Severe Obesity Linked to Increased Healthcare Costs

NEW YORK (Reuters Health) - As waistlines grow bigger, healthcare costs get higher, according to the results of a study that found healthcare expenses to be nearly twice as high in morbidly obese individuals than in their normal-weight peers.

An analysis of 2000 data show that 10 percent of all healthcare expenditures in the US that year, a total $56 billion, were somehow linked to excess body weight, according to study author Dr. David E. Arterburn and his colleagues. Twenty percent of those costs were incurred by the nearly 5 million men and women considered to be morbidly obese.

"Morbid obesity is an increasingly important health problem in the United States, and our study highlights the economic impact of this condition among adults," Arterburn and his team write in the International Journal of Obesity.

Morbidly obese individuals have a higher risk of sickness and death from diabetes, high blood pressure, cardiovascular disease, cancer and various other chronic health conditions.

The prevalence of morbid obesity is increasing twice as fast as obesity. As of 2000, 2.2 percent of the US population was morbidly obese, up from 0.78 percent just 10 years earlier.

"Given the continued increase in the number of obese adults in the US, we can anticipate that obesity will continue to have a major impact on US health care expenditures," Arterburn, of the University of Cincinnati College of Medicine, told Reuters Health.

Arterburn and his colleagues analyzed data for more than 16,000 adults involved in a nationwide medical expenditure survey. The expenditures included office-and hospital-based care, dental services, vision aids and prescription medications.

Fifty-eight percent of the survey respondents were overweight or obese, including 2.8 percent who fit the criteria for morbid obesity, defined as having a body mass index of 40 or higher or weighing at least 100 pounds over their ideal body weight.

Healthcare expenses in the morbidly obese were 81-percent higher, or $1,975 greater, than that in normal-weight adults and 65-percent higher than that in overweight adults.

"This means that private health insurers and federal programs (such as Medicaid and Medicare) shell out about twice as much money each year to cover the health care of their morbidly obese enrollees as they do for their normal-weight enrollees," Arterburn told Reuters Health.

Severely obese adults were up to two times more likely than normal-weight adults to incur medical expenses for office-based visits, a finding that translated into 50-percent greater annual expenses for office visits per individual, the report indicates. These adults were also 1.9 and 1.7 percent more likely to incur costs for outpatient hospital care and in-patient care, respectively, and nearly three times more likely to incur costs for prescription drugs.

The survey respondents' healthcare expenditures seemed to increase along with their increasing levels of obesity. Among overweight adults, 9 percent of per capita expenditures was associated with excess body weight, compared with 19 percent among those with class I obesity and 45 percent among severely obese adults.

"If the prevalence of morbid obesity continues to increase over the next decade, obesity-associated healthcare expenditures will likely rise at an alarming rate," the authors note.

One way to combat this increase in healthcare expenditures may include "broad-based and aggressive population-level interventions to reduce the incidence and prevalence of obesity in the US," Arterburn said.

Noting that insurers and employers pass along increased costs to consumers, Arterburn added that, "since obesity may be responsible for part of these cost increases, we all have real economic incentives to maintain a healthy lifestyle and a normal body weight."

SOURCE: International Journal of Obesity, February 14, 2005.