I recognize that obesity is a problem here in the United States probably more than anywhere else in the world. Our sugar epidemic is front page news on a regular basis. And I believe that most people have received the message to the point where obesity rates have leveled off from their ten year increase. Communities have banded together in weight loss incentives and it is now pretty much industry standard that if your employer offers health insurance your body mass index (BMI) is tied to an available discount in payment deduction coming out of your salary. I remember having this discussion years ago thinking this would be positive reinforcement to keep people healthy. I should have figured business and politics would take a good idea and turn it into a punishment. I know this because I have heard more than one story from friends and patients who honestly work hard on getting to a goal just so at the last minute the employer or insurance company declined the discount. The excuse is “well your BMI is not at goal by a particular date”. Forget that the individual exercised and counted calories and meditated their way to a better lifestyle. Forget that they worked hard for six months or a full year. The “bean counters”, the actuarial geniuses, have decided arbitrary deadlines for people to follow, just to be not moved into a silver category from bronze. It stinks and it is not fair!
The only ones making money here are the national dieting and exercise organizations that make the corporate deals with the insurance companies or self funded employers. If they can get you to sign up they make money on every one of you. The employee or the family member do not get a break on the price they pay for insurance if the deadline is missed. No partial credit is given even if most of the goal is attained. What a disincentive. If I am not going to get my promised reward, the discount on my insurance deductions out of my paycheck, why should I continue?
So I ask you can I be overweight and still be healthy? We used to think so. It was called the Obesity Paradox, meaning there was a possibility that a person could be obese and healthy. But this week the Journal of the American College of Cardiology published a study where healthy obese people were followed for twenty years. It was found that after that period of time obesity took its toll on the health of the body and became unhealthy. The authors noted a natural progression of obesity entered a state of metabolic degeneration. In other words, cardiovascular disease, diabetes and high blood pressure developed and treatment was necessary. The conclusion is that compared to a healthy weight there really is no such thing as a healthy obese person. I am disappointed. I believed in the idea of healthy obesity, just because losing weight is so hard, particularly when you are under high stress, I am sure I am not alone.
Well, I am glad the researchers shared the study. It gives me more incentive to keep track of my numbers and exercise every day and do that meditation. Regarding the insurance discount issues, I recommend everyone complain by writing a letter to your local congressman and senator, and to the insurance industry about this unfair decision. Credit should be given to even the most sincere effort in stress reduction, exercise and diet. Most people either wear a fit device or it is on their phones so there is no cheating. If you do the work daily you should get the discount, period!