The costs of being fat: A good reason to run away from carrot cake, as we did last night.

Extracts from
Extra Weight, Higher Costs
By Damon Darlin for the New York Times, December 2, 2006
As you snatch a couple more Christmas cookies or down another eggnog, you might be thinking about what those extra calories will do to your health.

But have you 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.

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 spend more than normal-size people on food, 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 then a harder time winning plum assignments and promotions.

"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 various economic and sociological factors and a measure of obesity called the body mass index.

[You can find your body mass index using] a Web calculator like the one at www.nhlbisupport.com/bmi/ or www.halls.md/ideal-weight/body.htm.

Anything under 25 is considered a normal reading of the index. From 25 to 30 is overweight, and above 30 is obese. People who rate above 40 are considered morbidly obese, meaning they are facing serious and sustained health problems.

It is by this measure that academics estimate that 97 million Americans, about a third of the population, are considered obese. Almost 10 million Americans could be considered morbidly obese.

Academics have struggled to place a price tag 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 not uncommon consequence of untreated diabetes, averages $15,000, she estimates.

Academics have not spent much time calculating what that care costs the overweight individual. Instead, they look at what obesity costs society or insurers. The sum usually arrived at is 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.

While the health problems ravage savings, an overweight person may 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. More 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 a weight increase of 64 pounds above the average for white women was associated with 9 percent lower wages.

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 Mr. Roehling terms the obese, are lazy, weak-willed or considered too unattractive to interact with customers.

Brian A. Nosek, a psychology professor at the University of Virginia who helped develop it, said that test results showed that bias against blacks and the overweight was about equal, but that while people rarely admit to race bias, they freely admit to weight bias. "There is no social sanction against saying you don't like fat people," Mr. Nosek said.

The weight penalties come in other forms as well. 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.

The end result? The obese accumulate only about half the assets of the normal-size American, said Mr. Zagorsky, the Ohio State University research scientist.

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