Is it expensive to eat a healthy diet? The cost of eating healthy vs. the cost of being obesed

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Obesity's rising prevalence places a significant financial strain on health-care delivery systems and the economy as a whole. Obesity's effect is being studied in ever-increasing numbers of studies that are evidence-based. The nature of the research, on the other hand, varies depending on the study population. This research paper aims to add to the existing body of knowledge about the costs of obesity. Many academic articles were found through a computerized search of electronic databases, and those that applied to both the direct and indirect costs of obesity were reviewed. Absenteeism, presenteeism, loss of productivity, and early mortality are all examples of indirect costs. The immediate consequences are related to management and hospital stay. Indirect costs are higher for most of the countries, but the heterogeneity of the research hindered comparison. Greater good exists in avoiding unhealthy diet as an even treatment of itself has potential side effects. There is a need for further research in all states to determine the actual indirect and direct costs of obesity and other weight-related diseases.

Key words: cost, benefits, unhealthy, healthy, obesity.

Is it expensive to eat healthily? The cost of healthy food vs. the cost of obesity

Introduction

Weight-related disease conditions are tough health issues to address. The causative factors of obesity are usually multifactorial with major factors being behavioral and partly genetics. The behaviors are dietary patterns, physical inactivity and medication among other things. In our society, there are additional contributing factors. These factors include food, environment, education, skills and food marketing and promotion. Obesity and related diseases have serious financial and health implications. There are several disadvantages of eating unhealthy, which can be avoided by eating healthy.

Literature review

In 2008, the expenditure on obesity alone in America was 147 million dollars. The annual estimate of medical cost from obesity and related illness is at 190.2 Billion dollars in the United States. This amount is almost twenty-one percent of the yearly expenditure on health care in America. The yearly national productive cost of obesity is 79 dollars per obese individual and 132 dollars per person for obesity-related absenteeism (Trogdon, Finkelstein, Hylands, Dellea, & Kamal-Bahl, 2008).

In 2005 US study, the direct costs were all medical costs while the indirect ones were calculated from absenteeism and presenteeism. They were estimated to be 30.3 billion and 42.8 billion respectively (Dee et al., 2014). In a Swedish study; the direct costs were from hospital inpatients only while indirect costs were from lost productivity due to high mortality. The estimate costs were SEK 2.17 and 2.93 billion respectively (Dee et al., 2014).

Objectives

  • To find out economic cost of obesity
  • To determine benefits of healthy eating
  • To determine health consequences of obesity
  • To find out the treatment implication of obesity
  • To find out other challenges of obesity and its treatment

Method

The study is a retrospective study that analyzes previous scholarly articles on the research topics related to the cost of obesity. Electronic databases were used to search for relevant materials. The three websites included in data search are PubMed, Google Scholar, and Google search engines. With PubMed, there were only sixteen articles with only two articles being eligible for inclusion. The other databases had over 10,100 results. Few studies that based on the relevance of research title were chosen. The keywords were: cost, unhealthy diet, obesity, scholarly articles, America, healthy diet, benefits. Recently published were given preference for review.

Findings

Economic cost of obesity

In a Canadian study in 2010, the indirect cost due to morbidity was 5.96 billion Canadian dollars. The percentage of results that were indirect was 54 %( Dee et al., 2014). Childhood obesity in itself consumes about 14 billion dollars in direct medical costs. If children are obese today, the adults will be obese tomorrow. This rise will add significantly to the expense of the medical care of obesity-related medical condition (Wang, Chyen, Lee, & Lowry, 2008). In the next two decades, the projected savings on medical costs will be 549.5 billion if the obesity rates are to be constant are its 2010 levels (Finkelstein et al., 2012)

The indirect hidden and direct costs of obesity stifle organizations and businesses that stimulate growth, developments, and jobs in the American cities. In ten cities with the highest prevalence and incidence rates of obesity, the costs (direct) of obesity and its related conditions are at about five million dollars for every 10,000 of its citizens. If the ten state cities reduce their rates of obesity to the mean level of the nation, their total savings would be about $ 500 million. This saving can be used to benefit other aspects of health care or even improve another sector of the economy altogether (Bhattacharya & Bundorf, 2009).

  In another study in German in 2011, the direct costs were from inpatient and outpatient management, rehabilitation and administrative and research costs. The indirect costs were from sickness absence, early retirement, and mortality. These costs were estimated to be at 4.85 and 5.02 euros respectively (Dee et al., 2014).  

There is also a higher cost to the nation for unemployment and disability benefits. Businesses are undergoing losses (estimated to be at $ 4.3 billion annually). Even more poorly, these costs will keep rising (Cawley, Rizzo, & Haas, 2007).It is not an impossible task to stop bad eating habits. Poor eating and nutrition habits affect health, overall wellbeing and safety of the individuals. For the people of age over twenty years, 34. 2% of them are overweight while 33.8% being obese. What is worse is that 5.7 percent of these adults have morbid obesity. (Cawley, Rizzo, & Haas, 2007).

Every year, American loses about 39 million workdays due to obesity and other weight related disease conditions (Reichert, n. d.). Imagine those many unproductive days and the impacts that come with them. The proportion of those who get sick every year due to poor, unhealthy diet is about 17 percent of the population. That translates to about one person for every six people. To even worsen the situation, 3000 reported deaths from illness are related to foods. Just by appropriate dietary consumption all, the above problems are avoidable (Reichert, n. d.).

In Minnesota alone, the financial costs of obesity were 1.3 billion dollars as of 2003. The financial implication for children with obesity is hard to know, as there is no clear data. (Koplan, Liverman & Kraak, 2005).

Benefits of healthy eating

Good practice on eating start at birth giving the best nutrition to the children that benefits them through their life. Healthy eating not only helps by preventing obesity, but it also reduces the risk of the three most killer diseases, cardiovascular diseases, cancer, and stroke. The World Health Organization states that 80% of all types of heart diseases, diabetes (type 2) and stroke are preventable if only people ate healthily. There will also be a 40 percent reduction in cancer if only people chose to eat a healthy diet, engaged in physical activity and stopped the use of tobacco (Barbour, 2011).

It is cheaper to eat healthy meals than an unhealthy diet. Fruit and vegetable diet reduces the chances of tumors and other diseases of chronicity. Statistics from the American CDC Center shows that only about 21% of adults take in the required amounts of fruits each day. The statistics are better for the recommended vegetable intake as at least 33 percent of adult Americans take in the right quantity of vegetables each day (Barbour, 2011).These proportions are however low. The food intake schedule of each person varies, as the calorie requirement of each person is different. Several factors influence these variations including the number of years lived, the weight of the person, the level of physical activity and the height of the person. The Daily Food Plan is a tool that helps one determine what amount of calories to take and what groups of food that the calories must come from. The balanced diet contains foods that are readily available and include vegetables, fruits, leans proteins like meat and milk products with low-fat quantity. There are multiple combinations of these foods that can provide the body with the nutrient it requires. Therefore, it is not hard to control weight.

Eating health might not be the easiest thing to do. However, the choice to eat well will be the smartest decision one can make. Consuming healthy diet means little or no intake of foods that have excess glucose content, fats that are saturated and foods that have excess sodium content. That, therefore, includes a large number of fast foods. These foods include refined snacks, drinks like sodas and chips. Eating healthy does not only make one better in terms of health and fitness, but it also saves unforeseen future medical expenditure.

The brain needs enough and quality energy to work efficiently.  The people who work with efficiency are more likely to get promotions or salary increases. The sick ones, for instance, those suffering from obesity superimposed with stroke are not in a position to work. Debra Nessel of the Torrance Memorial Medical Center reports that her patients frequently feel raised focus immediately following the improvement in their diets.  According to 2012 Population Health Management, consumption of unhealthy food puts one at 66% increased the risk of productivity loss. Further, unhealthy food represents the biggest determinant factor for poor productivity out of the 19 potential causative factors, some of which include lack of physical activity, chronic pain, and financial instability (Hu, Liu & Willett, 2011).

The food that one eats influences the brain, including the hypothalamic center, which controls pleasure and mood among other things. There is no food known to have antidepressive effects.  However, maintenance of stable blood sugar through proper diet helps one to feel better on most days. A diet that has rich contents of vitamins and minerals, like fruits, vegetables, and whole-grain have a lower risk of depression. The list also includes food rich in omega 3 fats like nuts and salmon among other fishes. Eating well means more vigorous energy, more solid foods, better sleep, and decreased joint pain. People who eat healthily also have a greater way of focusing their minds on changing to a healthier dietary pattern. Healthy food leads to a reduction in stress. When the body is under chronic stress, it breaks down protein to replenish energy stores. Certain diets have the capacity to regulate the level of cortisol. Consumption of omega-3 fatty acids and magnesium may lead to a reduction in the levels of cortisol. Eating a diet rich in protein increases the protein store and keep the levels of cortisol low (Hu, Liu & Willett, 2011).

Most people are probably familiar with the concept that healthy diet control weights. However, it still deserves mention. This is because more than half Americans have weight-related conditions. Obesity is also responsible for a fifth of deaths in America. Even a reduction in weight by at least 5-10 % lowers hypertension. The reduction also decreases the levels of bad cholesterols and incidence of diabetes mellitus (type 2).  Uncomplicated healthy dietary behavior such as replacing sodas with water and choosing vegetables over chips or French fries reduces weight in addition to saving money.   An obese patient spends about $ 2741 more on health care annually compared to the non-obese lean patient.The weight of an individual is not a determinant of health. Thinness does not necessarily mean being healthy, neither being overweight does not mean being unhealthy. However, the consumption of a healthy diet can mean a significant improvement in health even for thin people who are junk food eaters. Junk food has one thing in common. They have small quantities of micronutrients like minerals and vitamins and very high calories. Lack of consumption of these minerals and vitamins for a long time leads to early death. BMJ journal publications give evidence that five servings of vegetables and fruits minimize the risk of dying from any weight-related causes (Hu, Liu & Willett, 2011).).

Diseases, in general, reduce life expectancy. They, also, cost lots of money and make people feel bad. The same situation (or even worse) applies to obesity. Moderate to vigorous exercise, in combination with a healthy diet of vegetables and fruits prolong lives for women in their 70 years of age. This fact is according to the Journal of the American Geriatrics Society. Healthy eating can play a significant role in how long you will live (Glover, 2017).The foods that have less unhealthy nutrients are easily available. Whole grains and wheat together with rice and barley undergo slow digestion. In their less refined forms, they have a slower metabolism. The slow digestion means less effect on insulin hormone and the glucose levels. Such in turn leads to less hunger. Besides, vegetables and fruits have tremendous protective effects against diseases.  In addition, it is evident that they have an added advantage of weight reduction than most vegetables and fruits.

Whole grain and barley have greater proof in weight control than fruits and vegetables (Ledoux, Hingle, & Baranowski, 2010).  The persons who raise their intake of whole grains gains only about 0.4 pounds less every year. The person who takes whole fruits losses about 0.5 pounds less yearly (Mozaffarian, Hao, Rimm, Willett, & Hu, 2011). Moreover, vegetables together fruits have huge solvent quantity, making people feel more satisfied on fewer calories.

It is a known fact that the people who take in large quantities of drinks with sugar have a greater probability of developing lifestyle diseases. They specifically include metabolic disease like obesity and diabetes (Vartanian, Schwartz, & Brownell, 2007). Prospective analyses of 88 studies showed clear associations of soft drink intake with increased caloric intake and body weight (Vartanian, Schwartz, & Brownell, 2007). There is 0.08 increase in the units of BMI with additional daily intake of 12 ounces of drinks that are sugary (Malik, Willett, & Hu, 2008). In yet another study, it was found that people who had regular drinks with sugar content had about twenty-six percent chance higher probability of suffering from type 2 diabetes and obesity than people who took less quantity of refreshments with high sugar content. The risk of development of coronary artery disease is also higher in such people (Malik et al., 2010).

Fast foods are famous and preferred because of some of their characteristics. One, the package is higher and in larger portions. Secondly, their prices are also small in comparison to organic food. Thirdly, they have high consumability. Fourthly, they all have a relative higher sugar (Pereira et al., 2005).  CARDIA study, for example, had a sample population of 3000 young adults followed up for 13 years. The sample population of those who had a higher intake of fast foods at the inception of the research had a mean of 13 pounds higher than the sample population that consumed low quantity of fast foods. The initial sample had also high levels of lipids compared to the second group. The second sample also had smaller circumferences of the waist in comparison to those who took in large quantities of fast foods. Additionally, the consumers of fast food had extremely higher chances for the onset of metabolic syndrome (Duffey, Gordon-Larsen, Steffen, Jacobs, & Popkin, 2009).  All the above problems can be avoided with consumption of healthy diet.

There is no difficulty in eating healthy. You are what you eat. Everyone should switch to healthy diet. There are payoffs from the small changes in dietary improvement. A few tips to stay healthy and win against obesity are available. There is need to stay hydrated. Hydration reduces cravings and prevents the feeling of being fuller. There is also need to sticking to the meals. One needs to eat at the same every day if possible. Being active also goes a long way in being healthy. There is also a need for preplanning around cravings. Good behavior comes at no cost. It also comes one at a time. Small changes in person’s daily life in terms of diet can help them a great deal. In fact, it also helps them save money.

The cause of obesity is not any other strange factor. It is purely through individual's choice. Obesity is something that all people can avoid if they so the wish. It results from an imbalance of energy expenditure (physical activity) and consumption (dietary habits). The cause of healthy bodyweight is vegetables and fruits. In states like Minnesota, the young adults take in fruits and vegetables to a level that is too low with the recommended one. The recommendation is that there should be consumption of fruits by children and youth at least five times in a day. In a study done on students, there was only 21% of students in grade 6 who took fruits and vegetables more than five times in a day. The percentage of those in grade nine was only 15% (Koplan, Liverman & Kraak, 2005).

Health consequences of obesity

Obesity is a serious concern because it has associations with many adverse health outcomes. It is the leading cause of death together with other lifestyle diseases. Obese people have poor mental health outcomes. Additionally, those with obesity have reduced the quality of life in general (Roberts, Deleger, Strawbridge, & Kaplan, 2003).

Obesity results from being overweight. It is worse when one has a fat deposition in some parts of the body. Obese men and women who have an abdominal diameter more than 102 cm have increased chances of developing stroke, suffering Diabetes mellitus, heart diseases and premature loss of life in comparison to men with a smaller circumference. The same case applies to women who have circumference more than 88 cm or high waist-hip ratios. Visceral fat (in the body) is even more hazardous than the abdominal subcutaneous fatty tissue. Avoiding overweight helps one prevent the above conditions (Wadden & Berkowitz, 2016).

There is also a high association of obesity and metabolic syndrome. In fact, data shows that about 60 percent of patients who are obese also have the syndrome (Barbour, 2011). The syndrome has three or more of the following conditions. There is increased blood pressure above the normal limit; there is also increasing fasting sugar and increased serum triglycerides. The increases in abdominal circumference and low HDL cholesterol are other possibilities (Barbour, 2011).

Some types of neoplasms are more common in obese patients than in thin people. The three common ones are colorectal, ovarian and breast cancers. There is also increment in the risk of developing of thromboembolic diseases. Additionally, the prevalence of some gastrointestinal disorders rises in obesity. They are diseases of gallbladder and GERD among others. The prevalence of dermatological conditions is also high in obese patients. The risks of surgery and obstetric conditions are certainly high in comparison to lean body patients. In patients who are obese, the risks of an impairment of pulmonary functions arise. Major psychotic depression among other psychiatric diseases also happens in those with obesity. Myriads of other problems occur in obesity including hormonal conditions and hemoglobin abnormalities. Even socially, these people are likely to face isolation (Dee et al., 2014)

A terrifying aspect is that other disease/conditions come with obesity apart from it being an all-time cause of death. Hypertension and dyslipidemia are other diseases in association with obesity. Also, there is diabetes (type II diabetes mellitus) and chronic heart diseases. Obesity and some of these diseases are risk factors for stroke development. Other diseases that come with obesity is gallbladder disease and osteoarthritis. Respiratory problems like breathing difficulties and sleep apnea are also common in obese people. Some neoplastic diseases are an additional problem in obesity including endometrial cancers, breast, kidney, gallbladder, and colon and liver cancers. Psychotic conditions like depression, mood, anxiety, and other form mental disorders are additional risks that obese people have. Lastly, these people have body pains, difficult physical functioning, and low quality of life as a whole (Hu, Liu & Willett, 2011)

Treatment implications of obesity

Once people become obese, they are subjected to dietary control techniques. However, using these techniques, there is only 20 percent of people who will lose 20 lb of weight and maintain the loss for over 20 years. Only 5 percent of obese people will lose 40 lbs. of weight (Wadden & Berkowitz, 2016). The weight loss using the dietary measures is about 7 percent of the weight at baseline. Continuous close contact with the health care providers is more beneficial than any other specific treatment regimen. One can imagine what it takes to have close contact with health workers.  The doctors have to choose the patients carefully to decrease frustration among patients. It takes great motivation to have patients undergoing an active program of treatment (Wadden & Berkowitz, 2016). Therefore is wise to prevent the condition as treatment using the conventional dietary mechanisms yields no much positive result.

The treatment of obesity is far much more complex. There is a need for many team members to be on board to manage the condition. In treatment, weight loss combined with diets that are hypocaloric are encouraged. There is a need for behavior modifications to change the behavior of eating. Additionally, there must be social support and aerobic exercise to emphasize on the loss (Wadden & Berkowitz, 2016). There should be no need risk all these factors which might not be available when one can avoid the condition from the beginning. The emphasis on treating diabetes is weight loss. The instructions on a diet are the same for those who do not have obesity. The principle is the same. The instructions are to have foods that not processed. Additional instructions are to limit diets that have large quantities of energy without the provision of other nutrients. Therefore, people should strive to avoid the condition even before it sets in.

The dietary requirement is, however, more involved in the treatment than in prevention. Keeping the loss of weight constant over a long time calls for overhaul changes in the dietary behavior of a person.  There is an obligation of clinicians to impart knowledge to obese patients on fundamental behavioral techniques. The modification of actions is more formal in treatment than in prevention. Something formal is usually more complex than informal. Additionally, there is the requirement of a plan of menu and record of actual behavior. There is involvement of planning and keeping records. One goes through hustles and stresses of self-monitoring just to make sure they are on track (Wadden & Berkowitz, 2016).No complexities arise with preventive measures.

An additional factor that is important in the treatment of obesity is a fully functional support system. Many people might not even have this support. On the other hand, consumption of healthy diet to prevent obesity does not require any form of social support. There is a need for family and peers to keep one in check to reinforce change of behavior and help in the prevention of isolation and loneliness (Wadden & Berkowitz, 2016). The situation is worse for those who have a severe form of obesity. These people require a very aggressive form of treatment. They also need a diet that is very low in calorie. The calories must be below 800Kcal/d as such results in quick weight loss and prevention of complications of metabolism. They have to maintain the program for at least 4-6 months. The average loss of weight in a week is 2lbs being a maximum loss of appropriately 15 percent of the baseline weight (Wadden & Berkowitz, 2016).

The programs in treatment usually involve the replacement of meals to get a few calories. The maintenance of weight in the long term, together with meals replacement have not predictable outcomes. There is a need for the concurrent change of behavior together with diets that have low calories in combination with regular moderate exercise and regular monitoring.  

Various side effects result from a reduction in calories intake. They need close monitoring by the clinicians. They include Cardiac arrhythmias, Cold intolerance, Fatigue, Gallbladder disease, Gout, and Orthostatic hypotension (Foster, 2006).

Some drugs are available to treat obesity. However, various controversies surround the appropriateness of the medications. Some guidelines recommend that drugs are usable for obese clients with Body mass index exceeding 30 or 27 with risk factors for obesity.  Apart from the controversy, very few studies say that medications help with long-term outcomes of obese patients (Xia, Kelton, Guo, Bian & Heaton, 2015).

The FDA recommends many medications for use in obesity. Some include phentermine, diethylpropion, and mazindol. These catecholaminergic drugs have very few utility and are the only applicable short-term. Another common drug that was approved by FDA is Sibutramine. However, there was a withdrawal of this drug from the market in 2010. The reason was a demonstrable association with strokes and heart attack (Xia, Kelton, Guo, Bian & Heaton, 2015).

Another common medication is Orlistat. It blocks the absorption of fat by limiting the functions of the lipase in the intestine. The drug, however, results in many gastrointestinal side effects, including, but not limited to diarrhea and cramping. It also reduces the absorption of vitamins.  Additionally, there are no long-term benefits of this drug regarding clinical outcomes. In some clinical trials, some drugs resulted in some additional loss of weight if they were used for two years. However, in other studies, there is no benefit regarding metabolic parameters and clinical outcomes (Foster, 2006).

There is also the role of surgery for patients with severe obesity. It is called Bariatric surgery. The procedure of choice is operation on the intestines. The common is a by-pass operation through laparoscopic means. The weight loss in this method is great. Some studies point out a weight loss that is almost a third of the initial weight (Foster, 2006). However, there are complications in 40 percent who undergo this surgery.  Some of the complications include Ulcers-marginal, Neuropathy, Narrowing or stenosis of the stoma and Stones in the gallbladder among others. The death rate while being on the operating table is higher in those patients who have Medicare insurance. The mortality rate in one year is about 7.5 percent of men in Medicare (Foster, 2006).

Another common type of operation done on obese patients is Gastric banding (GB). This surgery results in minimal weight loss. However, the complications are fewer. A significant disadvantage is the need of continuous follow up to adjust the band (Foster, 2006).

In the youth population, the death rate and morbidity from obesity and related disorders rise in proportion to a class of obese condition. The proportionality is not the case in old age. The relative risk decreases with age. In the elderly, weight is not a risk factor (Koplan, Liverman & Kraak, 2005). It, therefore, means then, that obesity takes away the vibrant young people who are the backbone of our country's growth and development. The old might not have the positive impact on the economy as the youths do.

In America, there are no new medications or combinations of drugs that have approval. However, several of the drugs are under investigation. One such drug is Lorcaserin. It did not undergo approval phases because of the side effects. One outstanding one is the increased acquisition of breast adenocarcinoma.  Another combination under trial was that of phentermine and topiramate. The combination did not undergo approval due to increased development of psychotic symptoms and having toxic effects on the neonates (Xia, Kelton, Guo, Bian & Heaton, 2015). Therefore, it is wise to avoid being obese as the medications themselves have many side effect.

Other challenges of obesity and its treatment

Obesity and its related disorders also have a tremendous impact on the recruitment of armed forces. There are certain variables one must fulfill to join the American army.  There is usually a consideration for body fat percentage in addition to heights and weights. These variables were compared to the baseline requirement for the specific ages of the American army. Ten years ago, this comparison revealed that 5.7 million men exceeded the requirements and therefore could not qualify to join the army. The number of women was even worse at 16.5 million. It is, therefore, clear that weight and fat are a big hindrance when it comes to the labor force in the army. If only people could watch their weight, the pool of people to join the army will increase (Cawley & Maclean, 2011).

Some diseases have been well researched on. For such conditions, the data is available and guides the management process. For obesity, there are not enough data in most of the states. The lack of data impairs the preparedness by the States and the entire Nation to curb the rise in the incidence of obesity and the related conditions. A study done in Minnesota gives a recommendation for the need for information on the weights and heights of children and youth (Koplan, Liverman & Kraak, 2005). The data is to help them follow the problem of overweight and obesity, identify solutions, and track progress. The data for the trend of obesity is unavailable; however, there is a likelihood that is a representative of the national data. The growth rate of obesity in children is the same for adults. The availability of the data is not a rule in the United States. The weight estimates are not available for states in the nation. The only accurate information is the nutrition surveillance program. The program tracks indicators of children enrolled in their hospital units. The data shows that the rate of obesity in children from 2-5 years of age rose by 41 percent (from 9.8 to 13.8% in 1995-2004). Many states lack children data for height and weight to measure their BMI. They rely on the self-reported Body Mass Index measurement of students in high school through the CDC Youth Risk Behavior Survey (Koplan, Liverman & Kraak, 2005).  It is because of this lack of preparedness by the State to curb obesity, that one should not get obesity. Probably, the condition is worse in different States.  

There is a remarkable growth rate of the number of children who are obese and overweight in the United States. The prevalence has grown four times among the adolescents and the children between 6-11years old. It has tripled for those between the 12-19 years of age. The data is from the 1971-1974 and 1999-2002 respectively (Miller, 2006).

Discussion

There is both direct and indirect cost of obesity. The direct expenses of this condition involve all the preventative measures undertaken. Others direct costs are diagnostic and treatment/management of obesity or those related to it. There is also huge indirect financial implication through morbidity and mortality. An example of indirect cost is productivity. The measure of productivity include losses due to workers being absent from work or reduction of productivity while being at work. There is as well premature mortality and morbidity.

Variation in the calculation of indirect and direct costs exists. It is evident that the costs of direct cost are less than the direct costs in most studies. The cost of health care rises with the increase in the weight and the loss of productivity.  There is enough worldwide literature on the cost implications of obesity and its related disease. Nonetheless, the review and synthesis of these past research materials are strenuous as they are heterogeneous in terms of their sources of data, their approach in methodology, the quality of data and scope. In theory, the use of longitudinal data that comprise measured BMI, morbidity, utilization of health care, mortality and loss of productivity gives the best quality on the costs of obesity.

It is reasonable to imagine that there are ties between youth obesity and future adulthood weight-related diseases and costs. When compared to countries in the world, Americans spend the lion's share of their Gross National Product on health care. The proportion of money spent on the preventive programs is only a fifth of the GDP. Prevention of obesity would hugely reduce the expenditure on the chronic health diseases in total.

The prevalence rate of obesity is on an upward trend as time passes. This growth pulls the country's resources to deal with the menace. It is; therefore, wise to do the little things to stay obesity-free than getting into a pool of sick people who are ever increasing in large numbers.

Healthy behaviors avoid obesity. A healthy pattern of diet and regular physical activity prevents weight-related disorders.  Prevention of excess weight gain goes a long way in prevention of obesity. The excess weight gain is avoidable through the striking balance of the calories that is consumed and that required the body. Consumption of diet that is free of fat or that has minimal fat with a combination of water helps prevent weight gain in obesity. Additional foods that prevent obesity are vegetables and small quantities of protein. These diets are in addition to fruits and whole grains recommended by the Dietary Guidelines for Americans as good behaviors in the prevention of obesity. It is not hard to create environments that are safe or those that prevent/discourage obesity. Community, childcare, and schools all play a role. Home healthcare and workplace all have an impact as they influence daily habits of people in terms of food consumption. If all these sectors collaborate, the nation can save huge amounts of money.

In weight loss, exercise plays a crucial role and has so many advantages. In prevention or treatment, the value is the same. There is no point to wait to incur all the costs of obesity and suffer all the diseases. Exercise increases the daily consumption of energy. It is also useful for maintenance of weight over a long term. Also, moderate to vigorous exercise leads to a reduction in energy expenditure at basal level (BEE) and preserves lean body mass. On the other hand, the use of exercise alone in the treatment helps a little. There is a need for combination with other forms of treatment. The use of exercise with a combination of diet causes more loss of weight when compared to exercise alone. Up to one hour of exercise combined with healthy eating has a positive impact in terms long-term maintenance of weight (Wadden & Berkowitz, 2016).  

The greatest contributor to overweight and obesity in America are poor dietary habits combined with a lack of physical activity. If only people can change their habits, the figures will be too low. There will also be much savings from the costs of obesity.

Conclusion

Healthy eating has greater benefits than unhealthy food. The price people pay for unhealthy food has huge impacts. The cost is both direct and indirect. Obesity in itself is a killer disease with adverse physical and health outcomes. Together with its related diseases, there is the doubling of the consequences. Good dietary habit combined with moderate to vigorous exercise, not only prevents obesity but other chronic non-communicable diseases like cancer, stroke and heart diseases.  It has economic, social, and physical impacts. Healthy eating is cheaper and helps one avoid all the above problems. There are no standards conventional measures of treatment of obesity. The treatments options available do more harm than good. The treatment has an emphasis on weight loss. It means the aim is the same both before one becomes obese and after. The difference is that the struggle to lose weight after obesity has more complication than in non-obese patients. There is a need for everyone to make it a habit of trying to eat healthy diet alongside engaging in physical activity. The practice is beneficial to everyone, whether their weight exceeds the normal range; they are underweight or have an appropriate weight-height scale (BMI). The simple changes in diet can have huge positive impact on the well-being of a person. The research on obesity and the determinants factors of indirect costs in many countries are varied and heterogeneous in terms of quality and scope. There is a need for further research especially in other states in America to find out the exact indirect and direct costs of obesity.

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