgunduz/Pixabay

All Sorts of Prices

After the turn of the century, it became more evident every year that spending a smaller amount in the present could avoid much larger bills later on. Teenagers were shuffling around looking like pathetic retirees, and once America had become accustomed to the idea that there were not enough physically fit youth to make an army, it quickly became clear that a large part of the national workforce might lose the capacity to perform any work at all, due to physical neglect and a reluctance to acquire better habits.

Over the century’s second decade, it became clearer every day that the obesity train had jumped the track. Dangerous body weight became a common media topic. Percentages and ratios were calculated, and inventive minds conjured ways to impress audiences with shocking conclusions:

Some 40 to 50 percent of food eaten by kids is consumed at school, and school cafeterias, which have to be financially self-sufficient, push unhealthy, packaged food at kids.

The average teenager was daily gulping down four containers of sugar-sweetened beverages, which, as statisticians and journalists warned the public, are…

[…] the equivalent of an entire extra meal in terms of calories… With a 90 percent profit margin on their products, the soft drink industry can spend millions on hyperactive advertising.

Point being, obesity was getting more expensive every day. The Federal Trade Commission banded together with several other distinguished agencies in an attempt to make the food industry adopt a few nutritional guidelines, but this concept was shot down. Dire and unarguable predictions were made:

Americans are doomed to pay even more for the cost of treating obesity-related illness if the weight epidemic is not addressed. And unless we’re willing to respond to the timely wake-up call […] many of us — and many of our children — will pay with their lives.

Those remarks were made in response to the acclaimed four-part TV series, “The Weight of the Nation.” Journalist Molly Creeden compares the obesity alarm response to the time years before when people began to react against the dangers of tobacco smoking. Again, bad habits correlated obviously with huge expenses:

Nearly 69 percent of American adults and 32 percent of children are overweight or obese… The U.S. spends nearly $150 billion on obesity-related healthcare annually, and the affliction costs American businesses $73.1 billion a year.

Ouch!

Those sugar-sweetened beverages were not the only villain. Blame should also be laid at the feet of “conglomerate food companies, whose marketing of unhealthy choices —particularly to children — is painted as merciless.”

Of course, the available food itself is not the only source of blame. There is always a need to look at what inspires a child to eat too much. In various posts, Childhood Obesity News pointed out that sometimes a history of abuse causes a young person to deliberately become obese in order to deflect unwanted and unwelcome physical attention, and this can be true of both girls and boys.

A male child who was bullied in his younger years might grow to a massive size to intimidate hostile others by his sheer bulk. A youth who does not ever want to be inducted into the military might, consciously or subconsciously, decide to become obese to avoid that fate. When psychological depths are plumbed, anything might happen.

A child might feel that layers of fat provide a sort of cushioned armor that can protect her or him from the world’s perils. Sometimes a young girl will discover this on her own. In other unfortunate cases, there may be misbehavior or a threat of assault on the horizon. An anxious, misguided mother who holds the belief that chubbiness will protect her female child from unwanted male attention might purposely overfeed that little girl to provide protection in the only way she knows how.

Many different kinds of mistakes can be made, and they all come with a price attached.

Your responses and feedback are welcome!

Source: “’The Weight of the Nation’ review: Obesity crisis,” SFGate.com, 05/10/12
Source: “American Emergency: HBO’s The Weight of the Nation,” Vogue.com 05/11/12
Image by trtasfiq/Pixabay

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources