Could money motivate healthy behaviour?

[minkydog]

this mindset always amazes me. first of all, you are being mighty judgemental about who uses a scooter, why do you care? but anyway, i'd like to pose a question to you... my sister-in-law is 5'4" and weighs 300 lbs, she is never sick, goes once a year for a checkup and has normal blood pressure, and has high "good" cholesterol, very low "bad" cholesterol, low triglycerides and leads a fairly active lifestyle. i have a brainstem tumor that has delibitated me significantly over the past 8 years, i'm rarely sick (i've only been to the doctor once in the past 3 years, and that was for a uti), i've had no treatment for my tumor save a biopsy at diagnosis, i don't even get mri's anymore since my tumor can't be treated, i've gained some weight, mostly since i can't really stand up well, basically i cost my insurance company zero. my mother-in-law has had 3 bouts with recurrent breast cancer over the last 20 years, has been on a weekly "maintenance chemo" for the past 9 years, has had numerous surgeries to remove pop-up tumors on her chest wall, had reconstructive surgery, then had it all removed again, goes to the doctor at least once a week, actually has to see about 6 different types of specialists because all of the chemo and radiation she has done has really destroyed her bones, heart and other organs, has had both knees replaced TWICE, and essentially will go to as many doctors as possible until she hears what she wants to hear--which usually involves being put on some new, trial drug that runs about $10k a month (that she will get for free through the pharmacutical company's charity program).

following your "fat people are the scourge of society and will drain us all financially" mentality, i'm guessing you would think my sister-in-law should pay higher rates? that's funny to me since she costs the health system virtually no money, and my mom-in-law costs the taxpayers hundreds of thousands through medicare. she hit her 2 million lifetime benefit a long time ago for her employer sponsored retiree plan.

I agree with you. My sister is well over 300-lbs, eats an unhealthy diet, gets no exercise, and yet her cholesteral and triglycerides are perfect. She has no high blood pressure or heart disease, no diabetes. The one and only real chronic illness she has is sleep apnea and her CPAP machine is paid for. She rarely gets sick.

DH, on the other hand, has been a health nut all his life. Always keeps his weight in control, worked out several times a week, non-smoker, non-drinker. At age 47 he developed a serious lung-heart disease. He is hospitalized about once or twice a year with Chronic pericarditis--that means a week in CCU (cha-ching!$$$$$$) His meds would cost over $1000/month if he didn't have health insurance and Medicare. He averages 3 doctor visits a month, wears oxygen, and uses a nebulizer. I have no idea how much it costs to keep him going every year, but it has to be well into 6 figures. DH did NOTHING to bring on this condition.THey don't know what causes it and there's no cure. Potentially, this could go on for another 5-10 years until he dies.

I think there is something to be said for taking responsibility for your health. Last year I was unable to get life insurance because I was obese and my triglycerides were almost 500. That was a wakeup call. Now I've lost enough weight that I'm considered merely overweight and with meds my triglycerides are normal. I would be thrilled if my insurance company gave me a bonus for all my hard work, but truthfully, the bonus has to be better health and potentially longer life for me.

Money talks. If money is what it takes to make people get serious about changing lifestyle choices(smoking, drinking, obesity, unsafe sex, speeding) then I say let's go for it. But don't raise insurance rates on those people who are heavy users of healthcare resources because we never know what they're reallly dealing with.

 

[Sparx]

I don't know how motivating it is. Everyone on my staff, with the exception of one person, is overweight. After installing a nice gym with showers, TV's, music, etc that no one uses, the President and I decided to offer each employee $25 for every pound lost (on the honor system, nobody was going to have to disclose weight). Not one person was interested.

I'd be hitting the gym for 25$ per pound lost.

 

[DisneyBamaFan]

...ETA: Will power has NOTHING to do with my weight. I quit smoking cold turkey and every few weeks/months I STILL have the urge to smoke yet I don't. It is something else and I don't know what it is. I would like to weigh less if anyone can tell me what the problem is exactly.

The problem is simple. You know that smoking will kill you, so you quit. You need to know that obesity will kill you, as well. In fact, you are far more likely to die prematurely from obesity than from smoking.

The food tastes just as good, because you can eat the same exact food - anything in moderation.

 

[chisnpeke]

I'd be hitting the gym for 25$ per pound lost.

Yea, me too. This country is just lazy.

 

[chisnpeke]

this mindset always amazes me. first of all, you are being mighty judgemental about who uses a scooter, why do you care? but anyway, i'd like to pose a question to you... my sister-in-law is 5'4" and weighs 300 lbs, she is never sick, goes once a year for a checkup and has normal blood pressure, and has high "good" cholesterol, very low "bad" cholesterol, low triglycerides and leads a fairly active lifestyle. i have a brainstem tumor that has delibitated me significantly over the past 8 years, i'm rarely sick (i've only been to the doctor once in the past 3 years, and that was for a uti), i've had no treatment for my tumor save a biopsy at diagnosis, i don't even get mri's anymore since my tumor can't be treated, i've gained some weight, mostly since i can't really stand up well, basically i cost my insurance company zero. my mother-in-law has had 3 bouts with recurrent breast cancer over the last 20 years, has been on a weekly "maintenance chemo" for the past 9 years, has had numerous surgeries to remove pop-up tumors on her chest wall, had reconstructive surgery, then had it all removed again, goes to the doctor at least once a week, actually has to see about 6 different types of specialists because all of the chemo and radiation she has done has really destroyed her bones, heart and other organs, has had both knees replaced TWICE, and essentially will go to as many doctors as possible until she hears what she wants to hear--which usually involves being put on some new, trial drug that runs about $10k a month (that she will get for free through the pharmacutical company's charity program).

following your "fat people are the scourge of society and will drain us all financially" mentality, i'm guessing you would think my sister-in-law should pay higher rates? that's funny to me since she costs the health system virtually no money, and my mom-in-law costs the taxpayers hundreds of thousands through medicare. she hit her 2 million lifetime benefit a long time ago for her employer sponsored retiree plan.

I'm sorry you feel I'm being judgmental. But the truth is that there are a lot more people on scooters simply because they are overweight than there used to be. I know that people who are overweight are on them for other reasons as well, I'm not that oblivious. I also know that the amount of young people that are overweight is rising. There is no excuse for that except for eating poorly and not being active. Period. There is probably the very rare child who has a medical problem that causes obesity but overall, far too many kids are overweight and that is not normal.

My mother is overweight...about 5'9" and 250 lbs so I'm not a "fat person hater". If she had problems related directly to her weight, she would have to pay higher premiums under this philosophy. I also never said that fat people are the scrouge of society and will drain us financially. People who have bad lifestyles from smoking or overeating, will cause insurance to go up. These are preventable problems that can be avoided. I don't understand why people have a problem with promoting healthy lifestyles with money. Nothing else seems to be working

I'm saying that I have seen FAR too many people eating insane amounts of food and they are in a scooter and morbidly obese. You don't think something is wrong with that picture? That's about the same as being on oxygen and smoking cigarettes.

 

[minkydog]

Someone just needs to make healthy food taste better.

ETA: Will power has NOTHING to do with my weight. I quit smoking cold turkey and every few weeks/months I STILL have the urge to smoke yet I don't. It is something else and I don't know what it is. I would like to weigh less if anyone can tell me what the problem is exactly.

You are RIGHT. Willpower has NOTHING to do with whether we take the weight off and keep it off.We're not fat because we're lazy (most of us, anyway.) It's much more complicated than that. There can be physiological factors, such as MS, long-term steroid use, pre-diabetes or insulin resistance which makes losing weight extremely hard. There can be psychological factors too, such as depression, childhood trauma, PTSD, and eating disorders(that's right. Obesity can be caused by an eating disorder.) Not to say that we can't lose weight. But I think it has to be treated almost like addiction. I may very well lose the rest of the weight(I have about 30-lbs to go) but I know that it will be a life-long struggle for maintenance.

ETA: The answer for me has been low carb diet(100mg/day) and counting cals. Not glamourous, but it works. And working out 3 times a week. Learning that I have type 2 diabetes was a VERY powerful motivator.

I also know that the amount of young people that are overweight is rising. There is no excuse for that except for eating poorly and not being active. Period. There is probably the very rare child who has a medical problem that causes obesity but overall, far too many kids are overweight and that is not normal.

I'm saying that I have seen FAR too many people eating insane amounts of food... <snip> That's about the same as being on oxygen and smoking cigarettes.

I snipped a sentence in your post because I think it misses the main point. This discussion istn' about scooters so let's just take that bit out of the equation. Too many people,adults AND children, are eating insane amounts of mostly processed food and not getting enough exercise to burn off the excess calories. I read recently that 60% of American adults are overweight. I can't remember the exact number who are obese and morbidly obese, but it was higher than I thought it would be.

I'm a school nurse and I am very alarmed at how many students I see who are overweight and grossly overweight. When I see what these kids eat at school. Ice cream bars, chips, french fries, 20-oz Powerades. The school lunches are almost entirely pre-packaged, heavy on the breading and frying. They make decent veggies, but the kids don't eat them. Last year I had a 6th grader come to me with chest pain and shortness of breath after running in PE.(note: he was not in true respiratory or cardiac distress, just winded.) I didn't even have a BP cuff that would go around his arm! He was well over 350-lbs. Thankfully, he felt better once he sat down, and of course, I called his mom and she came and got him. He may be only 12 but this kid is at high risk for diabetes, stroke, and heart disease, and I don't mean as an adult. He's at high risk RIGHT NOW!

 

[FireDancer]

I'm a school nurse and I am very alarmed at how many students I see who are overweight and grossly overweight. When I see what these kids eat at school. Ice cream bars, chips, french fries, 20-oz Powerades. The school lunches are almost entirely pre-packaged, heavy on the breading and frying. They make decent veggies, but the kids don't eat them. Last year I had a 6th grader come to me with chest pain and shortness of breath after running in PE.(note: he was not in true respiratory or cardiac distress, just winded.) I didn't even have a BP cuff that would go around his arm! He was well over 350-lbs. Thankfully, he felt better once he sat down, and of course, I called his mom and she came and got him. He may be only 12 but this kid is at high risk for diabetes, stroke, and heart disease, and I don't mean as an adult. He's at high risk RIGHT NOW!

Personally I think that allowing your child to get that overweight is abuse. When I was living in Florida there was a little girl in our apartment complex that looked maybe 4 or 5. She was so fat that she walked like the stay-puff marshmallow man. Everyday when the ice cream truck would go through the complex one of her parents and her would be out there getting ice cream from it. It was infuriating on the part of the parents and sad for the little girl.

At that age a kid can't make nutritional decisions, the parents have to step up and do something about it. We ate well because our parents (mostly our mom actually) made us eat well as kids. Ice Cream, McDonald's, any food not made by her, my grandma, or my great grandma was a rare treat.

The obesity epidemic in the country is multi-faced, there is no sole reason for it and there is no single solution. In the end though, it is up to us to take responsibility for it ourselves and our family. That may mean taking the stairs instead of the elevator, parking at the far end of the parking lot, or riding a bike up to the store. It means that food is fuel, not a friend that makes us feel better about something. It means using the oven or stove top more and the microwave less. It means buying produce, meat, and fruit instead of frankenfood.

It seems daunting at first but after you rethink and rework your lifestyle it really does become just as natural as what people are doing now. It isn't easy, but it is simple.

 

[minkydog]

Personally I think that allowing your child to get that overweight is abuse. When I was living in Florida there was a little girl in our apartment complex that looked maybe 4 or 5. She was so fat that she walked like the stay-puff marshmallow man. Everyday when the ice cream truck would go through the complex one of her parents and her would be out there getting ice cream from it. It was infuriating on the part of the parents and sad for the little girl.

At that age a kid can't make nutritional decisions, the parents have to step up and do something about it. We ate well because our parents (mostly our mom actually) made us eat well as kids. Ice Cream, McDonald's, any food not made by her, my grandma, or my great grandma was a rare treat.

The obesity epidemic in the country is multi-faced, there is no sole reason for it and there is no single solution. In the end though, it is up to us to take responsibility for it ourselves and our family. That may mean taking the stairs instead of the elevator, parking at the far end of the parking lot, or riding a bike up to the store. It means that food is fuel, not a friend that makes us feel better about something. It means using the oven or stove top more and the microwave less. It means buying produce, meat, and fruit instead of frankenfood.

It seems daunting at first but after you rethink and rework your lifestyle it really does become just as natural as what people are doing now. It isn't easy, but it is simple.

"Frankenfood" Isn't that the truth. I rarely eat anything my grandmother wouldn't recognize.

You make excellent points regarding childhood obesity. The nutritional habits we learn as children are great predictors of future obesity. If children are of normal weight at 5yrs and 13 yrs, they are much more likely to keep their adult weight at a near-normal level. I, too, think that it's child abuse to allow a child to be obese. In my 32 years as a pediatric nurse i have come across exactly 3 kids who had truly organic reasons for being obese. All three of them had Prader-Willi Syndrome, a chromosome disorder which causes mental retardation and shuts down the body's ability to recognize satiety. These children are *constantly* hungry and will stop at NOTHING to find food. All three of these parents had put key locks on their pantry and fridge because their children would get up at night and literally clean out the entire pantry in one sitting.

That said, most of the rest of our obese kids simply eat crap diets and don't move. They sit in the house and play video games and eat whatever can be managed in one hand. I have two sisters who allow their children to do this.They started when their kids were young, letting them choose whatever they wanted because "he/she just won't eat!" Um, yes they will, if you take away all the junk and give them healthy choices. My DNephew is 8yo and weighs well over 100-lbs. My DNeice is 12yo and she weighs 130-lbs. Both children are shorter and heavier than my DD16 and DS14. DD dances 18hrs a week and DS walks 1-2 miles/day. I have never allowed my kids to eat willy-nilly. I don't keep junk in the house. They can buy junk if they want, but they have to go to the store to get it. And they don't drive.

 

[LuvOrlando]

I think it might work, but I don't think it's particularly ethical to single out healthy people for being that way. It's a slippery slope because where do you draw the line on healthy. What if they start offering rewards to people who spend less company money on medications? People who do not have sick or disabled kids? My kid have Asthma and their medicines are expensive... we're already penalized by paying a higher co-pay on my DD's Flovent because the pencil pushers decided it wasn't 'preferred"... who are they to say what is or isn't preferred? If my Dr says its the best choice then it's the best choice, the fact he prefers it is enough for me and should be for them too... who are they to get in between that decision? I pay out of pocket because I will do whatever my Dr says to do but I don't think it's good that these companies have the power to penalize us for being who we are. Giving out rewards for certain behaviors is just them pushing themselves on us further. After all, the inverse of rewarding for good behavior is punishment for the opposite isn't it? Who would be able to tell when the discount becomes the new standard? I believe the rewards system is just a backdoor way to penalties. Think about that little bit of fancy footwork for a while.... it steams me.

 

[FireDancer]

That said, most of the rest of our obese kids simply eat crap diets and don't move. They sit in the house and play video games and eat whatever can be managed in one hand. I have two sisters who allow their children to do this.They started when their kids were young, letting them choose whatever they wanted because "he/she just won't eat!" Um, yes they will, if you take away all the junk and give them healthy choices. My DNephew is 8yo and weighs well over 100-lbs. My DNeice is 12yo and she weighs 130-lbs. Both children are shorter and heavier than my DD16 and DS14. DD dances 18hrs a week and DS walks 1-2 miles/day. I have never allowed my kids to eat willy-nilly. I don't keep junk in the house. They can buy junk if they want, but they have to go to the store to get it. And they don't drive.

We were basically kicked out of the house every evening when it wasn't winter. Even on school nights we were expected to be out playing after dinner. We had video games but we weren't allowed to sit there and just veg out. People like to blame the modern age but we had video games and television as kids but it wasn't the first thing we did for entertainment. We got out in the neighborhood and when it wasn't covered in snow we played sports in the streets, in fields around the neighborhood, and in people's driveways. We took hikes in the woods or brought our bikes down there. We rode to grandma's house (about a mile). Even though I am single when I was house shopping I made sure to get something in a safe, kid inductive neighborhood so when I do have kids they can have a similar upbringing.

You are so right about the kids learning habits from their parents. If you start off your adolescence 40 lbs over weight you already have a huge disadvantage. So often you hear this weird elevation of food to mean more then it does. There was a thread on this board a while ago where someone was complaining that when their mom had their kids they fed them junk against their wishes. People actually defended this and said that their right as a grandma is to feed them what ever they want like they were equating love to food. I don't mean a trip to the ice cream shop once or twice a summer, but daily.