Paying the Obese

Should We Pay the Obese to Lose Weight, or Fine Them When They Don’t?

The “carrot and stick” approach of rewarding overweight people with money for weight loss has been around for a few years, but I’m currently seeing some new interest in the topic. A 2008 article on the topic focused on England, where a “Pounds for Pounds” approach was being considered.

The same British paper ran a story over a year later updating the public on the program, touting the results of a loosely-controlled study which claims success. It seems that the program really was pretty successful, because Britain held on to the idea and increased payments that same year in a “Weight Wins” program which had 2,000 applicants for a mere 400 places; participants were paid up to a maximum of £425 for varying amounts of weight lost.

An update on the trial a year later says 45 percent of participants lost 5 percent of their body weight or more, making monetary reward “more successful than traditional diets.”

Now, what are the reasons behind government institutions like the UK’s NHS funding such programs? The reasons don’t lie far from the methods: money. The Western world is seeing a crisis of obesity which is costing institutions a hefty sum of cash; taking care of obese patients puts a strain on government’s finances as surgeries, medications and public services require extra care and readjustment. The US alone spends $168 billion on patients who are overweight or obese — and for every $1 spent on health care, 83 cents is spent on a patient who is overweight or obese.

In fact, some doctors are even closing their doors to obese patients, saying that those over 200 lbs put a strain on their equipment (such as examination tables), placing them at a higher risk of entering into a lawsuit if a patient falls and hurts themselves — a risk they would simply rather not take. Just under 15 percent of doctors polled feel this way, and since there is currently no law stating that doctors must treat all who come to them, they are free to run their business as they see fit, as it is — after all — a business.

The UK is taking this bribing methodology pretty seriously, because they are currently pushing forth a plan to pay GPs for referring their obese and overweight patients to weight management programs and for suggesting they live healthier lifestyles.

In another twist, the state of Arizona wants to chip away at its Medicaid bill by fining obese people $50 (other than parents and/or those with a medical condition).

It surely is good to see some changes in a problem which is known to be growing — just over a quarter of the US population is currently obese, and future prognoses of the situation are looking pretty grim with strains on healthcare costs and resource division (like doctors’ time). But should we really address the problem by paying people for doing one thing or fining them for another? My personal response is a resolute “No”.

Despite the positive changes that such programs may bring, they are a flimsy band-aid at best, and bury the real problem deeper, at worst.

By rewarding people monetarily, this type of program in no way contributes to building individual’s mental strength (that which is required to restrict oneself from over-indulgence in food) while at the same time encouraging materialistic reward for the most priceless of possessions: one’s health. However, it is surely the case that some families will benefit from some added income, although the sums awarded are pretty meager for many to lean on.

There is also the concept that such a program has little way of assessing whether a patient has stuck with the plan or not, and — once again — does not address those individuals suffering from underlying causes of mental illness (ranging from what would be considered mild forms of depression, lack of control or other, more serious and deeper possible concerns).

Although it may be the case that a lot of overweight individuals will benefit from a better diet and exercise plan, monetary reward does not teach a predisposition to these lifestyle choices, and doesn’t seem to have at its heart the desire to instill these values in the target population.

There is also the problem of a large proportion of the overweight population suffering from obesity because there is simply no access to fresh food in their neighborhoods, which are often the poorest ones; not to mention the very striking lack of education about such matters to these same groups.

And on the other end of the spectrum, consumerism rears its ugly head again, with corporations selling us “pretty” food that is absolutely laden with chemicals, yet is advertised so well that most, if not all of us, simply can’t help but salivate at it during commercials.

Monetary rewards are simple, flimsy band-aids that seem to create some positive effects yet get nowhere near the heart of the problem. The organizations behind this monetary scheme no doubt know the complexity of the issue, but there are always new and clever plans surfacing to help individuals lead better lives. But the answer ultimately lies in a re-education of the masses — it will (inescapably) involve the dollar bill, yet will also require some heftier tools.

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All images: mahalie/Flickr



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    194. But those bad behaviors are very tough to break and also after being back at the workplace for eight months (and resting 9 hrs a day) my back pain has actually returned with a revenge.

    195. Evening Primrose, Black Currant, and also Borage Oils – The fatty acid gamma linoleic acid (GLA) discovered in these oils serves for dealing with arthritic discomfort.

    196. We can absolutely assist relieve neck and back pain with extending workouts yet if discomfort proceeds a physician needs to be sought advice from to establish if the reason could be due to various other more major wellness issues.

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    199. Sadly, it’s fairly typical for sciatic discomfort and also disturbance with walking to last for a while, even after gaining back flexibility.

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    202. It eases discomfort by depleting the physical body’s supply of substance P, a chemical element of nerve cells that sends pain signals to your brain.

    203. Individuals with more significant kinds of pain in the back brought on by issues with the vertebrae or spinal nerves might have much more consistent
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    204. If your pain in the back is associated with a long-lasting problem, such as curvature of the spinal column (scoliosis), or to a previous injury or surgical treatment, plan ahead.

    205. The factor for extending these areas is that when they’re tight, they change the curvature in your lower back (which is essential to maintaining the weight equally on your spinal column).

    206. Meditation and tension scanning (to help deal with the discomfort levels), gentle stretching as well as movement to obtain even more movement and minimize compression on the nerve.

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    217. This research study presents to that osteopathic manipulative treatment can ease their discomfort without medication that might be passed to a breastfeeding baby,” she stated.

    218. Normal exercise. can protect you from back pain (Gjestland et al 2013), but it could be difficult making time for a routine exercise regimen if you already have a youngster Strenuous work and also previous lower pain in the back or pelvic pain can also make back pain more likely in pregnancy (Vermani et alia 2010).

    219. I wish you could locate a new drug, and some stretches and also workouts that could help reduce the discomfort and also the tightness in your piriformis and sacroiliac joints!

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    221. Please aid me … i am 23 years old and having sciatica pain in my appropriate leg from very last 1 year and also i am not obtaining alleviation after consulting many orthopedicians as well as physio therapists.

    222. Another important herb with a lot of therapeutic characteristics is tulsi. Acid Reflux – The medical name is gastroesophageal reflux disease or GERD and is when stomach acids move backwards up into the esophagus. You can still get a great workout even if you have asthma by punching a little slower and not lifting your legs as high to start.

    223. You ought to consistently be seeing them first.There are hundreds of other websites telling you to simply go see your medical professional or a physical therapist.

    224. Research study has actually shown that massage therapy as well as the use of pressure points (in mix with joint adjustment, exercise, as well as relaxation therapy) works for both chronic and severe lower neck and back pain.

    225. A cozy bathroom, a very hot pack or a cozy jet of water from a shower head can ease soreness, or ice bags may bring some relief (GOOD 2014, Vermani et al 2010).

    226. Take a look at our impressive overview of lower neck and back pain alleviation to find out more concerning exactly how I (and also numerous others) did away with most of my pain in the back each day.

    227. In the USA lower neck and back pain’s economic effect discloses that it is the top reason for people under the age of 45 to restrict their task, second highest grievance seen in medical professional’s workplaces, 5th most typical demand for hospitalization, as well as the 3rd leading source for surgical procedure.

    228. Pregnancy-related low neck and back pain (PLBP) can be a very incapacitating syndrome that makes up one of the most typical cause of sick leave for expectant females.

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    230. Whether it’s brought on by an abrupt injury or merely by long-term tension, intense back pain is often mechanical in nature– the outcome of injury to the back or a condition like arthritis.

    231. Research study has revealed that massage and making use of stress points (in combo with joint manipulation, exercise, as well as leisure therapy) is effective for both chronic and also intense reduced back pain.

    232. The interesting aspect of trigger points is that even though you assume your discomfort could be originating from a specific location (e.g. your lower back or knee), differ hardly ever is that the situation.

    233. Knee continued to be knumb up until 3 weeks ago it went incredibly bad again, i tried decompression which resembles traction, disnt help one little bit emergency situation provided me oxycodone prescription, ketorolac and also gabapentin for the nerve discomfort during the night which aids me rest.

    234. Pain in the kidneys is not substantially influenced by the body movements, however in conditions, such as a kidney infection, applying stress to the influenced kidney could be excruciating.

    235. At the end of the research study, just 21 percent of the individuals who take the yoga course were taking pain medicine, down from practically 60 percent at the start.

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    237. It may also be of some convenience to recognize, that if the pain is a sign of a major underlying disorder, there will certainly most likely be one or more going along with signs.

    238. In most cases, this discomfort is mechanical in nature – it is NOT triggered by a significant medical condition, such as inflammatory joint inflammation or crack.

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    240. Perhaps the end result would certainly have been different if the physician had actually remembered that several of the nerve fibers to the stomach (specifically, natural afferents that take a trip in the greater splanchnic nerve) convey discomfort signals to the same spinal cord degrees (specifically T5 and T6) that obtain pain signals from the skin in between the shoulder blades.

    241. If your sciatic discomfort is triggered by stress from a cramped or brief piriformus muscle – the muscle mass that runs into your hip and also across the butt – you could have piriformis disorder.

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    245. It reduces the blood circulation as well as restricts blood vessels, which consequently avoids necessary nutrients from getting to the reduced back as well as discs, creating them to end up being weak and vulnerable to injury.

    246. Meditation as well as tension scanning (to assist handle the discomfort levels), gentle extending and also movement to get more movement and decrease compression on the nerve.

    247. You are likewise most likely to experience reduced pain in the back throughout your maternity if you are unsuited or overweight (Gjestland et alia
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    248. This was really helpful. I have actually taken care of this because I was a youngster as a result of a ATV accident and it worsened after an ectopic maternity which bring about great deals of nerve damage as well as epilepsy.

    249. Static stretches, like those carried out in Yoga, can be a wonderful means to relieve reduced neck and back pain for two reasons: # 1 you’re relaxing locals that are constantly experiencing tension as well as getting more blood circulation to them, and also # 2 you’re extending areas that grow tight as well as minimized from absence of daily use.

    250. In the past couple days, my flexibility has returned practically entirely and also I have no wonderful discomfort standing up and so on. yet the sciatic discomfort in my leg is still there and sometimes just as strong.

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