Fatter body, skinnier wallet

Studies say obesity can limit wealth

The New York TimesDecember 2, 2006 

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

Have you also considered what they will do to your wealth?

The sugar and fat will add pounds, which can lead to heart disease, diabetes and a shortened life span. But there is another consequence to packing on extra weight: Being fat costs money -- tens of thousands of dollars over a lifetime.

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

We're not talking here about people who are merely chubby, carrying a few extra pounds, or only those who are truly enormous in their dimensions, either. People carrying an extra 30 to 40 pounds can be affected.

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

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

Complications from obesity -- particularly diabetes, which afflicts 21 million Americans -- push up the bill: $44,000 for a heart attack, $40,200 for a stroke or $37,000 for end-state kidney disease, estimates Judith A. O'Brien, the director of cost research at the Caro Research Institute, a health-costs consulting firm. Amputating just a toe, a common consequence of untreated diabetes, averages $15,000, she estimates.

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

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

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

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

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

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

Sociologists have long noted that in developed countries, the higher-status people tend to be thin and the lower-status ones are fat. "That heavier people have a harder time getting married is pretty well supported," said Jeffery Sobal, a professor at Cornell University who has studied obesity.

Marriage can be crucial in wealth creation, especially when a person "marries up" to someone with money or a higher education. That might be a rarer occurrence for the obese.

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

The end result? The obese accumulate only about half the assets of an American at a healthier weight, said Zagorsky, the Ohio State researcher. He matched BMI and wealth data in the National Longitudinal Survey of Youth, a multiyear sampling done by the U.S. Bureau of Labor Statistics, and found that for every one-point increase in the index, net worth dropped by $1,000. The typical female baby boomer, he said, earned $313.70 less annually for every one-point increase in her BMI, while the typical male earned $161.30 less for every point.

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

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