Welcome to the session on diabetes and obesity the the two major pandemics that I think we face in the United States and I’m calling them pandemics because it’s a global issue I think we have a fabulous panel today beginning on my left with Oh actually I don’t have your name down it’s a joke I think you gotta remember.

I know exactly risk who’s CEO sorry next is Mark Hyman who’s the medical director of the Center for functional medicine at the Cleveland Clinic to my right is Kelly close who’s the founder and chair of the diatribe foundation.

And president of closed concerns and next to her is Sean Duffy who is CEO and co-founder of Amada health and finally Hugh wall waters director of health economics research Milken Institute and Hugh we’re going to start with you to see some data great thank you yeah so I have the pleasure of giving all the bad news at the very beginning and then the rest of the panel will then give you the solutions to these.

Problems so I’m in a bit of a very quick overview of some of the economic impacts of for starting with the chronic disease burden in the US and then looking specifically at obesity and diabetes in terms of the epidemiologic and economic outcomes associated with those two so I’ll go ahead and bring up a slide see okay.

First slide so we’ve done at the Milken Institute a very detailed study on the cost of chronic diseases in the US using.

A wide sore you know a wide variety of sources of data from Center for Disease Control from American Heart Association from a number of other professional organizations but very using very detailed and reputable sources.

On both prevalence of these diseases and also the costs of these diseases so categorizing chronic diseases broadly and into these categories we calculated that the direct cost and when we say as health.

Economists we say direct cost we mean that costs actually a healthcare delivery what patients pay what insurance pays ends and what employers pay for the health care itself so that’s what we call direct and as you can see if we group chronic diseases into large categories the total is 1.
8 percent of our of our GDP s and you may.

Know that health care spending in this country is a little bit over almost 19 percent so so a significant portion of the US healthcare spending in this country goes directly to pay for treatment of chronic disease if we go to the next slide if we combine the direct health care costs that treat the treatment of the diseases in.

The healthcare system if we combine that with productivity losses what a health economist called indirect costs so these include lost.

Productivity lost work time the the effects of the chronic diseases in terms of the economic total economic outcomes.

We can see that the costs are much higher so some of these chronic diseases lead to a lot of obviously disability of reduced productivity in the workplace so the total costs calculating using indirect and direct cost together are almost 20 percent of our economy nineteen point six percent of GDP three.

Point four trillion dollars and you can see looking at the the categories you can see that you know diabetes is a significant chunk well over almost half a trillion dollars over five hundred billion dollars cardiovascular conditions in general all by themselves more than one trillion dollars in the u. so we’re gonna be talking today about obesity and diabetes which really underline a lot of these things which I’ll just get to here.

In a second okay I’m like okay here we care sorry about this cost of diabetes if we look at it as a subsection of these costs total treatment costs direct health care in terms of again hospital hospital visits healthcare visits about a hundred and ninety billion in the US and including the productivity cost this is the difference.
Between the direct health care treatment.

And the indirect productivity losses if we include the indirect productivity losses.

Almost half a trillion can can be attributed to diabetes.

The diabetes epidemic and you the US so.

So it’s a significant significant chunk of change okay and then of course obesity and being overweight this is the study that.

We have done it’s a very again very detailed looking at each of the specific diseases the spending on those diseases and then looking at the portion of the spending that can be considered attributable to to obesity so the way we do that is it’s a mix of Epidemiology and economics to really calculate correctly the the attributable risk yeah in the epidemiologic sense that’s due to obesity you need to know two things you need.

To know the prevalence of obesity and you need to know the relative risk relative risk is how much more likely is the person who has obesity to get that condition whether it’s diabetes or cardiovascular disease then a person who does not have that condition sorry keeping everything else equal level how much more likely is the person who has.

Obesity to to have the healthcare condition in question so that’s that’s a relative risk and.
So the relative risks are kind of stunning so it makes you think a.

Little bit about your diet perhaps so if you have obesity in the u.

You are three point four times more likely to have diabetes holding.

Everything else constant if you have obesity.

You’re over two times more likely to get Alzheimer’s disease or vascular dementia so if you if you take those number and then congestive heart failure 1.3 times more likely coronary heart disease one point six times more likely if you.

To go backwards okay if we take those numbers and go back here okay so you can see so these.

Conditions alright so obesity.

Twice as likely to have Alzheimer’s and vascular dementia if.

You have obesity so in other words a significant contributor to the light-blue PI diabetes three point four.

Times more likely to have if you have obesity the big blue slice of the pie and cardiovascular conditions varies depending on the condition but also significantly more likely if you have obesity compared to having a healthy weight that’s that’s the concept of relative risk so so using the relative risk and using the prevalence of obesity.

We can calculate in gory detail which which is the total contribution of obesity so so the total cost of diseases due to obesity.

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