5 ms·

> countries without that or with less generally have better outcomes at less cost. > Looking for evidence to the contrary There was no evidence behind your c

> countries without that or with less generally have better outcomes at less cost. > Looking for evidence to the contrary There was no evidence behind your claim either. 90% of US healthcare costs go to managing ( not treating ) obesity/metabolic disease . Yes 90% [1]. Which country with similar metabolic disease rate has better outcomes with less costs? 1. https://www.cdc.gov/chronicdisease/about/costs/index.htm https://www.cdc.gov/chronicdisease/about/costs/index.htm

groby_b 4y ago
That is not at all what your link says. "90% of the nation's $4.1 trillion in annual health care expenditures go to people with chronic and mental health conditions" Obesity is $173 billion, diabetes $327 billion. We could certainly do much better, but blaming health care cost on metabolic diseases is disingenuous. Diabetes cost is roughly the same percentage of total expenditure as it is in other industrialized nations. (I didn't check obesity) It stands to reason that really, the problem is the size of the pie, not the size of the slice.
- dominotw 4y ago
  see: page 20 https://www.rand.org/content/dam/rand/pubs/tools/TL200/TL221/RAND_TL221.pdf https://www.rand.org/content/dam/rand/pubs/tools/TL200/TL221... > We could certainly do much better, but blaming health care cost on metabolic diseases is disingenuous. How so? Only recommendation for all these chronic conditions is 'diet and exercise' is it not ? Obesity isn't the only one. I am not obese , not even close, but I have hyperlipidemia. I am managing it with 'diet and exercise' after initially being put on statins. Same with hypertension, heart disease ect. All of these are metabolic diseases. Sure, I'll give you 'mental health conditions' may not be a lifestyle disease ( Even those are being now linked to diet ) .
  - groby_b 4y ago
    No, "diet and exercise" is not the only recommendation. I don't even know what point you're trying to make there - if that were the only recommendation, health care costs would be fairly low. And it's not just mental health issues (~25% of all chronic health issues), it's also respiratory issues (~10%). Then add to that the fact that many metabolic diseases have long lists of causes that amount to "not really sure". Atherosclerosis? Can be caused by physical activity. Hypertension? Being older than 65 is a cause. What the Rand paper does say is "90% of all health care cost is incurred by people with at least one chronic condition". Not metabolic diseases. What it also doesn't say is that the entire 90% are attributable to chronic diseases. (It's sort of akin to claiming that 10% of all healthcare costs are incurred by people named John, Robert, or James. True, but certainly not causal) Again, I'm not saying that chronic diseases aren't contributing a huge cost burden. I am saying that they're far from the only cause of the cost burden, and that blaming it on metabolic diseases is highly misleading even if you just focus on chronic diseases.
    - deleted 4y ago
      [deleted]
    - dominotw 4y ago
      > No, "diet and exercise" is not the only recommendation. What else is there though? I consulted many physicians for my hyperlipidemia and all of them suggested 'diet and exercise' as the only solution. It is the only thing that worked for me. yes 'not all' high cholesterol can be managed by lifestyle modifications( eg: your genetics might predispose you to high cholesterol. Do you know how much of healthcare spend goes to to the exceptions you are talking about. I certainly couldn't find any data about this, not sure why. > Hypertension? Being older than 65 is a cause. Yes we don't know the cause but we do know the fix even if you are over 65. AHA recommendation https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure https://www.heart.org/en/health-topics/high-blood-pressure/c...
      - groby_b 4y ago
        Dude. If "diet and exercise" were the only thing physicians did to treat these diseases, have you tried to think about the internal consistency of your "and at the same time, this is 90% of healthcare costs" argument? Have you, even for a moment, considered your own statement that your doctor prescribed you statins? Did this not lead you, for a brief nanosecond, to ponder that "maybe other people get treatment beyond diet and exercise too"? Also, did it occur to you your nows on argument 3? "It's obesity". "It's metabolic diseases". "Actually, I'd like to argue there's no treatment outside of diet and exercise".
        dominotw 4y ago
        Imagine thinking statins are used to 'treat' hyperlipidemia. Statins block the production of cholestrol, they don't treat the disease which is causing your body to produce high cholesterol. Maybe you need to ponder about the difference between treatment and management, or ask your doctor about it next time. All this was clearly explained to me by doctor when I was started on statins and that only way to treat the disease itself is through lifestyle modifications. Unfortunately, There is a whole swath of idiots on internet who think they know better than doctors and experts. https://www.aafp.org/pubs/afp/issues/2020/0915/p347.html https://www.aafp.org/pubs/afp/issues/2020/0915/p347.html
  - aquaticsunset 4y ago
    Thank you for bringing this up. The medical community's intense obsession with people's size and shape over their health causes a lot of misleading conclusions and misguided efforts. If you walk into the doctor's office underweight and concerned about an issue you're having, the doctor doesn't put you on a strict fettuccine Alfredo and hamburger diet before treating you. If you're overweight and concerned about an issue, you're far more likely to be told to lose weight and ignored.
    - Eleison23 4y ago
      Whether or not you're overweight, when you come in they'll take your vitals and run some standard tests until they find something they can treat and medicate for the rest of your life. You'll be tested for thyroid dysfunction, for diabetes, for hypertension, for all sorts of stuff that won't be on your radar until a blood test turns up "abnormal" results once. Then you'll get pills, all the pills you care to eat and remember, there is no road map for getting off those pills, you'll just get larger doses and more frequent as your problems worsen (because you're not addressing root causes, just being medicated for "treatable" issues which correspond to existing pharmaceuticals.)
cmalmberg23 4y ago
The link you posted says that the 90% is to treat all "chronic and mental health conditions," which is a much larger grouping than just obesity/metabolic disease.
- dominotw 4y ago
  > just obesity/metabolic disease. yes we don't measure this and is impossible to measure.

groby_b 4y ago

That is not at all what your link says. "90% of the nation's $4.1 trillion in annual health care expenditures go to people with chronic and mental health conditions" Obesity is $173 billion, diabetes $327 billion. We could certainly do much better, but blaming health care cost on metabolic diseases is disingenuous. Diabetes cost is roughly the same percentage of total expenditure as it is in other industrialized nations. (I didn't check obesity) It stands to reason that really, the problem is the size of the pie, not the size of the slice.

dominotw 4y ago
see: page 20 https://www.rand.org/content/dam/rand/pubs/tools/TL200/TL221/RAND_TL221.pdf https://www.rand.org/content/dam/rand/pubs/tools/TL200/TL221... > We could certainly do much better, but blaming health care cost on metabolic diseases is disingenuous. How so? Only recommendation for all these chronic conditions is 'diet and exercise' is it not ? Obesity isn't the only one. I am not obese , not even close, but I have hyperlipidemia. I am managing it with 'diet and exercise' after initially being put on statins. Same with hypertension, heart disease ect. All of these are metabolic diseases. Sure, I'll give you 'mental health conditions' may not be a lifestyle disease ( Even those are being now linked to diet ) .
- groby_b 4y ago
  No, "diet and exercise" is not the only recommendation. I don't even know what point you're trying to make there - if that were the only recommendation, health care costs would be fairly low. And it's not just mental health issues (~25% of all chronic health issues), it's also respiratory issues (~10%). Then add to that the fact that many metabolic diseases have long lists of causes that amount to "not really sure". Atherosclerosis? Can be caused by physical activity. Hypertension? Being older than 65 is a cause. What the Rand paper does say is "90% of all health care cost is incurred by people with at least one chronic condition". Not metabolic diseases. What it also doesn't say is that the entire 90% are attributable to chronic diseases. (It's sort of akin to claiming that 10% of all healthcare costs are incurred by people named John, Robert, or James. True, but certainly not causal) Again, I'm not saying that chronic diseases aren't contributing a huge cost burden. I am saying that they're far from the only cause of the cost burden, and that blaming it on metabolic diseases is highly misleading even if you just focus on chronic diseases.
  - deleted 4y ago
    [deleted]
  - dominotw 4y ago
    > No, "diet and exercise" is not the only recommendation. What else is there though? I consulted many physicians for my hyperlipidemia and all of them suggested 'diet and exercise' as the only solution. It is the only thing that worked for me. yes 'not all' high cholesterol can be managed by lifestyle modifications( eg: your genetics might predispose you to high cholesterol. Do you know how much of healthcare spend goes to to the exceptions you are talking about. I certainly couldn't find any data about this, not sure why. > Hypertension? Being older than 65 is a cause. Yes we don't know the cause but we do know the fix even if you are over 65. AHA recommendation https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure https://www.heart.org/en/health-topics/high-blood-pressure/c...
    - groby_b 4y ago
      Dude. If "diet and exercise" were the only thing physicians did to treat these diseases, have you tried to think about the internal consistency of your "and at the same time, this is 90% of healthcare costs" argument? Have you, even for a moment, considered your own statement that your doctor prescribed you statins? Did this not lead you, for a brief nanosecond, to ponder that "maybe other people get treatment beyond diet and exercise too"? Also, did it occur to you your nows on argument 3? "It's obesity". "It's metabolic diseases". "Actually, I'd like to argue there's no treatment outside of diet and exercise".
      - dominotw 4y ago
        Imagine thinking statins are used to 'treat' hyperlipidemia. Statins block the production of cholestrol, they don't treat the disease which is causing your body to produce high cholesterol. Maybe you need to ponder about the difference between treatment and management, or ask your doctor about it next time. All this was clearly explained to me by doctor when I was started on statins and that only way to treat the disease itself is through lifestyle modifications. Unfortunately, There is a whole swath of idiots on internet who think they know better than doctors and experts. https://www.aafp.org/pubs/afp/issues/2020/0915/p347.html https://www.aafp.org/pubs/afp/issues/2020/0915/p347.html
- aquaticsunset 4y ago
  Thank you for bringing this up. The medical community's intense obsession with people's size and shape over their health causes a lot of misleading conclusions and misguided efforts. If you walk into the doctor's office underweight and concerned about an issue you're having, the doctor doesn't put you on a strict fettuccine Alfredo and hamburger diet before treating you. If you're overweight and concerned about an issue, you're far more likely to be told to lose weight and ignored.
  - Eleison23 4y ago
    Whether or not you're overweight, when you come in they'll take your vitals and run some standard tests until they find something they can treat and medicate for the rest of your life. You'll be tested for thyroid dysfunction, for diabetes, for hypertension, for all sorts of stuff that won't be on your radar until a blood test turns up "abnormal" results once. Then you'll get pills, all the pills you care to eat and remember, there is no road map for getting off those pills, you'll just get larger doses and more frequent as your problems worsen (because you're not addressing root causes, just being medicated for "treatable" issues which correspond to existing pharmaceuticals.)

cmalmberg23 4y ago

The link you posted says that the 90% is to treat all "chronic and mental health conditions," which is a much larger grouping than just obesity/metabolic disease.

dominotw 4y ago
> just obesity/metabolic disease. yes we don't measure this and is impossible to measure.