Fighting the cost of obesity

A new research study by a Lehigh economist shows that the cost to medically treat obese individuals in America has increased by 14 percent since 2005 and the full cost of obesity treatment nationally is now $315 billion per year.

The article, Savings in Medical Expenditures Associated with Reductions in Body Mass Index Among US Adults with Obesity, by Diabetes Status, appears in the health economics journal PharmacoEconomics. It is an extension of the researchers’ highly cited Journal of Health Economics paper, The Medical Care Costs of Obesity, which concluded that obesity accounts for almost 21 percent of U.S. health care costs – more than twice previous estimates.

In the current study, Chad Meyerhoefer, associate professor of economics; Ph.D. candidate Adam Biener, and their coauthors used data from the 2000-2010 Medical Expenditure Panel Survey to analyze the effect of changes in body mass index (BMI) on medical care expenditures and predict the savings in total medical and prescription drug costs for obese individuals who reduce their weight. Savings are estimated for specific amounts of weight loss ranging from 5 percent to 20 percent. The researchers also compared the cost savings from weight loss for patients with and without diabetes. The findings were presented at the recent annual meeting of The Obesity Society.

"Costs really aren't elevated for people with BMI levels just over the obesity cut-off, but they increase rapidly as BMI escalates towards morbid obesity,” said Meyerhoefer. “As a result, a relatively modest 5 percent reduction in body weight for someone with a BMI level above 40 can save thousands of dollars per year in medical care costs."

Findings from the study:

• The average inflation-adjusted annual medical care costs per obese individual in the United States rose from $3,070 in 2005 to $3,508 in 2010, an increase of 14.3 percent.
• For the United States as a whole, adult obesity raises annual medical care costs by $315.8 billion per year (2010 values).
• Individuals with Class 1, or low-risk obesity, do not have elevated healthcare costs, but healthcare costs rise rapidly with BMI in the range of Class 2 (moderate risk) and Class 3 (high risk) obesity.  
• A given percent of weight loss results in more savings the heavier the starting weight of the individual. The estimated savings in annual medical care costs from a 5 percent reduction in weight is $2,137 for those with a starting BMI of 40, $528 for those with a starting BMI of 35, and only $69 for those with a starting BMI of 30.
• The medical care costs for individuals with diabetes are greater than for those without diabetes at every unit of BMI, and, at high levels of BMI, this difference amounts to thousands of dollars per year.

Meyerhoefer’s growing body of research on the effect of weight loss (or avoided weight gain) on medical care spending provides  important information needed to calculate the cost-effectiveness analysis of anti-obesity interventions, which are used by health care providers, insurance companies, employers and policy makers.

The prevalence of obesity has more than doubled in the United States in the past 30 years, with obesity a significant risk factor for diabetes, cardiovascular disease, and other clinically significant co-orbidities.

Meyerhoefer's research focuses broadly on the economics of health and nutrition. Much of his work involves the use of microeconometric methods to evaluate and inform public policy.  Some of his current research projects include examining the relationship between food assistance programs and health, estimating the price responsiveness of consumer demand for medical services, and determining the impact of electronic medical record adoption on pregnancy outcomes. He is a research associate with the National Bureau of Economic Research.

The research team included Meyerhoefer and Biener; John Cawley of the department of policy analysis and management and the department of economics at Cornell University; and Mette Hammer and Neil Wintfeld of Novo Nordisk Inc. Financial support for the study was provided by Novo Nordisk.