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Open Access
Article
Publication date: 14 February 2024

Dusanee Kesavayuth and Vasileios Zikos

Obesity is a significant public health issue. With obesity increasing worldwide, risk factors for obesity need to be better understood and require careful examination. This study…

Abstract

Purpose

Obesity is a significant public health issue. With obesity increasing worldwide, risk factors for obesity need to be better understood and require careful examination. This study aims to examine mental health as a risk factor for obesity using longitudinal data from Australia.

Design/methodology/approach

The main identification strategy relies on the recent death of a close friend and a serious injury or illness to a family member as exogenous shocks to mental health.

Findings

The authors’ preferred estimates, which account for the endogeneity of mental health, suggest that mental health has a significant negative impact on obesity. This result proves to be robust to a suite of sensitivity checks. Further investigations reveal that poor mental health leads to increased smoking, which also has an effect on obesity.

Originality/value

The study’s findings provide a new perspective on how good mental health helps curb obesity.

Details

Applied Economic Analysis, vol. 32 no. 94
Type: Research Article
ISSN: 2632-7627

Keywords

Book part
Publication date: 9 March 2015

Roel Pieterman

This paper investigates whether in the case of obesity medicalization implies transforming deviants into patients. First, a brief history is presented of the social construction…

Abstract

This paper investigates whether in the case of obesity medicalization implies transforming deviants into patients. First, a brief history is presented of the social construction of obesity as an epidemic. Since the turn of the millennium obesity experts claim that a continuously increasing proportion of the Western population is becoming overweight and that this trend is spreading across the globe. Other claims have been made as well, such as that fatter people die younger and add substantially to the cost of health care. Counterclaims have been made too, such as that in Western countries obesity no longer increases and that only extreme obesity increases the risk of dying young.

Furthermore, several explanations for the obesity epidemic are discussed. Public health experts all over the world prefer two explanations that suggest the obesity problem is amenable to intervention. Most basically, it is held that people become overweight because their intake of calories exceeds their expenditure. In addition it is proposed that modern societies are obesogenic, for example, offering food in abundance while removing the need for physical exertion. The first explanation leads to blaming overweight people for their own condition. The second offers opportunities for disciplining the food industry, which following the anti-tobacco movement is labeled “big food.” Especially with regard to individual citizens the conclusion seems warranted that medicalizing fatness adds opportunities for stigmatization and discrimination beyond those offered by conceptions of beauty and fitness. This causes a double bind for governments that want to fight both obesity and stigmatization.

Details

Contributions from European Symbolic Interactionists: Reflections on Methods
Type: Book
ISBN: 978-1-78441-854-0

Keywords

Book part
Publication date: 9 August 2012

Igor Ryabov

Using the data from a unique sample of Mexican-American adults from the U.S.-Mexico border area, this chapter offers explanations for Mexican-American obesity, with the special…

Abstract

Using the data from a unique sample of Mexican-American adults from the U.S.-Mexico border area, this chapter offers explanations for Mexican-American obesity, with the special focus on immigrant generation status, income, and gender. On a theoretical plane, this study attempts to apply the nutrition transition theory to the study of immigrant assimilation in a regional context. Considered are the most important structural dimensions of immigrant assimilation – country of birth (the United States vs. Mexico) and age of arrival. Of the two aforementioned factors, age of arrival is found to be a stronger predictor of obesity that country of birth. As Mexican-American immigrants’ length of residence increases, so does their Body Mass Index (BMI) that reflects the adoption of less diverse diet and sedentary lifestyles. Through the use of multilevel hierarchical modeling, I also found sizeable variation in obesity by income, gender, and family history of obesity. The analyses suggest that the interventions aimed at reducing overweight and obesity among Mexican-Americans in the U.S.-Mexico border region should be better targeted by focusing on women and low-income households.

Details

Issues in Health and Health Care Related to Race/Ethnicity, Immigration, SES and Gender
Type: Book
ISBN: 978-1-78190-125-0

Keywords

Book part
Publication date: 1 January 2006

Jay Bhattacharya and Neeraj Sood

If rational individuals pay the full costs of their decisions about food intake and exercise, economists, policy makers, and public health officials should treat the obesity

Abstract

If rational individuals pay the full costs of their decisions about food intake and exercise, economists, policy makers, and public health officials should treat the obesity epidemic as a matter of indifference. In this paper, we show that, as long as insurance premiums are not risk rated for obesity, health insurance coverage systematically shields those covered from the full costs of physical inactivity and overeating. Since the obese consume significantly more medical resources than the non-obese, but pay the same health insurance premiums, they impose a negative externality on normal weight individuals in their insurance pool.

To estimate the size of this externality, we develop a model of weight loss and health insurance under two regimes – (1) underwriting on weight is allowed and (2) underwriting on weight is not allowed. We show that under regime (1), there is no obesity externality. Under regime (2), where there is an obesity externality, all plan participants face inefficient incentives to undertake unpleasant dieting and exercise. These reduced incentives lead to inefficient increases in bodyweight, and reduced social welfare.

Using data on medical expenditures and bodyweight from the National Health and Interview Survey and the Medical Expenditure Panel Survey, we estimate that, in a health plan with a coinsurance rate of 17.5%, the obesity externality imposes a welfare cost of about $150 per capita. Our results also indicate that the welfare loss can be reduced by technological change that lowers the pecuniary and non-pecuniary costs of losing weight, and also by increasing the coinsurance rate.

Details

The Economics of Obesity
Type: Book
ISBN: 978-1-84950-482-9

Book part
Publication date: 15 December 2004

Qi Zhang and Youfa Wang

This study examined the secular trends in socioeconomic inequality in obesity during the period 1971–1994 in the United States. We analyzed the national representative data…

Abstract

This study examined the secular trends in socioeconomic inequality in obesity during the period 1971–1994 in the United States. We analyzed the national representative data collected from three waves of the National Health and Nutrition Examination Survey (NHANES) conducted between those years. The Concentration Index was calculated to measure the socioeconomic inequality in obesity across gender, age, and ethnic groups in each survey period. In general, socioeconomic inequality in obesity was reduced between the 1970s and 1990s in women and black men, although the trend was not statistically significant for black women and was stable in white men. Our results indicate that, first, the association between obesity and socioeconomic status (SES) weakened over time, and second, SES inequality was not an important contributor to the dramatic increase in the prevalence of obesity in the United States. Our findings suggest that other social and environmental factors, which have influenced changes in people’s lifestyle, might better explain the increasing overweight problem in the United States. Effective intervention efforts for the prevention and management of obesity should target all SES groups from a population perspective.

Details

Studies on Economic Well-Being: Essays in the Honor of John P. Formby
Type: Book
ISBN: 978-0-76231-136-1

Book part
Publication date: 1 January 2006

Jaume Garcia and Climent Quintana-Domeque

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…

Abstract

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.

Details

The Economics of Obesity
Type: Book
ISBN: 978-1-84950-482-9

Book part
Publication date: 21 April 2010

Deborah A. Sullivan

Purpose – Obesity has reached epidemic levels in the United States and many other affluent countries and is a growing problem in some developing countries. World Health…

Abstract

Purpose – Obesity has reached epidemic levels in the United States and many other affluent countries and is a growing problem in some developing countries. World Health Organization estimates that the global rate will reach 13 percent by 2015. Because obesity increases the risk of many diseases ranging from type 2 diabetes and asthma to cardiovascular disease and some cancers, it threatens to undermine twentieth-century gains in life expectancy. This chapter offers a theoretical model of obesity that postulates the epidemic is a latent dysfunction of macro-structural changes initiated by industrialization that have decreased the physical activity of everyday life and promoted a nutrition transition to a high-calorie diet.

Methodology/approach – Comparative and historical population data are presented that generally support the conceptual model, although some significant cultural differences are found in particular race/ethnic groups.

Findings – The finding that structural changes in society created and continue to support the obesity epidemic will make it difficult to control by focusing only on health education campaigns aimed at changing individual behaviors.

Contribution to the Field – This chapter offers data and analysis that can support policy making needed to change the structural influences.

Details

Understanding Emerging Epidemics: Social and Political Approaches
Type: Book
ISBN: 978-1-84855-080-3

Book part
Publication date: 1 January 2006

John Cawley and John A. Rizzo

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…

Abstract

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.

Details

The Economics of Obesity
Type: Book
ISBN: 978-1-84950-482-9

Book part
Publication date: 1 January 2006

Nana Bro Folmann, Kristine Skovgaard Bossen, Ingrid Willaing, Jan Sørensen, John Sahl Andersen, Steen Ladelund and Torben Jørgensen

Objective. To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts – number of inpatient admissions, number of…

Abstract

Objective. To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts – number of inpatient admissions, number of outpatient visits, and number of emergency department visits – based on anthropometric measurements of waist circumference (WC) and information from The National Patient Registry and The Danish Case-Mix System (DRG).

Participants. The study population consisted of two sub-samples from the Inter99 study at Research Centre for Prevention and Health in 1999–2001. One sub-sample used WC as an indicator for obesity (n=5,151), whereas the other used BMI as an indicator for obesity (n=4,048). Using WC, obesity was defined as WC > 102cm for men and > 88cm for women. Normal weight was defined as circumference < 94cm for men and < 80cm for women. Using BMI, obesity was defined as BMI > 30kg/m2, whereas individuals with BMI=18.5–24.9kg/m2 were defined as normal weight. Individuals with BMI < 18.5kg/m2 were excluded from both sub-samples.

Design. We undertook a 3-year retrospective study of the relationship between obesity and use of hospital resources. Data on hospital contacts and costs were obtained from The National Patient Registry and DRG. Analyses were performed using two-part models and Poisson regression. Outcome variables were costs and hospital contacts.

Results. This study has demonstrated that obese individuals have a greater use of hospital services and greater hospital costs compared with normal weight individuals. When using WC as an indicator for obesity, mean hospital costs were 33.8% greater among obese women and 45.3% greater among obese men in a 3-year period but the differences were not significant. When using BMI to measure obesity, obese men had significantly greater costs (57.5%) than normal weight men.

Furthermore, obese men and women (indicated byWC) had an increased number of hospital contacts compared with normal weight individuals (rate ratio 1.32, 95% CI 1.21–1.43 for men and 1.20, 95% CI 1.11–1.28 for women) including inpatient admissions, outpatient visits, and emergency department visits. The same trends were seen when obesity was indicated by BMI.

Details

The Economics of Obesity
Type: Book
ISBN: 978-1-84950-482-9

Book part
Publication date: 1 January 2006

Petter Lundborg, Kristian Bolin, Sören Höjgård and Björn Lindgren

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…

Abstract

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.

Details

The Economics of Obesity
Type: Book
ISBN: 978-1-84950-482-9

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