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American Journal of Public Health logoLink to American Journal of Public Health
. 1999 Aug;89(8):1194–1199. doi: 10.2105/ajph.89.8.1194

The direct health care costs of obesity in the United States.

D B Allison 1, R Zannolli 1, K M Narayan 1
PMCID: PMC1508703  PMID: 10432905

Abstract

OBJECTIVES: Recent estimates suggest that obesity accounts for 5.7% of US total direct health care costs, but these estimates have not accounted for the increased death rate among obese people. This article examines whether the estimated direct health care costs attributable to obesity are offset by the increased mortality rate among obese individuals. METHODS: Data on death rates, relative risks of death with obesity, and health care costs at different ages were used to estimate direct health care costs of obesity from 20 to 85 years of age with and without accounting for increased death rates associated with obesity. Sensitivity analyses used different values of relative risk of death, given obesity, and allowed the relative costs due to obesity per unit of time to vary with age. RESULTS: Direct health care costs from 20 to 85 years of age were estimated to be approximately 25% lower when differential mortality was taken into account. Sensitivity analyses suggested that direct health care costs of obesity are unlikely to exceed 4.32% or to be lower than 0.89%. CONCLUSIONS: Increased mortality among obese people should be accounted for in order not to overestimate health care costs.

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Selected References

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  1. Barendregt J. J., Bonneux L., van der Maas P. J. The health care costs of smoking. N Engl J Med. 1997 Oct 9;337(15):1052–1057. doi: 10.1056/NEJM199710093371506. [DOI] [PubMed] [Google Scholar]
  2. Bonneux L., Barendregt J. J., Nusselder W. J., der Maas P. J. Preventing fatal diseases increases healthcare costs: cause elimination life table approach. BMJ. 1998 Jan 3;316(7124):26–29. doi: 10.1136/bmj.316.7124.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Han T. S., Tijhuis M. A., Lean M. E., Seidell J. C. Quality of life in relation to overweight and body fat distribution. Am J Public Health. 1998 Dec;88(12):1814–1820. doi: 10.2105/ajph.88.12.1814. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hannon B. M., Lohman T. G. The energy cost of overweight in the United States. Am J Public Health. 1978 Aug;68(8):765–767. doi: 10.2105/ajph.68.8.765. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Heithoff K. A., Cuffel B. J., Kennedy S., Peters J. The association between body mass and health care expenditures. Clin Ther. 1997 Jul-Aug;19(4):811–820. doi: 10.1016/s0149-2918(97)80104-x. [DOI] [PubMed] [Google Scholar]
  6. Kuczmarski R. J., Carroll M. D., Flegal K. M., Troiano R. P. Varying body mass index cutoff points to describe overweight prevalence among U.S. adults: NHANES III (1988 to 1994). Obes Res. 1997 Nov;5(6):542–548. doi: 10.1002/j.1550-8528.1997.tb00575.x. [DOI] [PubMed] [Google Scholar]
  7. Manson J. E., Willett W. C., Stampfer M. J., Colditz G. A., Hunter D. J., Hankinson S. E., Hennekens C. H., Speizer F. E. Body weight and mortality among women. N Engl J Med. 1995 Sep 14;333(11):677–685. doi: 10.1056/NEJM199509143331101. [DOI] [PubMed] [Google Scholar]
  8. Pi-Sunyer F. X. Health implications of obesity. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1595S–1603S. doi: 10.1093/ajcn/53.6.1595S. [DOI] [PubMed] [Google Scholar]
  9. Quesenberry C. P., Jr, Caan B., Jacobson A. Obesity, health services use, and health care costs among members of a health maintenance organization. Arch Intern Med. 1998 Mar 9;158(5):466–472. doi: 10.1001/archinte.158.5.466. [DOI] [PubMed] [Google Scholar]
  10. Ramalingam S., Pawlish K., Gadgeel S., Demers R., Kalemkerian G. P. Lung cancer in young patients: analysis of a Surveillance, Epidemiology, and End Results database. J Clin Oncol. 1998 Feb;16(2):651–657. doi: 10.1200/JCO.1998.16.2.651. [DOI] [PubMed] [Google Scholar]
  11. Schneider E. L., Guralnik J. M. The aging of America. Impact on health care costs. JAMA. 1990 May 2;263(17):2335–2340. [PubMed] [Google Scholar]
  12. Stevens J., Cai J., Pamuk E. R., Williamson D. F., Thun M. J., Wood J. L. The effect of age on the association between body-mass index and mortality. N Engl J Med. 1998 Jan 1;338(1):1–7. doi: 10.1056/NEJM199801013380101. [DOI] [PubMed] [Google Scholar]
  13. Swinburn B., Ashton T., Gillespie J., Cox B., Menon A., Simmons D., Birkbeck J. Health care costs of obesity in New Zealand. Int J Obes Relat Metab Disord. 1997 Oct;21(10):891–896. doi: 10.1038/sj.ijo.0800486. [DOI] [PubMed] [Google Scholar]
  14. Troiano R. P., Frongillo E. A., Jr, Sobal J., Levitsky D. A. The relationship between body weight and mortality: a quantitative analysis of combined information from existing studies. Int J Obes Relat Metab Disord. 1996 Jan;20(1):63–75. [PubMed] [Google Scholar]
  15. Williamson D. F., Narayan K. M., Teutsch S. M. The economic impact of obesity in the United States: whither? Obes Res. 1998 Mar;6(2):173–175. doi: 10.1002/j.1550-8528.1998.tb00332.x. [DOI] [PubMed] [Google Scholar]
  16. Wolf A. M., Colditz G. A. Current estimates of the economic cost of obesity in the United States. Obes Res. 1998 Mar;6(2):97–106. doi: 10.1002/j.1550-8528.1998.tb00322.x. [DOI] [PubMed] [Google Scholar]

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