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Report: Spike in obesity could cost state billions in added healthcare costs

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WASHINGTON – After years of struggling with a food obsession, Dianna’s obesity finally caught up with her: On her 56th birthday, the Phoenix woman was diagnosed with diabetes.

Compounding the bad news – Dianna said she cried for two days after the diagnosis – were the bills that come with an obesity-related illness.

Dianna, who did not have health insurance at the time, had to pay $125 for each doctor’s visit, about $150 every month for diabetes medications and almost $40 every time she had blood work done.

Now, four years later, things have turned around. Dianna rejoined Overeaters Anonymous, has lost 173 pounds in the last 18 months and has been able to stop taking her diabetes and high blood-pressure medications.

“I got my life back,” said Dianna, who, in keeping with Overeaters Anonymous rules, goes only by her first name.

But while she continues to work at it, Dianna is still among the one Arizonan in four who are obese. And officials say that number could explode in coming years, increasing the likelihood of obesity-related diseases and raising healthcare costs by as much as $13.6 billion during that time.

“Obesity is linked to many chronic diseases, and there is a related healthcare cost,” said Laura Segal, spokeswoman for Trust for America’s Health, which wrote “F as in Fat: How Obesity Threatens America’s Future 2012.”

The report predicts that obesity nationally will grow from more than 35 percent now to more than 44 percent by 2030. Associated healthcare costs to treat preventable obesity-related diseases could swell between $48 billion and $66 billion per year as a result, up from current estimates that range from $147 billion to nearly $210 billion per year.

In Arizona, the report predicts that the number of obese adults could more than double in the same period, to 58.8 percent of the state’s population.

That would put 154,737 Arizonans at risk of type-2 diabetes while 114,546 could suffer coronary heart disease and stroke, 112,018 from hypertension, 68,326 from arthritis and 9,983 from obesity-related cancer, the report said.

That means higher costs for insurers, public and private. Dwayne Proctor, director of childhood obesity programs at the Robert Wood Johnson Foundation, which funded the report, said this trickles down to taxpayers.

“Medicaid and Medicare are government-funded programs,” Proctor said. “That means if high obesity rates are not contained, there will be high healthcare costs, which will be picked up by taxpayers.”

Proctor said that without a 5 percent decrease in the average body-mass index, more people are at risk for obesity-related diseases, which led to the “conservative estimate” of $13.6 billion in higher costs in Arizona.

“That’s a scary statistic,” said Cynthia Melde, nutrition and physical activity manager at the Arizona Department of Health Services.

While she was shocked by the trust’s projection, Melde conceded that obesity is an epidemic problem. She attributes the rapid growth in obesity to changes in the way we move, the way we eat and our environment.

“Children are spending more time in front of screens – cellphones, computers, television – being sedentary, not playing after school,” Melde said.

“More unhealthy food is accessible, the size of our dinner plates and portion sizes have grown, we consume more calories without even thinking about it,” she said.

Craig Primack, a specialist in obesity medicine at Scottsdale Weight Loss Center, said it’s hard to project out 20 years into the future, but he believes the number in the trust report is on the right track. As a society, he said, we are not done gaining weight.

“It may not reach 58.8 percent, but it will get higher than it is now,” Primack said. “It’s only going to get worse, and we will keep spending more of our money on healthcare.”

He spoke about managing weight gain early, likening the problem to car care: If you wait until it breaks down completely before fixing it, it becomes extremely costly.

“The tools are not cheap but if we don’t spend money on them now, the more expensive it will get in the future,” Primack said.

Melde agreed that future state health spending will depend on how prevention and mitigation measures are implemented now.

“Our approach to public health has shifted,” Melde said. “The societal and community-based level is where we’re focusing.”

That includes everything from educating children about nutrition and teaching people about healthy food and proper portion sizes to making sure there are safe places for people to walk and play, she said.

Segal said those changes have to be made quickly.

“We have to expand how much we spend now,” Segal said. “Invest today and you will see returns in the future by money saved.”

But Melde said obesity presents its own set of challenges. Unlike anti-smoking policies, she noted, “not everyone has to smoke, but everyone has to eat.”

Melde said “support networks” on a community level are successful because of their integrated social support.

For Dianna, tt was the support of Overeaters Anonymous that gave her her life back.

Her struggles with obesity began in high school, when her doctor gave her injections of speed to help her lose weight. She was in Overeaters Anonymous in her 20s, but dropped out after several years and gained weight steadily until, by age 49, she needed a knee replacement.

She said she tried different weight-loss programs and almost every fad diet available, but nothing helped.

“I resigned myself to thinking I was just going to die fat,” Dianna said. “My weight ruled my life.”

She came back to Overeaters Anonymous after the diagnosis of diabetes made her realize that “if you continue on this path, you are committing a very slow suicide.”

The group offered something different, she said. Instead of focusing only on the physical, she had mental and emotional support. Those meetings showed her that her compulsion to eat was not unique.

“I realized I was not alone in my obsession with food,” she said.