November 3 2011
Obesity: It's Complicated
A study published last week in The New England Journal of Medicine (which makes me want to immediately consume seven éclairs and a bucket of moose tracks ice cream) says dieters who lose weight will almost inevitably gain it back because most dieters develop a post-diet hormone imbalance. Tear...
After tracking 50 overweight or obese adults on a low-calorie diet over a 10-week period, Australian researchers found that once participants lost weight, hormone levels -- particularly those that influence hunger -- shifted in the body, leading to increase appetites and weight regain. The study involved 50 adults with a body mass index (BMI) or between 27 and 40, averaging 209 lbs. After an initial loss of about 29 lbs scientists at the University of Melbourne found that the levels of appetite-regulating hormones changed, resulting in a regain of about 11 lbs) over the course of a year.
These findings are important for several reasons:
First, maybe the White House should change the name of its much vaulted anti-obesity program from “Let’s Move” to “Let’s Move…and receive hormone treatments.” Members of the Obama Administration – from the First Lady to cabinet level secretaries – often hype the dangers of obesity and repeat the statistically inaccurate figures about deaths due to obesity. We’ve heard these same individuals warn, in a vaguely discriminatory way, that obese people are a burden on society and businesses; they aggressively push government solutions like greater reliance on school lunches, regulations on restaurants and food manufacturers, and government grants to combat so called “food desserts.” The White House’s advice on how to lose weight is simple: just stop eating so much and move around a little. It’s too bad studies like this have to come out and ruin that simple message. As this study shows, obesity is a complex issue. The White House’s regulatory efforts to fix it won’t work.
Second, given this recent study, should employers charge obese employees higher rates for health insurance? A growing number of companies have been trying to encourage employees to lose weight by hiking healthcare costs for obese employees. Yet, this new study clearly shows that obesity is a complicated disease—one that can’t simply be remedied through diet and exercise. And employers who hike the health care prices for obese employees suggest that weight alone determines health—which simply isn’t true. According to President’s Council on Physical Fitness and Sports, obese individuals that are active actually have lower morbidity and mortality than normal weight individuals who are sedentary. In other words, the health risks of obesity are largely controlled if a person is physically active. So, should employers begin hiking healthcare costs for couch potatoes too?
Third, should we be comfortable with our employers essentially getting in the business of punishing employees for things they do on their own time—in the privacy of their own homes? It seems a pretty dangerous precedent to set. If companies start charging overweight people more for health insurance, what stops them from charging “promiscuous” individuals; after all, those employees are more likely to get a sexually transmitted disease. Maybe drug testing is next; or how about charging religious people less for insurance; after all, those folks have that whole “hell” concept hanging over their heads which keeps them in line. Where exactly does this “reward good/punish bad behavior” strategy end?