This post is from staff writer April Dykman.
Weight and finances have been discussed at length on personal finance blogs, but mostly the similarities between money and weight management. There’s been little discussion about the total annual cost of obesity for an individual because most research offers anecdotal evidence of higher costs associated with obesity, but not a dollar amount for a single person.
Last fall George Washington University released a report [PDF] that put a figure to the staggering individual costs of being obese in America. Dr. Avi Dor, report author and professor and director of the health economics program at The George Washington University, and his colleagues quantified indirect costs, direct costs, and lost productivity to arrive at an estimated total cost of being an obese individual.
The high price of a high BMI
After tabulating various costs associated with being overweight or obese, the researchers found that being an obese individual in the U.S. costs $4,879 for women and $2,646 for men each year. The overall annual costs of being overweight are $524 for women and $432 for men. The researchers defined “obesity” as a body mass index (BMI) higher than 30, and “overweight” as a BMI between 25–29.
Adding the value of lost life to these yearly costs makes the price tag even higher: $8,365 and $6,518 for women and men, respectively.
The analysis showed that obese women pay nine times more and obese men pay six times more in associated costs than do individuals at a healthy BMI. The results also showed that women are affected much more than men when it comes to obesity and job-related costs, including lost wages, absenteeism, and disability.
Non-medical costs of obesity
Direct medical costs are an obvious cost driver—for overweight individuals, it accounts for 66% of weight-related costs for women and 80% for men. It’s also the cost driver for obese men, but for obese women it accounts for just 30% of the overall costs. An obese female loses more income through lost wages (38%) than from medical costs.
“The data demonstrate that an individual affected by obesity faces not only high medical-related costs, but also higher non-medical costs…,” said Joe Nadglowski, President and Chief Executive Officer of the Obesity Action Coalition, in a press release. Non-medical, obesity-related costs accounted for in the research included the following measures:
- Wages. The annual wage loss for obese males is $75, but statistically that figure is insignificant, according to the report. Obese women earning a median annual wage of $32,450 make 6%, or $1,855, less per year. The researchers note that there isn’t enough data to determine why the relationship between weight and wages is clear for women, but not for men.
- Short-term disability. Annual costs of short-term disability are $55 higher for the average overweight employee and $349 higher for the average obese employee than for employees at a healthy weight.
- Disability pension insurance. The annual incremental costs of disability pension insurance is $69 more for obese employees. There wasn’t a significant difference in cost for overweight individuals.
- Sick leave (absenteeism). Five studies on absenteeism (missed work days due to illness or injury) found that obese employees are more likely to use sick days due to illness or injury. One of the studies (Finkelstein et al. 2005) found that severely to morbidly obese men miss two more days of work than men at a healthy weight, while overweight to morbidly obese women miss up between one and five more days than women at a healthy BMI.
- Productivity (presenteeism). Obese individuals have more self-reported limitations at work or limitations in the amount of work that an employee can be performed, which lowers productivity. One study cited (Ricci and Chee, 2005) used nationally representative data to estimate that reduced productivity will cost an obese individual $358 per year.
- Gasoline use. Jacobson and McLay (2006) studied the relationship between weight and fuel use, finding that almost 1 billion more gallons of gas are used each year due to average-passenger weight increases since 1960. The cost differences weren’t significant for overweight and obese people, but the morbidly obese spend $30 and $36 more for females and males, respectively. (That figure was calculated using $2.35 per gallon of gas, the average price in the U.S. in 2009.)
- Life insurance premiums. Compared to healthy-weight individuals, an overweight and obese person will pay an additional $14 and $111, respectively, in life insurance costs each year.
- Value of lost life due to premature mortality. The researchers calculated the value of years of life lost (for specifics on how they made the calculation, see the full report [PDF]) and found that, annualized, the cost of early mortality for a morbidly obese white male is $9,961 (data was only available for Caucasians). For a morbidly obese female, the cost is $7,946.
There are other costs associated with being overweight which weren’t included in the study. Dor writes that the report’s estimated likely understated the total cost: “The picture we have created is only a partial look at the individual costs related to obesity. Existing literature provides information on health- and work-related costs, but with the exception of fuel costs, no published academic research offers insight into consumer-related costs, such as clothing, air travel, automobile size or furniture.” There also isn’t data on socio-demographic factors such as education level or marital status, or on early retirement.
The report notes that when it comes to retirement, severely and morbidly obese employees retire earlier than normal-weight employees, which translates to less income in wages and benefits. This is particularly alarming for obese women, whose wages are significantly affected by their weight and who, as females, already lag behind men in retirement savings, when research shows women need to save more than men. Because early retirement benefits vary widely, the researchers didn’t include that data in their report.
Anecdotal evidence suggests that the costs not included are significant, says Dor.
A bigger problem
More than 60% of Americans are at an unhealthy weight, with 33.4% classified as obese. If we continue at this rate, by 2030 half of the population will be obese. Obesity-related conditions include heart disease, stroke, type-2 diabetes and some types of cancer, among the leading causes of death, according to The Center of Disease Control and Prevention.
Those are some scary facts and figures, and the George Washington University only underscores an already-critical situation. After all, paying $6,518–$8,365 more per year for obesity-related expenses hardly seems significant in light of words like cancer, stroke, and premature death. Your health is your most important asset.
I wish I had answers, but I don’t. Education seems like the go-to solution, but I’m not convinced it’s enough. Like personal finance, getting healthy means making difficult changes in habits and lifestyle, not simply being taught that French fries are bad and spin class is good. So readers, I’ll turn it over to you. Has your weight noticeably affected your expenses or income? If so, share specific examples and costs.
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The problem is the inability for the general public to admit to their choices, accept their choices, and then do something about those choices when adverse affects are experienced. The general public wants to blame others for their decisions, choices and lifestyle, whether it be marketing, genetics, family history etc.
I was obese from ages 12-26. I am 5′-11″ and weighed approximately 235 pounds. In August of 2009 my wife got the Wii Fit for Christmas. I told my wife iwas going to start with the Wii and make a change, so I did. I gradually decreased my food portions (in half) and increased my daily exercise to about 5-6 days a week. 18 months later I was feeling amazing, weighed 170 pounds and was in the best shape of my life. Now image a conscious effort to remain at this level. In short, I have changed my lifestyle.
As far as genetics are concerned, 3 out of my 4 grandparents were obese, my mother is morbidly obese, my father and sister are obese, and 4 out of 5 of my bloodlines aunts/uncles are obese, so I would imagine I carry the “fat gene” as well.
I believe there are genetic conditions or traits that will increase weight gain in lots of families, but to pretend that you, as an individual, do not have the will or ability to counteract and control your intake, in my opinion, is likely a lack of “really trying.”
Sometimes you can’t just want to change, you actually have to be the change.
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So what were you doing all those years before you got the Wii fit? Did you really spend 26 years as part of the general public? Shame, shame, shame…
Seriously, congratulations on your progress, and people can fight obesity, you’re right about that… but as your own life exemplifies, if you don’t get that Wii Fit in your hands (or that book that makes you see things clearly or you get drafted to the army or whatever), you might forever stay in the mass hypnosis that turns sweets for children into “food”.
I get that you’re in “ex-smoker crusader” mode at this time, but can you explain hat happened to you until you were 26 and can you see how that might happen to others?
E.g., I’ve been to supermarkets in rural areas where they have gallon-sized bottles of corn syrup for snow cones but no fresh vegetables anywhere in sight. Good luck growing up in a place like that, ‘Merica.
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…”if you don’t get that Wii Fit in your hands (or that book that makes you see things clearly or you get drafted to the army or whatever), you might forever stay in the mass hypnosis that turns sweets for children into “food”.”
Exactly, that was my point. There needs to be some “trigger” or stimulus to encourage or introduce the change; however, to that effect, the person needs to be willing and acceptance of change.
“I get that you’re in “ex-smoker crusader” mode at this time, but can you explain what happened to you until you were 26 and can you see how that might happen to others?”
What happened to me until age 26? I grew up in an obese family, I was still living at home and just finishing college. For me, eating large quantities of unhealthy food was typical, normal, even pleasurable. I was complacent and went along with the flow, but I am aware that I made the choice, I don’t blame my parents for offering great dinners every night or my grandparents for their genes.
I got married at 26, my wife and I moved away and started our own life together, making our own choices. And honestly, the Wii Fit just sparked an idea and provided encouragement by tracking my weight loss. In actuality the Wii Fit did nothing for my fitness, other than serve as the stimulus or trigger.
As far as being a crusader for health or fitness, far from. I have never suggested, inferred, or implied to any person I know how they should or could lose weight over the last 18 months, nor do I ever intend to. This was my decision, and my life choice.
The only reason I even commented was because of the numerous comments regarding genetics, advertising, etc. as mere excuses.
My comment is one directed at people making excuses for their own life decisions, rather than a direct comment towards losing weight. Replace weight/fitness with any other life choice and I would make the same comment.
Which in reality, I think is what ties this post back to the basics of the GRS blog. JD stopped making excuses, took responsibility, adjusted his life choices, and produced more favorable results. Whether that is increasing income, decreasing debt, increasing healthy foods, increasing exercise–in the end, it’s all the same premise.
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Yes, you can take charge, definitely, I’m just saying it’s sometimes too easy for us who got out of the swamp to point fingers and say “oh, they are there just because they want to be there.”
The first few years after I quit smoking I was an insufferable self-righteous anti-smoker. I had to, in a way– have to be an extremist to kick such a strong habit. After a few years my passions tempered– now I live and let live (or die, depending), and I’m not so quick to point fingers at smokers. Getting hooked in easy and quitting is hard.
My point is that when you manage to escape it is easy to forget how it was to be trapped. These aren’t excuses– the individual has power, yes, but we are social animals. Culture and environment play a role in what we are. So you change to a new environment where your horizons broaden and you are capable of doing new things– you were lucky. It’s not just about self-determination.
Life is a lot more complex than the individual– Americans don’t like to recognize that, which is why we have such poor public policy in many areas, but obesity is not just an individual problem– it’s a cultural and environmental one.
Just look at the Pimas north and south of the Mexican border– 95% of American Pimas are type 2 diabetic, whereas the Mexican Pimas are about average with the rest of the world. It’s not that the Mexican ones are better individuals with more self-determination. It’s that they live in a different environment with more physical activity and less access to processed foods.
This is not “making excuses”– it’s understanding reality for the complex web of cause and effect it is. If we’re going to make changes, whether individual or social, we have to see things for what they are. “Self-determination” is a useful fiction, just like many myths and legends, but useful only to the point where it ceases to function.
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@ El Nerdo — I saw a video lecture on sugar’s affect on the body and one thing that stuck in my mind was the doctor saying that any theory we have about the causes of obesity has to account for obesity in babies and toddlers. His theory was that it was liver toxicity due to sugars in baby formula.
I’m not sure I follow his particular theory — I need to do more research — but I agree that there’s more to the story than saying it’s because people are eating too much and not exercising. I’ve read that stress can alter our hormones (such as increasing our production of cortisol) that affects appetite and how we gain/store weight.
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@Elizabeth Not to mention the numerous studies linking sleep deprivation and weight gain.
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@Carla — that too! We also gain weight as we age — especially women. I have come to despise the word “menopot”, and don’t even get me started on the media’s obsession with “baby bumps” that make those of us without a flat stomach rather self-conscious
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Our environment in the US is a toxic food/health environment and it would be awesome to change that. You can change your immediate environment by moving like Jeff did. Or just eliminating things from your household helps, though we aren’t home that much these days. There are probably fundamental issues underlying the obesity epidemic in the US, maybe sugar or refined carbs or too much stress and too much easy access to bad food, whatever, I’m not saying I know what it is. Here I mean only the obesity cases that are unhealthy due to Type 2 diabetes issues or heart troubles or whatever. I’m not saying everyone defined as obese by BMI is unhealthy, as that is clearly not true. And some people have medical issues for their obesity that they may not have any control over. But the unhealthy obesity epidemic is something we should deal with at some level in our society.
However, if you wait for the government to do something about obesity before you try to do something, then you will probably die waiting. I’m just saying, I think we can all agree, whatever side you are on, that Congress is inept. So, although everyone’s case is different and some people have a harder time than others or are healthy and obese or whatever, people in the US who are obese AND unhealthy because of it should do something about it themselves and not wait for society to change. That’s all I’m saying. Yes, there are lots of things we could change societally to help more people at once (stop subsidizing corn which essentially subsidizes HFCS and instead subsidize fruits and veggies, for example), but waiting for Congress to act is like waiting for Godot.
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At 35 I had a BMI of 54, was on 8 prescription medications and seeing Dr’s & specialists regularly for severe GERD, sleep apnea, high blood pressure and the aches & pains of carrying around an extra person of fat, my insurance would cover the conditions I had because I was obese but would NOT cover anything weight loss related to treat the obesity… no nutrition classes, fitness programs, medical/therapeutic assistance. I self paid for weight loss surgery out of the country. It was the best gift I ever gave myself (and it turns out the best gift I ever gave my insurance company) as I am off all 8 medications, all health issues are resolved. I have been maintaining my 158 pound weight loss (through healthy choices and working on the whys of why I got fat) for 5 years and feel awesome. I was able to pay but so many continue to suffer. Obesity must be battled from all avenues education, prevention & treatment.
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“So readers, I’ll turn it over to you. Has your weight noticeably affected your expenses or income? If so, share specific examples and costs.”
The biggest cost related to my obesity is clothing. Plus size clothes cost more. I haven’t flown in a couple of years, but the clothes would indirectly cost me more there too. More material = less items fit in suitcases = more checked bags fees (If I’m going somewhere for a longer period of time).
I’m sure, over time, that it’s cost me more in gas than if I weighed 120# but I don’t know if that’s a significant amount of money. I rather doubt that it is.
What it hasn’t cost me: sick days or salary or prescription medication. I’ve called in twice this year … because I wasn’t willing to risk life, injury or my car traveling to work in a blizzard. I received one of the highest raises in my department (according to my manager, take that with a grain of salt). I have yet to be sick this year, aside from the allergies and asthma I’ve had since I was 18 months old. FYI, I wasn’t obese until I was as adult, so no, obesity did not cause my asthma and allergies issue. I was diagnosed with an ulcer when I was about 8 years old, while not obese, so it didn’t cause that either. I had migraines in grade school and middle school – not obese, it didn’t cause that either.
I was, however, diagnosed as diabetic 3 months ago. Not a big surprise to me. I am 5’6″, weight 285 pounds and have a family history of diabetes. I also LOVE sweets and HATE vegetables. I test my blood twice a day and am on no medications. The spike in sugars that precipitated my diagnosis was very sudden (because of my weight, my doctor had been monitoring things for a few years now – always normal across the board) and I wanted time to see if I could get it down again. I cut off pop (mostly) and started sporadic exercise. My sugars aren’t totally normal yet, but they’re getting there. I had my checkup last friday and the doc is still ok with me avoiding medications. I bought a treadmill (I’ve had gym memberships often, but never stuck with them) and I’m trying to get healthier.
I have issues from when I was younger and from now that make getting into better shape difficult, but I can do it through diet and exercise. It’s going to take awhile though. Even though I fit the stereotype of the fat person who just needs to exercise more and eat better/less, I absolutely empathize with those who have other things going on.
It has cost me more in intangible things than in money. And that will continue to be the case as long as people think it’s perfectly normal to mock and denigrate people based on their looks. I have yet to be penalized on salary, but I’ve also been with the same company for 12 years so they know ME and recognize my worth. I am wanting to change jobs and I carry myself very confidently, but sometimes these studies about salary make me nervous that some jacka$$ will try to cheat me based on my fat. And it is cheating me when you make a decision based on my body type rather than my skills (outside of a fitness related job). Anyway, hate these type of articles that encourage the fear mongering instead of taking a more balanced view of things.
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Has weight had an effect on my finances? YES! I work for a small doctor’s office that doesn’t provide medical insurance (yeah, ironic!) Blue Cross essentially flipped me the bird when I applied for individual coverage and reported my height & weight.
For those of you with insuranc who are curious about what medical care costs when you get sick, just take your per visit co-pay and multiply it by 20. I got pneumonia and the visit at the doc-in-the-box was over $500! THAT WAS JUST ONE VISIT W/O MEDS!
I’ve dropped 21 pounds, but I’m nowhere near where I need to be to get coverage.
For those of you who need motivation, picture this: a single woman with the typical American debts (car note, student loan, credit cards) who makes $30 K a year having to CASH HER WHOLE PAYCHECK just to take it to the doctor’s office! That should help you drop a pound or two, too!
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I am super-thin, BMI of 18. I have lived under the poverty line for most of my adult life. My thinness has NOT gotten me any favors for jobs (and I’ve been told I’m an excellent worker, so my low pay isn’t due to being a slacker).
I am not healthy either, despite eating healthy. I suffer from several conditions, such as Rheumatoid Arthritis, Lupus and the lowered immunity that comes with those (ie… I get sick with the common cold a lot easier than most people).
Meanwhile, my obese friends (some of them morbidly obese) make 6-figure incomes, and are overall healthier than I am.
Yes, this is anecdotal evidence, but then again, that’s what the question asked for at the end of the blog.
Also: Some of the comments from people in this blog were just plain hateful. :/
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This is only the beginning of a major problem facing the world. The various governments do not allow enough spending money to educate parents, teachers and children. Also the high street food chains are so big now the governments are not slapping them down there is too much fast food advertising which is driving this epidemic of obesity.
Over the last two to three decades, over nutrition and obesity have been transformed from relatively minor public health issues to a major threat to public health. The aim of this book is to show how serious obesity is and what needs to be done in order to solve the issue. It is important that anyone who is overweight or obese people know about their condition and learn that there is a solution to their weight issues and there are steps that they can take. Laid out in a modular fashion—each concept building on the next—The Menace of Obesity will help those affected to get started.
See http://www.The-Menace-Of–Obesity.com
Thank you
Oliver Greene
Author “The Menace of Obesity”
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First of all, I just wanna say that BMI is BS. It’s not an accurate reflection of someone’s actual health. The “obesity epidemic” mostly exists because suddenly folks decided that 25 was the cutoff for “overweight” instead of a higher number. When my BMI was 25.5, I was in amazing shape–I was running, kickboxing, and lifting weights pretty much every day. I was a size 4/6 and weighed 125 pounds. And my doctor still looked at me and said I could stand to lose 10 pounds because my BMI made me “overweight.” aww yeah. (and I’m not alone in this: http://kateharding.net/bmi-illustrated/)
Secondly, nowadays, I’m a fat girl, and I honestly don’t think my life costs me any more. I don’t eat junk. I have a cheap gym membership and I use it. I don’t buy any wacky weight-loss supplements. I don’t have any serious health problems (except insomnia, which I’ve had since I was 9). I’m just fat. That’s it. I have a freakishly slow metabolism (when I weighed 125, I was working out 2 hours a day and eating about 800 calories because that was the only way I could lose weight) and I’m fat. Tada!
I would rather wonder if part of the reason us chubsters have more expensive health costs is because we actually acknowledge our health. I go to the doctor for preventative reasons (blood tests, etc.) a LOT more than my skinny friends do. They just assume they’re healthy because they’re skinny. This is purely anecdata, of course, but I always wonder if people who put these figures together have issues with correlation vs. causation because that’s often a factor.
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The only diet you’ll ever need: 100% Raw Vegan to drop weight. Eat as many vegetables and fruits as you can and you’ll still lose weight if you’ve cut out all the more calorically dense foods in your diet. Take your veggies/fruits as homemade juices or smoothies if you need help getting down enough calories to feel sated. You will not be hungry.
Just about any weight goal is attainable within a year on this diet, but most will achieve their goals much faster than that.
Once goal weight is achieved, stabilize on a diet with very low bread/pasta/rice and low animal products (meat, cheese, eggs, milk, etc) and a high proportion of fresh, raw ingredients. It’s okay to eat anything sometimes (I enjoy fish, but don’t tell the vegetarians), however fruits and veg should always be the mainstay. Combine with regular physical activity for best results.
Most people are obese because they eat far too many calories in the form of bread, pasta, refined foods from boxes/packages, oily fried foods, and cheese. People will never get healthy until they decide to eat healthful foods. It’s simple.
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I think a number of things need to change in this country. I doubt there is one “magic fix.”
Agriculture policy needs to change. We should stop subsidizing corn so heavily. A ton of what we eat is derived from corn, including soda. High fructose corn syrup is dirt cheap and probably has a lot do with the obesity crisis. One early commenter mentioned that you will never get people to eat healthy when a fast-food meal for three costs so little. Modern agriculture (the production of corn, beef, etc.) is likely a significant contributor.
Personal responsibility and education play a part as well. We need to give people good information, and people need to make good decisions. Our culture needs to change, as well. It needs to be “cool” to eat and drink healthy foods–not Pepsi, Coke, and McDonald’s.
Corporate law should be modified. The shareholder-primacy model is stupid. We need to change the incentives that corporate executives face. Yes, the model does good and has produced a lot of progress, but it causes so many unquantifiable problems. If you think the CEOs of food and beverage corporations are interested in our health, then you are sorely mistaken. They get judged (and their jobs and social status depend on) short-term profits. They will do virtually anything to keep those profits coming. We need to give other stakeholders (employees, the community, etc.) real power in corporate decision-making.
We need to realize that while personal responsibility is important, humans are built to crave sugary and fatty foods. It’s how we’ve evolved. I think some regulation of food would help, mainly the really unhealthy and valueless stuff like soda and fast food.
We need to stop advertising crappy food to children. Food and beverage companies buy their way into schools and try to get our kids hooked on junk food…and it works.
Parents need to take responsibility for their kids’ health. Stop feeding your children junk food. A treat here and there is fine, but fruits and vegetables, whole grains, and lean meats need to be the basis of a good diet. If you start them early on this stuff, they will like it. My three-year old still loves black beans, homemade salsa, grapes, apples, salad, and much more because that’s what we’ve fed her from the start and that’s mainly what we keep around the house.
There are many other things, including exercise, that would help, but I’m not writing a book so I’ll stop now.
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This is a manufacturered epidemic, which groups people who weigh 190 lbs with people who weigh 400 lbs and calls them the same risk. Ask yourself (as some of these other comments have recommended) who benefits financially if you treat yourself for this “condition.” It is incredible to me that the only major cost listed here is lost income- which costs no one else anything- and yet there are several posts here about how obesity is costing all the thin people money. Add to that the researchers cannot explain why the next major cost- lower income in women- is peculiar to women. No speculations even? How about the many speculations on this site that if we all bought wiis and ate vegetables (which I do to a much greater degree than my much-thinner husband), this “problem” would go away. The cost is clearly a perception issue- women are expected to be thin, and men, well, they just earn money. If you weigh over 300 lbs, yes, it is time to think about that. If you are struggling to get down from 200 to 120, think again. There is NO evidence that you need to. When they break out the weight range to finer steps and still see an effect on heart disease, I will revise this.
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After reading through a slew of comments on this article, that have been very interesting! It was interesting to see how so people wanted to argue that this or that or the other study didn’t sound reliable beecause they read another one that disagreed. I hope everybody that looks at any study looks into who is funding the study because whether its about obesity, food quality, medicines or anything else if a manufactorer is paying for the study and not an independent payer the results are really just not that reliable. Thats what makes the FDA so scary. They don’t acutally do any studies in ‘labs’ they go off of the studies that they recieve. Which often time are studies paid for by the maker… you can see how they wouldn’t put any red flags on their own product.
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Glen, love what you put out here. I think a lot of us feel bad if we want to make money from our blogs. Luckily for me, I’m getting over that hump and hope to implement a lot of changes to EIP in the next couple of months.
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