Obesity prevention not cost-effective?

This article recently popped up on the Associated Press circuit, an analysis of the lifetime medical costs associated with obesity and smoking compared to healthy individuals. Basically, it’s suggesting that individuals who are obese or are smokers have less medical costs over their lifetimes, presumably because they die prematurely of lung cancer, heart disease, etc. In comparison, a healthy individual may avoid these diseases but will end up requiring more health-care dollars in the long run because of a longer life, including potentially long-term care when one develops dementia, etc.

Here’s the important perspective from the same issue that’s not discussed in the above article, and of course not in the AP’s coverage:

Most people want to live a longer life, and they do not consider the consequences to society. But a major goal of life is to maximise one’s total quality-adjusted life years (QALYs). Unfortunately, this new study provides little insight into the total QALYs associated with obesity and smoking. Certainly those who are obese and those who smoke will live fewer years on average, but will these people be compensated by enriched quality of their fewer years? Available evidence suggests strongly that quality of life, quite apart from increased illness rates, is considerably compromised by obesity.

That’s more like it. There’s a reason why there is an enormous market for weight loss and fitness, etc. – people do not enjoy being overweight/obese.

I’ll take 50 years of a high level of functioning in a fit state, free to enjoy any activities I so desire, over 80 years of being limited by obesity, unable to see my own toes and feeling short of breath when walking up a flight of stairs.

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