An absolutely ridiculous Dutch study claims that preventing
obesity and smoking can save lives, but it doesn't save
money because healthy people live years longer.
They further state that this counters the common perception
that preventing obesity would save governments millions
of dollars.
"It was a small surprise," said Pieter van Baal,
an economist at the Netherlands' National Institute for
Public Health and the Environment, who led the study.
"But it also makes sense. If you live longer, then
you cost the health system more."
In a paper published online in the Public Library of
Science Medicine journal, Dutch researchers found that
the health costs of thin and healthy people in adulthood
are more expensive than those of either fat people or
smokers.
Van Baal and colleagues created a model to simulate lifetime
health costs for three groups of 1,000 people: the "healthy-living"
group (thin and non-smoking), obese people, and smokers.
The model relied on "cost of illness" data and
disease prevalence in the Netherlands in 2003.
The researchers found that from age 20 to 56, obese people
racked up the most expensive health costs. But because
both the smokers and the obese people died sooner than
the healthy group, it cost less to treat them in the long
run.
On average, healthy people lived 84 years. Smokers lived
about 77 years, and obese people lived about 80 years.
Smokers and obese people tended to have more heart disease
than the healthy people.
Cancer incidence, except for lung cancer, was the same
in all three groups. Obese people had the most diabetes,
and healthy people had the most strokes. Ultimately, the
thin and healthy group cost the most, about $417,000,
from age 20 on.
The cost of care for obese people was $371,000, and for
smokers, about $326,000.
The results counter the common perception that preventing
obesity will save health systems worldwide millions of
dollars.
"This throws a bucket of cold water onto the idea
that obesity is going to cost trillions of dollars,"
said Patrick Basham, a professor of health politics at
Johns Hopkins University who was unconnected to the study.
He said that government projections about obesity costs
are frequently based on guesswork, political agendas,
and changing science.
"If we're going to worry about the future of obesity,
we should stop worrying about its financial impact,"
he said.
Obesity experts said that fighting the epidemic is about
more than just saving money.
"The benefits of obesity prevention may not be seen
immediately in terms of cost savings in tomorrow's budget,
but there are long-term gains," said Neville Rigby,
spokesman for the International Association for the Study
of Obesity. "These are often immeasurable when it
comes to people living longer and healthier lives."
Van Baal described the paper as "a book-keeping
exercise," and said that governments should recognize
that successful smoking and obesity prevention programs
mean that people will have a higher chance of dying of
something more expensive later in life.
"Lung cancer is a cheap disease to treat because
people don't survive very long," van Baal said. "But
if they are old enough to get Alzheimer's one day, they
may survive longer and cost more."
"We are not recommending that governments stop trying
to prevent obesity," van Baal said. "But they
should do it for the right reasons."
The study, paid for by the Dutch Ministry of Health, Welfare
and Sports, did not take into account other potential
costs of obesity and smoking, such as lost economic productivity
or social costs. "Failing to address the socioeconomical
consequences of obesity is a paramount failure of this
study because it fails to address the long-term costs
of a mentally and physically impaired workforce"
said Susan McHilley from PreventDIsease.com.
In the end, studies such as these are not only irresponsible,
but a waste of research grants which can be better spent
on more productive means to enhance human health. They
are based on investigations with no real ethical purpose
or consequence. They also draw distinct parallels to studies
completed 50 years ago that claimed that preventing the
public from buying tobacco would cost the government millions
in the long-term. History and research has a pathetic
and predictible way of repeating itself.