PhotoUp until recently, smoking was far and away the biggest issue health advocates attacked. Lately, however, the health problems related to obesity have shared the attention.

While both are serious threats, James P. Moriarty, MSc, and colleagues at the Mayo Clinic have determined that obesity now adds more to health care costs that smoking does. Fewer people are smoking but obesity rates are rising.

The researcher came to there conclusion after analyzing the incremental costs of smoking and obesity among more than 30,000 Mayo Clinic employees and retirees. All had continuous health insurance coverage between 2001 and 2007.

If you smoked or were obese, your health care costs were generally found to be higher. Compared to nonsmokers, average health costs were $1,275 higher for smokers.

The incremental costs associated with obesity were even higher: $1,850 more than for normal-weight individuals. For those with morbid obesity, the excess costs were up to $5,500 per year.

Hidden costs

The costs associated with obesity appeared lower at first, the researchers said, since they showed up in other health problems that, on the surface, didn't appear related to obesity, but were.

"This may lead to underestimation of the true incremental costs, since obesity is a risk factor for developing chronic conditions," Moriarty and colleagues write.

Smoking and obesity place a growing strain on an already stretched healthcare system. If you are an obese smoker, your drain on the health care system is even more severe.

In the workplace, employers have responded with wellness programs—such as quit-smoking and fitness programs—in an attempt to lower costs by reducing health risk factors. Since companies pick up a large portion of health insurance premiums, they have a strong incentive.

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