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The doubling of obesity in the U.S. over the last 25 years has led policymakers and physicians to encourage weight loss, but few methods of weight loss are effective. One promising avenue is pharmacotherapy. However, little is known about the use of anti-obesity drugs. This paper describes the market for anti-obesity drugs and studies the utilization of anti-obesity drugs using data from the Medical Expenditure Panel Survey for 1996–2002, a period that is interesting because it covers the introduction of three, and the withdrawal of two, anti-obesity drugs from the market.

Our results point to wide sociodemographic disparities in anti-obesity drug use. Women are almost 200% more likely than men to use anti-obesity drugs. Hispanics and African-Americans are only 39% as likely as Whites to use them. Those with prescription drug coverage are 46% more likely to use anti-obesity drugs.

We also find that the vast majority of subjects who are approved to take these drugs are not taking them, and a significant number who are not approved to take the drugs are taking them. We find strong evidence that the well-publicized 1997 withdrawal of fenfluramine and dexfenfluramine had a chilling effect on the overall market for anti-obesity drugs. We find little difference in observed characteristics between those who took the withdrawn drugs and those who took the other anti-obesity drugs in the market.

Five papers in the volume use economic models to predict obesity and related behaviours. Two of the papers are theoretical. Liqun Liu, Andrew J. Rettenmaier, and Thomas R. Saving analyse the importance of food quality for bodyweight. Bodyweight is treated as a variable of choice – the individual derives utility from health, food consumption and consumption of a composite good. Bodyweight is assumed to decrease health whenever it differs from its physiologically optimal level. Their model implies that much of further income growth will be used to improve food quality rather than increase caloric intake.

Several high-profile prescription drugs have been withdrawn from the U.S. market in the last decade, yet there is no direct evidence of how a prescription drug withdrawal affects consumers’ use of remaining drugs within the same therapeutic class. In theory, remaining drugs in the therapeutic class could enjoy competitive benefits or suffer negative spillovers from the withdrawal of a competing drug. Using the Medical Expenditure Panel Survey, we test for spillovers following prescription drug withdrawals in six therapeutic classes between 1997 and 2001. Results vary, but we find stronger evidence of negative spillovers than competitive benefits. We conclude with a discussion of the characteristics of drugs and classes that may influence how remaining drugs are affected by a withdrawal in the class.

Kevin Fiscella notes that, to date, progress in eliminating racial disparities has been slow. He calls for a comprehensive approach that goes beyond the narrow focus of current policy. Given the association between education and health, he advocates greater investments in early childhood education. In light of its broad geographic and demographic reach and role in preventing or delaying the onset of chronic disease, he also proposes to strengthen the delivery of primary care through the network of Federally Qualified Community Health Centers (FQHCs).

Previous research provides evidence of a negative effect of body mass on women's economic outcomes. We extend this research by using a much older sample of individuals from the Panel Study of Income Dynamics and by using a body mass measure that is lagged by 15 years instead of the traditional 7 years. One of the main contributions of this paper is a replication of previous research findings given our differing samples and measures. We compare OLS estimates with sibling fixed effects estimates and find that obesity is associated with an 18% reduction in women's wages, a 25% reduction in women's family income, and a 16% reduction in women's probability of marriage. These effects are robust – they persist much longer than previously understood and they persist across the life course, affecting older women as well as younger women.

This paper brings a European perspective to the mainly U.S.-based literature on the relationship between obesity and labour-market outcomes. Using micro-data on workers aged 50 and over from the newly developed SHARE database, the effects of obesity on employment, hours worked, and wages across 10 European countries were analysed. Pooling all countries, the results showed that being obese was associated with a significantly lower probability of being employed for both women and men. Moreover, the results showed that obese European women earned 10% less than their non-obese counterparts. For men, however, the effect was smaller in size and insignificant. Taking health status into account, obese women still earned 9% less. No significant effect of obesity on hours worked was obtained, however. Regressions by country-group revealed that the effects of obesity differed across Europe. For instance, the effect of obesity on employment was greatest for men in southern and central Europe, while women in central Europe faced the greatest wage penalty. The results in this study suggest that the ongoing rise in the prevalence of obesity in Europe may have a non-negligible effect on the European labour market.

This paper examines the associations between obesity, employment status and wages for several European countries. Our results provide weak evidence that obese workers are more likely to be unemployed or tend to be more segregated in self-employment jobs than their non-obese counterparts. We also find difficult to detect statistically significant relationships between obesity and wages. As previously reported in the literature, the associations between obesity, unemployment and wages seem to be different for men and women. Moreover, heterogeneity is also found across countries. Such heterogeneity can be somewhat explained by some labor market institutions, such as collective bargaining coverage and employer-provided health insurance.

This volume is part of an annual series entitled Advances in Health Economics and Health Services Research. We express our gratitude to the series editors Björn Lindgren and Michael Grossman for inviting us to edit this volume.

A five category self-reported health indicator together with the self-reported prevalence of diabetes and heart disease for older Canadians, are examined using data from five cohorts of men and women from the 2001 Canadian Community Health Survey. Consistent with other studies we find that smoking and dietary behaviors are highly correlated with general self-reported health, diabetes, and heart disease. Individual standardized weight, the body mass index, was negatively associated with health outcomes for all age groups, but became less important with age as socioeconomic variables became more important. Socioeconomic variables explained more of the variation in health outcomes than the combined effects of tobacco use and excessive weight problems. In addition, there is compelling evidence that obesity could overtake smoking as the leading cause of health problems in Canada.