KAI RYSSDAL: Two hundred-thousand Americans had bariatric surgery last year. That's operations like stomach stapling and stomach bypass to control obesity. Still, a report out from Rand yesterday said 3 percent of the population is now 100 pounds or more overweight. The government puts the medical cost of that obesity at about $200 billion a year.
Fat rights activists — their phrase, not ours — question that figure. And they question the usefulness of one common measurement of obesity: the body mass index. But even they admit there are costs of carrying too much flesh on your bones.
Here's Helen Palmer from the Marketplace Health Desk at WGBH with the second report in our occasional series on the economic effects of fat.
MARTHA DOLAN: Hello, welcome!
HELEN PALMER: Martha Dolan welcomes me to her home in Lexington, Mass. She's 50, a marketing manager for Philips — and carries 149 lbs on a 5'7" body.
Before she had gastric bypass surgery, she weighed 100 pounds more.
DOLAN: The cost is interesting. Because, you know, you wear out furniture, you wear out beds, you wear out your car seat. When you weigh more than the things were designed for, things break.
That's happened, says Dolan — a chair collapsing when she sat on it. Everyone laughed, but the effect of pounds on dollars is no joke.
Jay Zagorsky's an economist at Ohio State University. For 29 years, with data from a Department of Labor long-term study, he's correlated wealth and weight, plotting participants' BMI — body mass index — against their total assets.
JAY ZAGORSKY: People with high BMI tend to have low wealth. Exactly how much? Well, people who are in the obese category have half the wealth of normal people.
Zagorsky says each point on the BMI scale boosts or slashes your net worth by $1,300.
He points out he can't say that carrying extra pounds causes poverty — it could be the other way round. Still, changes in weight do affect wealth.
ZAGORSKY: Losing two pounds is not going to make you any richer. But people who had dramatic changes in their body mass — either up or down — tended to have relatively large increases or decreases in their net worth.
Research is less clear when it comes to wages.
But Marilyn Wann, who calls herself . . .
MARILYN WANN: A smart, sassy fat chick.
. . . says some studies have looked into this.
WANN: One New England Journal of Medicine survey found that fatter women's household income was nearly $7,000 less per year than their average-weight counterparts.
Discrimination's rife in the workplace, she says. Human resource managers say things like, "Well, you don't fit the corporate image."
As a business woman, Martha Dolan says she missed out when she weighed 250 pounds.
DOLAN: If you are very obese, people are not inclined to put you in front of a crowd and have you speak and have you escort customers. You know, they're more likely to pick someone else. So there's sort of an opportunity cost.
What turned Marilyn Wann from a writer into a fat rights activist was health insurance.
WANN: Instead of paying, you know, maybe $275 — that would be the rate that they would charge me for my age and my health level, without looking at weight — instead, I pay now nearly $900 every month for health insurance.
That's more than her rent in San Francisco, says Wann.
Fat people pay more for other things, too. Take clothes.
Brandi Mancuso, a baker who weighed 320 pounds before she had bypass surgery, says bigger sizes in specialist stores just cost a lot more.
BRANDI MANCUSO: The first coat I bought at Lane Bryant was $149. And if I could have gone to TJMaxx then . . . I just bought one the other day: $30.
MARTHA DOLAN: OK, well here's my closet. And you can see I've changed over my wardrobe from the large ladies to the normal-sized clothing.
Martha Dolan echoes Brandi Mancuso. She had a wardrobe full of expensive, fat clothes.
DOLAN: I was probably spending double what my colleagues would spend. Because if I found something that fit me, I had to buy it.
Both of them say they've saved over $100 a month on their food bills — they can only eat tiny meals since their operations. And Mancuso's saving cash on her car.
MANCUSO: I kept going through tires. And I'm like, why am I going through so many sets of tires? It's a brand new car. They're like, well, it's your weight. So now that I'm smaller, I don't have to go through so many sets of tires.
Dolan and Mancuso chose the radical step of surgery to shrink their stomachs. They feel they fit in better now and it's saving them cash.
Marilyn Wann's chosen a different path. She wants to change attitudes. She says she's healthy, she exercises and eats well, and she's not ashamed of her 285-pound, 5'4" body.
WANN: I love the "F" word. I love it. Fat! Now loud and proud from the belly: Fat. Ah, I love that word.
In Boston, I'm Helen Palmer for Marketplace.