"Long before it's in the papers"
January 27, 2015


Medical costs rise steadily with any excess weight: study

Dec. 16, 2013
Courtesy of Duke Medicine
and World Science staff

Health care costs rise in par­al­lel with body mass mea­sure­ments, even be­gin­ning at a rec­om­mended healthy weight, ac­cord­ing to a new study pub­lished in the jour­nal Obes­ity.

Re­search­ers found that costs as­so­ci­at­ed with med­i­cal and drug claims rose grad­u­ally with each un­it in­crease in body mass in­dex, a meas­ure of a per­son’s weight ad­justed for his or her height.

The in­creases sur­pris­ingly be­gan above an in­dex of 19—which falls in the low­er range of healthy, sci­en­tists said. “Our find­ings sug­gest that ex­cess fat is det­ri­men­tal at any lev­el,” said lead au­thor Truls Øst­bye of Duke Uni­vers­ity Med­i­cal Cen­ter in North Car­o­li­na.

Øst­bye and col­leagues said they sought to meas­ure the toll of obes­ity-re­lat­ed dis­ease through health care util­iz­a­tion and costs in or­der to provide an alt­er­na­tive per­spec­tive to a stu­dy pub­lished ear­li­er this year in the Jour­nal of the Amer­i­can Med­i­cal As­socia­t­ion. That one con­clud­ed that while great­er obes­ity was as­so­ci­at­ed with high­er mor­tal­ity, more mod­er­ate lev­els of ex­cess fat were sur­pris­ing­ly linked with low­er mor­tal­ity.

Us­ing health insur­ance claims da­ta for 17,703 Duke em­ploy­ees par­ti­ci­pat­ing in an­nu­al health ap­praisals from 2001 to 2011, Øst­bye and col­leagues re­lat­ed costs of doc­tors’ vis­its and use of pre­scrip­tion drugs to em­ploy­ees’ body mass in­di­ces.

A healthy or nor­mal body mass in­dex is con­sidered 19-24, while over­weight is 25-29 and obese is 30 and above. For ex­am­ple, a 5-foot-6-inch per­son who weighs 117.5 pounds has an in­dex of 19, while a per­son of the same height weigh­ing 279 pounds has an in­dex of 45. Un­der­weight peo­ple were ex­clud­ed from the stu­dy.

Meas­ur­ing costs re­lat­ed to doc­tors’ vis­its and pre­scrip­tions, the re­search­ers found that the prev­a­lence of obes­ity-re­lat­ed dis­eases rose grad­u­ally across all body mass in­dex lev­els. Be­sides di­a­be­tes and hy­per­ten­sion—the two dis­eases most com­monly linked to ex­cess fat—the rates of nearly a doz­en oth­er dis­ease cat­e­gories al­so grew. Car­di­o­vas­cu­lar dis­ease was as­so­ci­at­ed with the larg­est dol­lar in­creases.

The av­er­age an­nu­al health care costs for a per­son with a body mass in­dex of 19 was found to be $2,368; this grew to $4,880 for a per­son with an in­dex of 45 or great­er. Wom­en in the study had high­er over­all med­i­cal costs across all cat­e­gories, but men saw a sharp­er in­crease in med­i­cal costs with body mass in­dex.

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Health care costs rise in parallel with body mass measurements, even beginning at a recommended healthy weight, according to a new study published in the journal Obesity. Researchers found that costs associated with medical and drug claims rose gradually with each unit increase in body mass index, a measure of a person’s weight adjusted for his or her height. The increases surprisingly began above an index of 19—which falls in the lower range of healthy, scientists said. “Our findings suggest that excess fat is detrimental at any level,” said lead author Truls Østbye of Duke University Medical Center in North Carolina. A study published earlier this year in the Journal of the American Medical Association concluded that while greater obesity was associated with higher mortality, more moderate levels of excess fat were actually linked with lower mortality. Since these findings questioned the general belief that high body weight leads to poor health, Østbye and colleagues said, they sought to measure the toll of obesity-related disease through health care utilization and costs. Using health insurance claims data for 17,703 Duke employees participating in annual health appraisals from 2001 to 2011, the researchers related costs of doctors’ visits and use of prescription drugs to employees’ body mass indices. A healthy or normal body mass index is 19-24, while overweight is 25-29 and obese is 30 and above. For example, a 5-foot-6-inch person who weighs 117.5 pounds has an index of 19, while a person of the same height weighing 279 pounds has an index of 45. Underweight people were excluded from the study. Measuring costs related to doctors’ visits and prescriptions, the researchers found that the prevalence of obesity-related diseases rose gradually across all body mass index levels. Besides diabetes and hypertension—the two diseases most commonly linked to excess fat—the rates of nearly a dozen other disease categories also grew. Cardiovascular disease was associated with the largest dollar increases. The average annual health care costs for a person with a body mass index of 19 was found to be $2,368; this grew to $4,880 for a person with an index of 45 or greater. Women in the study had higher overall medical costs across all categories, but men saw a sharper increase in medical costs with body mass index.