and Medicine for Seniors
Obesity is an expensive disease, especially for
aging senior citizens
Obese 70-year-olds may live as long as healthy weight
70-year-olds but will spend $39,000 more on health care
Sarah Varney, Kaiser
March 2, 2015 - Bayou La Batre, Alabama, calls
itself the seafood capital of Alabama. Residents here depend on fishing
and shrimping for their livelihood, and when they sit down to eat, they
like most things fried.
It’s here that former U.S. Surgeon General Dr.
Regina Benjamin has been trying to reverse the nation’s obesity epidemic
one patient at a time. Benjamin grew up near Bayou La Batre and has run
a health clinic in this town of seafood workers and ship builders since
1990. As obesity became commonplace around the U.S., health care
providers like Benjamin began seeing the impacts of obesity all around
“We saw our patient population get heavier,”
Benjamin said. “We saw chronic diseases start to rise, and if we
continued, our entire community would totally be crippled, basically,
based on chronic diseases.”
Two major trends are on a collision course here, as
in the rest of the United States: a decades-long surge in obesity and
the aging of the U.S. population. Today, one out of every three adults
in the U.S. are clinically obese, and many who have lived for decades
with excess weight, diabetes and heart disease are now heading into
their senior years. Obese people are far more likely to become sick or
disabled as they age, and researchers say this burgeoning demographic
will strain hospitals and nursing homes.
“We’re potentially going to have a larger, older
population that’s more likely to be obese, surviving longer with
cardiovascular disease and other chronic diseases,” said Dr. Virginia
Chang, a demographer at New York University. “I think that the primary
fallout from increasing obesity is probably not going to be some huge
hit to mortality. It’s going to be disability.”
Those consequences may already be visible,
researchers say. Lifelong obesity, now common across the country, is
poised to undermine improvements in disability rates among older adults.
Steven Austad, chairman of the biology department
at the University of Alabama at Birmingham, studies the effects of diet
and nutrition on aging using mice. He says researchers used to think
that aging was driven by different processes.
“Your heart aged, your brain aged, your feet aged,”
he said. “But now, we’ve realized, there’s a handful of processes that
are involved in aging all parts of your body. And it turns out, one of
those processes is inflammation.”
Inflammation naturally increases as we age, but
that process is exacerbated by belly fat, which secretes chemicals that
cause further inflammation around the body. “If you’re obese, then your
system-wide levels of inflammation are higher, particularly when you get
older,” said Austad.
That’s one reason scientists think men and women
who are obese are more likely to develop dementia, Alzheimer’s disease
and certain cancers as they age.
Bob Parker, a Birmingham area resident, says his
own weight is starting to catch up with him. As a realtor and Democratic
party activist, he often attends meetings at restaurants and says all
those nights dining out make it hard to eat well.
Now, at age 60, he’s being treated for diabetes,
high blood pressure, high cholesterol and sleep apnea. He’s lost 90
pounds—twice—and gained it back. “It’s taken some energy away, for
sure,” Parker said of his weight. “I like to do things out in the yard
and I just can’t work on them as much. So, that’s pretty galling to be
Obesity is an expensive disease, especially for
aging seniors. One study found that while obese 70-year-olds live as
long as healthy weight 70-year-olds, they will spend $39,000 more on
“Obese people have higher healthcare costs than non-obese
people. This is true virtually throughout life,” said David Allison,
director of the Nutrition Obesity Research Center at the University of
Alabama at Birmingham. As a person gets into the age when health care
spending goes up, “that difference is going to be bigger and bigger and
more and more important.”
In part because of disability and poor health,
surveys show more obese people are heading into nursing homes at younger
ages and staying longer than non-obese residents. Two hours from
Birmingham, in the northwest corner of the state, Generations of Red Bay
is one of the only nursing homes in the region that is willing to take
on the added expense of caring for heavier residents. Patients come from
as far away as Texas.
Margaret Hilldouglas arrived here two years ago, at
age 47, after she broke her knee. Surgery was considered too risky
because of her congestive heart failure, so she languished in a hospital
for weeks while a social worker looked for a nursing home that would
Patients like Hilldouglas require additional staff
and costly equipment, including specialized beds, mechanical lifts,
larger blood pressure cuffs and longer needles, said Aundrea Fuller,
chief operating officer of Generations of Red Bay.
“There are two
certified nursing assistants for eight to ten residents. And that’s
about twice the staffing that you would have for the general population
of a skilled nursing facility.” Most of the obese residents that move in
here, even the younger ones, will need this type of care for the rest of
their lives, Fuller said.
At the University of Alabama at Birmingham’s weight
loss clinic, Bernard Rayford, 55, said he wants to avoid that fate.
“I’ve always prayed, Lord, before I be a burden, just take me. I saw
myself being a burden, and me being a major problem,” Rayford said after
a vigorous workout in the clinic’s gym. “The end was for me not to make
it. Or for me to end up being in an ambulance. And that’s, that’s the
direction I don’t want to be in.”
● This KHN story also ran on
PBS News Hour.
● KHN’s coverage of aging and
long term care issues is supported in part by a grant from
The SCAN Foundation.