The Fat Tax in Brazil

What 1960s worldwide hit went on to become the (probably) second-most recorded pop song in history? That’s right, “The Girl From Ipanema,” written by Vinícius de Moraes and Antônio Carlos Jobim:

Tall and tan and young and lovely
The girl from Ipanema goes walking
And when she passes
Each one she passes goes “Ah!”

Additionally, the cool swing and sway of her walk reminds onlookers of a dance called the samba… But what is the use of reminiscing about a sight that has become increasingly rare in Ipanema or anywhere else in Brazil? Sadly, the nation that The New York Times journalist Jack Nicas called “a country known for beach bodies” has changed a lot in the intervening six decades.

Brief digression

Obviously, no one here advocates that overweight and obese people should be mistreated in any way, whether at school, at work, or in the wild. On the other hand, it is a pretty good bet that most obese people would prefer not to be in that situation, which can be uncomfortable in many ways: physically, emotionally, and — as we have especially been looking these days — financially.

One current trend is that all sorts of people pay big bucks in efforts to counteract the unpleasant effects of obesity, their own and others’. But it does not have to be like this. If we could somehow manage to be honest with ourselves and tolerant of others, those two practices would go a long way toward figuring out how to turn this thing around.

Meanwhile, back in Brazil

Still, some might argue that there is such a thing as too much tolerance. For example, in Brazil, obese people are favored with “preferential seats on subways, priority at places like banks and, in some cases, protection from discrimination.”

Note: Many would say that “protection from discrimination” belongs on a different list, because everyone should be protected from discrimination at all times. Everyone has enough problems already, and nobody needs that nonsense.

At any rate, Nicas has described how new laws have “made Brazil the world leader in enshrining protections for the overweight” while an “accelerating movement” has caused the country to become “one of the world’s most accommodating places for people with obesity.” Nicas writes:

[T]he schools are buying bigger desks, the hospitals are purchasing larger beds and M.R.I. machines, and the historic theater downtown is offering wider seats.

Many citizens resent all this, reasoning that ultimately, sooner or later, one way or another, every customer pays for these seats and desks and beds and machines. Many people favor tolerance in theory but can’t help thinking that perhaps, in practice, there has been a bit too much of it. As Nicas reported in February, “Over the past 20 years, Brazil’s obesity rate has doubled to more than one in four adults.”

Each day when she walks to the sea…

Ipanema is an area of Rio de Janeiro that features a beach. More than a thousand miles north is Recife, another coastal metropolis with great beaches and a population of over four million, and the reputation, Nicas says, of being “one of the fattest cities in Brazil.” He speaks of a public school there that mandated classes on weight prejudice for teachers and students alike. Since the days of the Girl, this whole South American nation has gained weight.

(To be continued…)

Your responses and feedback are welcome!

Source: “Brazil, Land of the Thong, Embraces Its Heavier Self,” NYTimes.com. 02/27/22
Image by phadoca/Pixabay

The Lifelong Price of Obesity

Multitudinous examples illustrate how, ultimately, every sector and group of which our society is composed will ultimately pay the price of obesity one way or another. Before getting into another one of those, here is a generalization.

The victims of it suffer the most, of course. But even people whose personal body weights are healthy will, one way or another, foot the bill that always falls due for the existence of obesity. There are a few essential messages that, for various reasons, need to be discussed repeatedly and by many voices.

What could surpass badness?

An important point is: To blame obese people is not only unfair and ignorant, but it’s worse than bad — it’s useless. If fat-shaming and fat-blaming have not revolutionized the situation in all these years, such a change is unlikely to happen in the future.

As has been discussed here before, what might turn things around is an uprising against corporations that fill up boxes and bags with any old detritus that happens to be lying around the laboratory, rather than with actual, viable food. Of course, we already have that, in a way. Numerous companies and chains specialize in foodstuffs that are scientifically proven to be superior in every way, and some folks pay a lot for them.

Others cannot afford to do that, or rationalize and justify to themselves that they can’t, and either way, the result is the same. The status quo is unfair, but — as many would argue — still preferable to nobody having any choice at all.

Let’s face it

The bottom line is our kids. They grow and get jobs and fall in love, and all that good stuff. Later on, they struggle to support the families that result from those first two milestones. Then, inevitably, one way or another, our children and their children will be handed a bill for a portion of obesity’s cost.

An article titled “Obesity is linked to higher rates of bankruptcy, according to a new study,” published not long ago by a website specializing in success, makes some interesting points. The information source was a study of bankruptcy in 3,000 counties in America, which found that the economic costs of obesity are staggeringly enormous and inescapable.

The medical costs are ultimately paid by everyone, regardless of individual weight status. According to the article,

The Center[s] for Disease Control and Prevention (CDC) reports that people who have obesity are at increased risk for many serious diseases and health conditions. This includes high blood pressure, type 2 diabetes, coronary heart disease, stroke, and many types of cancers, to name a few.

Those costs are shared by other insured individuals, patients’ family members, taxpayers, doctors who are pressured into corporate employment rather than private practice, and so on. Here is the technical, financial gist of the matter, as conveyed by economics professor Masanori Kuroki,

A one-percentage-point increase in the obesity rate is associated with a 0.02-0.03 increase (or a 1.0 percent increase) in Chapter 7 bankruptcy rates per 1,000 residents and a 0.02-0.04 increase (or a 3-4 percent increase) in Chapter 13 bankruptcy rates per 1,000 residents.

In addition to the cost of obesity, there is the cost of avoiding obesity, which also fits onto the scale when weighing the overall cost to the public. Childhood Obesity News has previously quoted Dr. Katy Miller, whose words are worth repeating:

We are proposing treatment strategies that are expensive and even in the best circumstances are often unsuccessful. How can we ask someone to diet when we’re not addressing things like poverty, food scarcity and housing instability?

This is true not only of Dr. Miller’s clientele, consisting of teenagers with eating disorders, but of every person in the USA. Furthermore, weight-loss pharmaceuticals will probably not vanquish obesity, and surgery is only suitable and affordable for a small minority of concerned individuals. And the money to pay for treatments of any kind could dry up any day.

Of course, there is the ongoing debate over which is worse: obesity that leads to poverty, or poverty that leads to obesity? The simple answer is that both need to be fixed. So, instead of wasting our breath debating that fine point, we might as well just get on with vanquishing both.

Your responses and feedback are welcome!

Source: “Obesity is linked to higher rates of bankruptcy, according to a new study,” TheLadders.com, 09/13/20
Image by Surprising Media/Pixabay

The Fat Tax at Work

The title of this piece is a two-fer, because it refers to the condition of someone who is inconveniently overweight in the job market and the workplace, but also it describes how obesity stays on the job every minute of every day, always doing its best to cheat a person of the full enjoyment of life in all its aspects.

Evidence that this is a widespread problem is provided in an essay, “The Real Cost of Being Fat.” Author Christian Curet begins with some thoughts about time and how a person tends to become careless, and to underestimate its worth. It does seem that in life, the specifics are negotiable. A person might put the highest value on work, or on personal relationships, or both, and that is a matter of individual preference. The point to keep in mind, however, is that wasted time is something we will never get back. Also, we will regret (sometimes bitterly) its loss.

As a prime example of a time-waster, the author offers, perhaps surprisingly, “excessive leisure,” an intriguing idea that stirs curiosity but is not discussed further in this essay.

Back to business

Meanwhile, he describes how much of his time is wasted by an activity which, while stationary and maybe even relaxing, could by no means be described as leisure. That is sitting in an outpatient clinic with a needle in his arm, receiving infusions to treat Crohn’s disease and ankylosing spondylitis.

To that information, he adds, “Because I’m about 100 lbs overweight, I have to sit in this chair for an extra hour every time because the volume of medicine is based on weight.” A repetitious weekly chore is organizing all the medications for the following seven days. In confessional mode, he writes:

I have to take time each day to deal with my CPAP machine for my sleep apnea. I have to take time to measure my blood sugar because I’m a Type 2 diabetic. I have multiple doctor appointments for these conditions too. You add all that up and I’m losing hours of my life a month because I didn’t take time to take care of myself before.

The great majority of this patient’s health problems are routinely associated with obesity. He admits, as many of us will if we are honest, that in our younger years, we were in fact quite careless, taking on board a plethora of inappropriate foods, and too much of them, as well as ignoring the necessity for frequent and meaningful exercise.

But wait, there’s more

Medical care is not the only cause of monetary outflow. Clothing is a major expense, and a sensitive issue. (See “Fatsploitation is Alive and Well.“) And food? Eating well is more expensive. Only junk food is cheap.

Now, here is an aspect of carrying too much weight that never occurs to most healthy-weight people. With 100 or more extra pounds of body weight, even the most motivated customer can find that the equipment for many health-inducing activities is forbiddingly expensive. A person who wants to get some exercise could be forever discouraged by the price difference between two different kayaks, one of them extra-large.

To finish up, this very fortunate writer credits his wife and kids in a lovely tribute:

I’ve found that if I ask, my family will do most of these things with me. They’ll cook healthy foods with me, join me in exercising (if it’s fun) and will slow down and climb the steep trails with me. I just have to be humble enough to ask and not see it as a burden for them, but as an opportunity. For all of us.

Your responses and feedback are welcome!

Source: “The Real Cost of Being Fat,” Medium.com, 08/21/20
Image by CDD20/Pixabay

How Can the Federal Government Help?

This current series looks at the costs of obesity to society as a whole, and many readers may experience surprise as instances and examples of harmful influence are revealed. One certainty cannot be repeated too often, and that is the unavoidable fact that childhood obesity affects all children — if not directly, then indirectly.

Our kids, no matter what shape they are in now, may grow into obese adults. Even if they do not personally share that fate, the society they live in for the rest of their lives will certainly be lavishly populated with obese adults. This fact will be reflected in the taxes they pay, as well as in many other aspects of their lives.

Many government departments are concerned about reducing the expenses that society is expected to cover, and in numerous cases, these bureaucracies can actually do something about the conditions that cause those expenses to mount.

As we have seen, adequate hydration is one of the conditions that can go some distance toward alleviating widespread obesity. The National Institutes of Health naturally want to know how workplaces, homes, and schools can be helped to maintain standards that will cause less obesity and less illness, and fewer injuries and thus, less expense to the national budget.

Consequently, that agency paid attention to a publication describing WHPPs, or workplace health promotion programs. Any WHPP that the government comes up with is intended to improve citizens’ lifestyles and consequently their health, and furthermore the prosperity and well-being of the businesses where they earn their salaries.

Every such program ever initiated has been launched with the purpose of promoting physical and mental health. By aiming to promote physical activity, such programs hope to increase workplace productivity and, ultimately, to reduce the number of sick days claimed by the workers. Furthermore, a well-designed WHPP can improve “employee productivity, working energy, and job satisfaction, as well as decrease absenteeism, enhance a sense of community, health behaviors, and overall well-being.”

That is a tall order, but the designers of these programs are quite serious and dedicated to their goals. The hope, always, is that employees who benefit from these well-intentioned programs will speak generously of them to other workers, thus making further adoption of the ideas frictionless.

When someone does not drink enough water, the body is aware of being deprived of something important, and may react by malfunctioning in ways that no employer wants to see — like changes in attitude and consciousness that can lead to expensive mistakes or counter-productive hostility, or even to internal conditions that foster actual physical illness.

The changes in people’s knowledge, attitudes, and expectations may be minor, and yet still exert significant influence on their capabilities and moods, and meaningfully impact the work environment’s overall emotional and cognitive weather. All in all,

Adequate water intake is a low-cost and effectively non-invasive strategy for individual health outcomes… Besides significantly increasing water intake, the intervention improved other health behaviors, thereby benefiting physical and mental health. Hence, promoting water consumption in workplaces till it becomes a habit may benefit the employees.

Your responses and feedback are welcome!

Source: “Effectiveness of a Water Intake Program at the Workplace in Physical and Mental Health Outcomes,” NIH.gov, 2022
Image by daha3131053/Pixabay

Overweight Because Impoverished, or Impoverished Because Overweight?

The title poses a trick question, because there is no “either-or” about it. People get fat because they are poor, and also become poor because they are fat. Both propositions are sadly and eternally true. One of the easiest tasks on the planet would be to populate a series of articles with references to reciprocity: specifically, about how overeating (which almost always results in obesity) can have a negative effect on personal and familial food budgets; and how either too much money or too little money can both drive a person toward obesity.

Of course, formal academic papers have been written about these stubborn questions. One such document is “Income and obesity: what is the direction of the relationship?,” which was published in 2018 by two researchers from the Department of Medical Sociology at Germany’s University Medical Center Hamburg-Eppendorf.

The subtitle is, “A systematic review and meta-analysis;” the “meta” designation being appropriate because 21 different studies were consulted, most from institutions in the United States, along with a few from the U.K. and Canada.

As the authors scrutinized the various sources, a pattern was apparent, of lower income being associated with a higher risk of obesity. At the same time, it became clear that “the perspective of a potential reverse causality is often neglected, in which obesity is considered a cause for lower income.” Their intention was to explore the relation between income and obesity by “specifically assessing the importance of social causation and reverse causality.” The materials included 14 studies on causation, along with half as many on reverse causality.

On a superficial level, it is easy to grasp some of the major reasons why poor people tend to become fat. A lot of cheap, fattening food is available, especially in what are called “food deserts,” where people don’t have the transportation opportunities to go to stores where healthier fare is available, cannot afford to pay for memberships to big discount stores, and don’t have access to gyms, and so on.

However…

Yet these researchers suspected, perhaps counter-intuitively, that “Findings suggest that there is more consistent evidence for reverse causality.” This indicated a need to take a closer look at reverse causality processes than had been previously attempted. So why and how, exactly, is obesity likely to lower a person’s income?

In general, a body perceived as too large conveys the impression, whether true or not, that the individual is weak-willed, lazy, and undisciplined. In the labor market, this translates into fewer opportunities to be hired, lower chances of being promoted, and a higher likelihood of being “let go” when staff needs to be reduced.

In the minds of many non-obese people, difficulties are presupposed, and penalties are pre-imposed. Judgment is not reserved until a chair is actually broken, but is arbitrarily rendered, based on suspicion that the person might break the chair.

Obviously, that reverse causality involves a massive amount of social causation. Obese people tend to “drift into lower-income jobs due to labor–market discrimination and public stigmatisation.” This is particularly true for women, who tend to draw much more criticism for being overweight, and who, when carrying excess pounds, find it more difficult to present themselves in public as being worthy of respect for other reasons.

To explain such differences, one of the researchers suggests that…

[…] obese women are confronted with disadvantages that derive from the stigmatisation of fatness, and additionally face higher expectations to perform their gender properly. According to the cultivation theory of the social sciences, there is a stronger idealisation of thin women, which may help to explain why there is a stricter weight penalty for women than for men.

Your responses and feedback are welcome!

Source: “Income and obesity: what is the direction of the relationship? A systematic review and meta-analysis,” NIH.gov, January 2018
Image by Pixabay, used under the Pixabay content license

Obesity, It’s Everybody’s Baby

Childhood obesity will ultimately cost someone a significant amount of money; whether it be the parents, the institutions of learning that the kids attend; the kids themselves when they grow up; their employers; the airplane manufacturers who are required to provide wider seats; or the general public, in the form of taxes collected to alleviate medical conditions both congenital and acquired, for the betterment of society as a whole.

The harm generated by childhood obesity involves more than just the individual child’s health. Whether or not it is their fault, and whether or not others spitefully blame them, and regardless of whether it is fair — in one way or another, obese people constitute an expense to society.

On this blog, much attention has been focused on one very important facet of the societal impact of obesity, namely: It eventually touches everyone in some way. In many cases, this impact is physical, as the person joins the ranks of the overweight and obese. Still, hefty as those numbers are, direct physical participation in obesity is not universal. But financial participation is inevitable.

Big research

In 2018, much current information and many previous statistics were consolidated by Hugh Waters and Marlon Graf of the Milken Institute into a major report.

They looked into the costs that health conditions related to overweight and obesity were racking up, because these expenses would ultimately be paid for by “individuals and their households, employers, government, and society.” In other words, sooner or later, directly or indirectly, every person in the country would be liable for these costs. In some cases, it might be considered fair, because 60% of Americans (just over 180 million people) were either overweight and heading inexorably toward obesity, or had already arrived there.

Startling hindsight

Travel back in time for a moment, to 1962. In that year, a young teen could look around and observe an adult population in which only 13.4% of the men and women were obese. In 2016, that same person’s adolescent grandchild could look around and see 39.8% of the grownups in an obese condition. Where there used to be one obese person in a family, now there were three. Where there used to be 100 obese people in an auditorium, now there were 300.

To break it down another way, in that year about 100 million Americans were obese, and about 80 million were overweight, and these two combined statistics accounted for…. wait for it….

$480.7 billion in direct health care costs in the U.S., with an additional $1.24 trillion in indirect costs due to lost economic productivity.

If numbers like this do not cause people to sit up and take notice, nothing will. Just in case the message was not getting through, a mathematician did another calculation, which was announced at the same time:

The total cost of chronic diseases due to obesity and overweight was $1.72 trillion — equivalent to 9.3 percent of the U.S. gross domestic product (GDP).

Another formidable finding went like this:

Obesity as a risk factor is by far the greatest contributor to the burden of chronic diseases in the U.S., accounting for 47.1 percent of the total cost of chronic diseases nationwide.

“By far the greatest contributor…” Strong words, indeed. Where does the “risk factor” accusation come from? Apparently, obesity is implicated as a causative or exacerbating factor in a large assortment of diseases, from head (Alzheimer’s and vascular dementia) to toe (type 2 diabetes).

The report from the nonprofit, nonpartisan think tank notified the public about a major fact. Of all the factors that contribute to the continuing existence of chronic diseases, obesity is the undisputed champion because it “increases insulin resistance, blood pressure, LDL cholesterol, and triglycerides. Further, obesity lowers HDL cholesterol and places the body in a pro-inflammatory state.”

The authors explain how fat cells, even though they are distributed throughout the body, have perfected the technique of ganging up in a network to function as one discrete endocrine organ, and with ferocious effect. The report gives specific examples of how this works, and notes that together, “these multiple related pathways are referred to as metabolic syndrome.”

The report’s Table 8 is frightening, with its presentation of the direct and indirect cost per case (in 2016) of 23 serious conditions. (Two varieties of carcinoma come out on top.)

For the minutiae-minded, the report also offers over 100 source footnotes.

Your responses and feedback are welcome!

Source: “America’s Obesity Crisis: The Health and Economic Costs of Excess Weight,” MilkenInstitute.org,” 10/26/18
Image by World Obesity Federation

The Importance of Hydration Recognized

We have mentioned that businesses are interested in learning how to discourage workers from “doing things on company time that will eventually cost the company many dollars.” One of those factors is the consumption of sugar-sweetened beverages, which have been shown to cause obesity. The particular methodology of this threat is that employees who become obese tend to bend the “bottom line” expensively.

Most people probably do not have a clue about all the history behind the availability (or not) of water in either public locales or in places of business. Over the years, many laws have been argued, passed, contested, and rewritten, over the issue of water in the workplace. Considering the enormous number of different kinds of workplaces that exist, keeping up with the whole field must be an exhausting responsibility. It is good to know that special attention has been paid to the importance of water in preventing obesity.

In the USA, the Occupational Safety and Health Administration requires that potable water be available to workers, and that they should be encouraged to drink it, and cannot be asked to pay for it. The rule is not confined only to readily accessible water for the quenching of thirst, but encompasses every use for which potable (technically, safe to drink) water is utilized:

[…] for drinking, washing of the person, cooking, washing of foods, washing of cooking or eating utensils, washing of food preparation or processing premises, and personal service rooms.

Furthermore, “Each industry contains specific requirements tailored to the conditions of these fields,” including guidance on the provision of “reasonable opportunities” to hydrate. Of course, these considerations may be extended not just out of warm regard, but because companies have caught on to the fact that obesity costs them a considerable amount of money.

Perhaps the availability of good water might help to wean some workers off their habitual high-cal drink habits. Never mind that coffee with three spoons of sugar, and forget about sodas and juices, especially those with added sweetener.

In 2014, the Centers for Disease Control and Prevention produced the multiply-authored and lengthily titled “Impact of Individual and Worksite Environmental Factors on Water and Sugar-Sweetened Beverage Consumption Among Overweight Employees”. It was described as “the first extensive evaluation of the workplace environment and its influence on water and SSB consumption.”

After taking into consideration many reports, the researchers concluded that workplace factors definitely influence the behavior of overweight employees. They found that reduced access to vending machines could steer habits into healthier channels. Consultants also looked further into the roles played by water coolers, vending machines, and break frequency. Here is the bottom line from that study:

Future intervention trials are warranted to determine whether reducing SSB consumption and increasing water consumption could be an effective dietary strategy for worksite-based weight management interventions and whether individual and environmental intervention features mediate or moderate intervention effectiveness.

A few years ago, similar research scrutinized both “intensive-labor and static-type workplaces” and concluded that promoting the water consumption habit “may benefit employees,” which is pretty weak sauce, considering how the phraseology implies “… or it may not.” Well then, could the provision of both water and nudging reminders induce employees to drink lots of water in order to “diminish their tendency to gain weight”?

At the same time, this research project was looking for more than just how to encourage increased water consumption. Managerial and executive eyes were on a bigger prize, and WHPPs (Workplace Health Promotion Programs) were created to serve the need, and a sentence in the Conclusion affirmed the hope.

“If reminders about water intake can be sent to employees in a timely manner, and if they can be informed with the health benefits brought by drinking water regularly, combined with unforced health education, it may be possible to obtain other additional benefits in addition to enhancing employees’ water intake.”

Of course, businesses are not only concerned about employees’ health, and it would be silly to believe they are. But to discover a factor that can improve the lives of workers while at the same time reducing employer costs, well, that is something to write home about for sure.

Your responses and feedback are welcome!

Source: “Summary: OSHA Water Requirements,” ZTers.com, 09/09/24
Source: “Effectiveness of a Water Intake Program at the Workplace in Physical and Mental Health Outcomes,” NIH.gov, 2022
Image by Picsues/Pixabay

Our Jobs, Our Bodies, and Our Kids

Recent inquiries into the enormous cost that obesity imposes on society have covered a number of bases, but (no surprise here) plenty of angles remain to be explored. In observing places of employment, scholars have examined chronic stressors, acute stressors, and even the condition known as “turmoil in the workplace.” Many researchers are particularly interested in the relationship between those factors and the difficulty experienced by workers in maintaining a healthy body weight.

It seems odd that people — many of them lucky to be employed at all — will carelessly endanger their jobs and their health by allowing excessive weight to creep up on them. How can they be encouraged to remain well enough to perform the work adequately, and not take too many sick days? How can they be prevented from doing things on company time that will eventually cost the company many dollars?

It takes all kinds

Researchers looking for answers have created studies that concentrate specifically on middle-aged women. Grad students have scrutinized groups of men who do exhausting labor, and others whose pale shirt collars have never felt a drop of perspiration. They have probed the relationship between something called “job enrichment,” and abdominal obesity in particular, as those two factors may impact even “apparently healthy” individuals.

A typical news item, published near the end of 2017, confirmed what many corporate CEOs and small business owners had already figured out:

The increasingly high levels of overweight and obesity among the workforce are accompanied by a hidden cost burden due to losses in productivity.

That meta-study was called by its authors “a narrative synthesis of the reviewed studies [which] revealed substantial costs due to lost productivity among workers with obesity.” The information, derived from eight electronic databases, pointed out the extent of those indirect costs that might someday, somehow, be eliminated from the figures that populate the corporate budget. It was only one of a great number of academic papers that have explored these possibilities.

But what does this have to do with my kids?

Everything. No matter how much we love our children, and how wonderful we know them to be in every way, the opinion of the outside world may differ. Often, when that assessment is made plain, the results are not happy for anyone. Our kids are growing up in an environment where everyone is increasingly scrutinized from many angles, and information is retained forever.

They deserve our help

A few years from now, our daughters and sons might be secretly weighed every day they show up for work, and then be summarily fired for exceeding the decreed correct weight. These trends are capable of doing real damage, and we need to get a handle on them by understanding why it is probably a mistake to ignore the few extra pounds around a child’s middle. Without being hurtfully judgmental, we can still acknowledge that obesity has the power to mess up her, or his, entire future.

On another level, the situation could become even worse. Imagine this: Your child graduates high school, and the only available job is with a company that severely maintains strict weight standards. A year later, your excellent son is required to fire an employee who also happens to be his best friend since childhood. To both of them, it represents a betrayal, and your boy feels so lousy, he binge-eats to improve his mood, and winds up being fired himself, not long afterward.

Okay, maybe that scenario is a bit dramatic, but whether we like it or not, obesity seems determined to become a larger issue with every passing year. It is a challenge that a lot of kids just might face, if they don’t already. This is why we try to prevent childhood obesity, because people growing into adulthood have enough to contend with.

Your responses and feedback are welcome!

Source: “Productivity loss due to overweight and obesity: a systematic review of indirect costs,” NIH.gov, 10/05/17
Image by milaoktasafitri/Pixabay

Can You Multiply By 10?

The reason for the titular question is the existence of two random documents among many which all point to the same conclusion. The phenomenon known as “presenteeism” has grown immensely, and so has the societal expense associated with it.

Another branch of this knowledge tells us that since obesity is definitely associated with presenteeism, obesity is a problem here as in so many other areas of life. This is just one more of the multiple problems with which obese children who mature into obese adults will have to contend.

The first media production considered here, which appeared on YouTube about 14 years ago, is a very concise (2:27) explanation by Professor Cary Cooper of how presenteeism was at that time costing the American economy about $15 billion per year.

Exhibit #2 is an article published in 2020, a mere decade later, during which time the cost of presenteeism was said to have risen to a towering 150 billion per year. In other words, the annual toll of that phenomenon upon the economy of the USA had multiplied by a factor of 10. And you can bet your bottom dollar on this: In many instances when employees showed up in the workplace only to be unproductive and ineffective, that was, in one way or another, attributable to obesity.

Contemporaneously with the above-mentioned YouTube presentation, by the way, a very scholarly work authored by J. Borak was published by Oxford University Press.

“Obesity and the Workplace” referenced the “global tsunami” of obesity, which was predicted to “certainly demand increasing commitments from occupational health programmes in coming years.” Four obesity-related issues were listed:

1. Enormous negative societal impact
2. Huge financial costs
3. Decreased worker productivity and increased need for support services and disability management
4. Work environments that contribute to increased overweight and obesity

That report quoted a 2006 study whose results had indicated that “annual US obesity-related medical costs were about $86 billion, including $30.3 billion for full-time employed adults.” It also emphasized that obesity “is associated with substantially increased rates of absenteeism (i.e., more days out of work) and presenteeism (i.e., reduced productivity while at work).”

This is the job market our children are preparing to face. Success in employment, or even simply finding employment in which to succeed or fail, will not be solely about degrees or other official qualifications. It will increasingly depend on not being fat.

But… It takes two to tango

On the other hand, plenty of evidence exists to show that work conditions can contribute directly to obesity, so employers had better take some responsibility. Job stress, shift work, and long work hours are mentioned. Consequently, some employers…

[…] have adopted programmes to incentivize weight loss and the maintenance of recommended body weight, encourage exercise, and promote healthy diets.

The results of such interventions are described as encouraging, and deserving of wide support. The same article mentioned a concept of “libertarian paternalism”:

[…] the idea that private and public institutions can systematically (and legitimately) affect behaviour in order to ‘nudge’ people in directions that will make their lives go better, without eliminating freedom of choice. For example… occupational health professionals should encourage employers to make work sites ‘junk food free’, instead providing healthier alternatives in cafeterias and vending machines.

This tactic of benign psychological and circumstantial influence-wielding has certainly been, and today remains, a fertile field for behavioral studies.

Your responses and feedback are welcome!
Source: “Professor Cary Cooper explains presenteeism,” YouTube.com, undated
Source: “The Complete Guide on Presenteeism (w. Example Intervention),” AIHR.com, 2020
Source: “Obesity and the workplace,” DOI.org, 2011
Image by gugacurado/Pixabay

Obesity, Depression, and Costs

As we have seen, the opinion is widely held that research done so far on the relationship between employment and associated physical and mental disorders is insufficient. In some jobs and with some people, there may be a tendency to escape work whenever possible, on the thinnest of excuses. From the bosses’ side, there may be a tendency to take advantage of people who need jobs by making them do dangerous tasks and then blaming them if injury occurs. It would come as no surprise to learn of lawsuits and strikes related to these issues.

The history of labor has encompassed very complicated and conflict-prone areas. Hard-fought decisions have been made about who is entitled to compensation for being absent from work; as well as who is allowed to show up and underperform (presenteeism), which in the long run costs the company even more.

Obesity is one of the conditions that can influence worker productivity. If our kids are overweight or obese, it is likely they will grow up to be obese adults, and this relationship to work will be just one of the many problems they will be challenged to deal with.

Wider information, please

Archived studies on the subject have been recognized as excellent, but too narrow in scope. One example (published in 2020) focused on almost 3,000 Japanese office workers, of whom 70% were male. According to the researchers,

Ten health risk factors for presenteeism have been identified, including health-related behaviours such as smoking, lack of physical activity, high blood pressure, perception of health and stress. Studies have reported that workers with arthritis, allergies, fatigue, depressive symptoms, hypoglycaemia, overweight and obesity were at higher risk of presenteeism.

In the same paper, mention was made of such impactful organizational policies as sick pay, attendance management, and permanency of employment.

What about profit and loss?

Recently, Investopedia.com looked back at a 2016 study from Social Psychiatry and Psychiatric Epidemiology, which showed that…

[…] presenteeism associated with depression costs $5,524 per person annually in the U.S., five to 10 times higher on average than costs associated with absenteeism.

And of course, there is an extensive connection between depression and obesity. A 2015 article said,

Human obesity has serious consequences on health, including increased risks for depression, noninsulin-dependent diabetes mellitus, cancer, rheumatoid and osteoarthritis, hypertension, and heart disease. In addition, obesity has been found to reduce the quality of life for both men and women and markedly reduces life expectancy…

Those facts are quite depressing. Depression has been called the enemy of motivation, and one thing from which it can definitely demotivate a person is the desire to wake up, get spiffed up, and travel to a hated job.

And another thing…

It is possible that depression is being promoted for profit. This will not be gone into here, but the following quotation is worrisome in its implications, given all the ways through which obesity’s overall expense to society is likely to increase:

[M]any people who once called themselves alcoholics and drug addicts now say they are “dually diagnosed” with “major depressive disorder” and “bipolar disorder.”[…] Today, when alcoholics and drug addicts leave rehab, they are lifelong Pharma customers… For this lifelong, chronic and lucrative condition — resting on the now disproved chemical imbalance theory — they can remain on drugs like SSRIs for decades.

Whatever degree of legitimacy is represented there, it is bound to involve obesity in a large number of cases, and to be inimical to good employment relationships. Closer to home is a 2020 report from Sweden titled “Childhood obesity linked to higher risk of anxiety, depression and premature death.” Among other statements, we find:

Children with obesity have a three times higher risk of mortality in early adulthood compared with children in the general population and are more likely to suffer from anxiety and depression.

When these children grow up and become employed, their tendencies toward impaired physical health and depression are certain to impact their effectiveness at work, which in turn raises the employers’ costs to a greater or lesser extent in every business and in government jobs too, with the result that all these costs are passed on to customers and also eventually to every other facet of society.

Your responses and feedback are welcome!

Source: “Presenteeism among workers: health-related factors, work-related factors and health literacy,” Occupational Medicine, November 2020
Source: “Presenteeism: What It Is and How It Works,” Investopedia.com, 01/06/25
Source: “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity,” Academia.edu, 2015
Source: “Drugmakers Continue to Profiteer on ‘Free’ Mental Health Programs,” Academia.edu, 11/04/24
Source: “Childhood obesity linked to higher risk of anxiety, depression and premature death,” News.ki.se, 03/18/20
Image by KarlToon/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