We didn't used to be like this.
Once, people envied us.
Sixty years ago, they came to York County from around the country, around the world, to learn from Bob Hoffman, the man who invented the barbell. With every weight set stamped "YORK BARBELL," we exported strength. "Muscle capital of the world," the Saturday Evening Post called us.
But the Post is long dead, and look at us now -- just another fat city, surrounded by fat towns in a fat county.
About two-thirds of us are overweight or obese. We have a full variety of fat on display, from that extra 10 pounds, to the
20 pounds that followed the extra
10 pounds, to the perpetually pregnant men, pudding-armed women and children so heavy their legs can't help but bow.
Social scientists say eating and sitting around -- not smoking, drinking, snorting or sex -- is our riskiest behavior. It opens the door to diabetes, heart disease, depression, and a host of other maladies that are killing many of us young.
And what a financial price we pay to be sick, sad and dead.
Our bulk has added real dollar-and-cent costs to almost every aspect of life in York County. Obesity follows our wallets through life, and, eventually, into the grave.
We pay higher health care and insurance bills, but our businesses are less productive.
We spend more for XXL shirts, insulin, shoes, mattresses and fake knees. We refill our gas tanks more often. It takes more paramedics to carry us into an ambulance, we die younger and our relatives pay more for super-sized graves.
As we grow, the solutions to our problems grow all the more absurd: Reinforced toilets, double-wide office chairs and super-sized crematoriums, all coming to you soon, at a premium price. The numbers are not always easy to figure out.
York County, like much of America, has gotten so fat so fast that scientists are just beginning to measure the hidden costs.
For example, how quickly does an obese person wear out a mattress or a
We have a bit more of an idea on gas mileage. The Department of Energy says every 100 pounds added
to a vehicle cuts mileage by
2 percent. An overweight family of four could easily carry 100 pounds more than doctors say they should. A 6-foot person weighing
230 pounds takes a 1 percent mileage hit even without anyone else in the car.
Big-and-tall clothes cost more than regular size items. While clothing companies are adding more business wear for obese people, it can still be hard to find, especially for women.
Some costs get obscured because they are seldom paid directly.
Take medical expenses. Every year, medical costs are $732 higher than for people of healthy weight, according to a study done by the Stanford University School of Medicine. Individuals might see their health insurance premiums rise. But because insurance or Medicare picks up most of the cost of treatment, people might not realize their fat costs the equivalent of a one laptop computer a year.
We all pay, but the money goes to health insurance companies and the government, to support Medicare and Medicaid.
Businesses pay too. Higher health care costs, sure, but also in lost productivity. Nationally, obese people miss an extra three days of work each year. Studies have found that obese people are less likely to be hired. Those who get jobs are less likely to be promoted or given raises.
In a survey by the South Central Pennsylvania Manufacturers Association, 16 of 29 responding businesses said they had lost productivity because obese employees take longer to perform certain tasks. Twenty businesses said they had jobs an obese person would likely be unable to perform because of his or her size.
So, we work less, we work more slowly and we're limited in the work we can do. The money leaks away.
And we will need more money, because some costs are only getting worse.
Our bodies weren't designed to carry the weight that about two-thirds of us carry.
The longer people are overweight or obese, the more likely their back, knees and hips
More than 80 percent of obese people have back pain, Alhadeff said, because their back muscles are "constantly working to keep people upright and it's essentially a losing battle." Eventually, the discs can collapse, which would necessitate $50,000 spine-fusion surgery.
Replacing a knee or hip costs between $40,000 and $50,000, Alhadeff said. And once you replace one knee, it's often not long before the other one has to be replaced. Hips can soon follow.
"Now, you're looking at four major surgeries at a cost of close to $200,000 just because you're so fat," Alhadeff said.
Orthopedic surgeons are seeing more and more obese patients, Alhadeff said, and more kids, for diseases that used to be quite rare. For instance, Blount's disease, a growth plate disorder of the knee that develops after an obese child's legs bow because they are carrying far too much weight at a young age. Obese children can also have their hips dislocated from the pressure of pounds, Alhadeff said.
And those issues are often secondary to other costly problems, including diabetes.
Once a child becomes obese, it's likely her or she will stay obese through life, shelling out big bucks along the way.
Overweight adults are much more likely to develop heart disease and other conditions that can require emergency care, when mere minutes can mean the difference between life and death. But as our county's population has plumped, these trips are both slower and more costly.
White Rose Ambulance Company transports so many morbidly obese patients -- some weighing
400 pounds or more -- that it bought a bariatric truck, with an oversized gurney, ramp and winch system to haul patients into the ambulance.
Red Lion Ambulance Association replaced its traditional gurneys, which cost $2,000, with $9,000 electrical ones. Additionally, they answered so many calls from people who fell but were too heavy to pick themselves up, said director of operations Ron Harlacher, that Red Lion now charges $115 to get them from the floor to a chair.
"When we do this, we're putting ourselves at risk for back injuries," Harlacher said.
Back injuries became so common that White Rose Ambulance created a policy that four medics were needed to manually lift a person weighing more than
200 pounds, said president Jim Arvin.
"We probably spend $50,000 a year on light duty, paying people to sit around doing nothing because they have (minor) back injuries," said Arvin, noting that White Rose still pays an extra $25,000 a year in workers compensation insurance to cover all the lifting injuries.
Meanwhile, it can take two or three times longer to get an obese person into an ambulance. And once there, paramedics are often gasping for breath as they try to save lives, performing physical tasks like CPR.
And the cost of obesity still might not be over when you die.
Funeral homes now deal with extra-large corpses, on a regular basis. Most of time, it's as simple as arranging more pall bearers or parking the hearse closer to the grave, so those carrying the casket at the cemetery are less likely to have an embarrassing slip.
But increasingly, families have needed oversized caskets for their morbidly obese loved ones, said John Katora, a funeral director for Heffner Funeral Home and Crematory. And oversized caskets also require oversized grave openings and oversized vaults.
Because funerals are almost always on short notice, Prospect Hill Cemetery has started keeping an oversized vault on-site, said owner Jack Sommer, something that never would have happened 20 years ago.
These oversized funerals carry a cost.
If a family has previously paid for a standard 42-inch grave opening, Sommer said, they'll have to pay more for the larger 63-inch opening. An oversized casket, vault and opening will cost a family 44 percent more than their normal counterparts, Katora said. He called that a conservative estimate.
When Heffner builds its next crematorium, it will include an oversized oven.
f our society continues to expand, we will have to spend money on things previous generations never would have considered.
Emergency planners have not yet reconfigured evacuation plans to account for larger individuals potentially creating bottlenecks at doors, but they might have to, said Michael Shanabrook, York's emergency planning specialist.
York Hospital has already had a glimpse of the future.
Because of the number of morbidly obese patients it sees, the hospital has had to reinforce some of its wall-mounted toilets to prevent them from tearing out of the wall, dumping patient and porcelain on the floor. That's $500 per commode.
Standard-sized furniture won't accommodate many of these bariatric patients, so WellSpan has outfitted offices that specialize in obesity issues with double-wide, super-sturdy chairs that run between $400 and $1,250 each.
If obese becomes the new normal, and morbidly obese becomes the new obese, these modifications could be everywhere: businesses, government offices, churches, stadiums.
That is, if -- after spending on everything else -- we can even afford them.