Excess body weight increases the burden of age-associated chronic diseases and their associated health care expenditures

Abstract

Aging and excessive adiposity are both associated with an increased risk of developing multiple chronic diseases, which drive ever increasing health costs. The main aim of this study was to determine the net (non‐estimated) health costs of excessive adiposity and associated age‐related chronic diseases. We used a prevalence‐based approach that combines accurate data from the Health Search CSD‐LPD, an observational dataset with patient records collected by Italian general practitioners and up‐to‐date health care expenditures data from the SiSSI Project. In this very large study, 557,145 men and women older than 18 years were observed at different points in time between 2004 and 2010. The proportion of younger and older adults reporting no chronic disease decreased with increasing BMI. After adjustment for age, sex, geographic residence, and GPs heterogeneity, a strong J‐shaped association was found between BMI and total health care costs, more pronounced in middle‐aged and older adults. Relative to normal weight, in the 45‐64 age group, the per‐capita total cost was 10% higher in overweight individuals, and 27 to 68% greater in patients with obesity and very severe obesity, respectively. The association between BMI and diabetes, hypertension and cardiovascular disease largely explained these elevated costs.

Body mass index and healthcare costs: a systematic literature review of individual participant data studies

“…Two further studies were identified and included following review of the reference lists of included articles. In total, 75 studies were included in the systematic review .…”

Determinants of outpatient expenditure within primary care in the Brazilian National Health System

“…23 A similar pattern has been observed in developed nations. 24,25 Our findings also point out that primary care services have strategic relevance regarding preventive actions aimed towards controlling obesity and its future complications.…”

A comprehensive descriptive assessment of obesity related chronic morbidity and estimated annual cost burden from a population-based electronic health record database

“…In addition to documented co-morbidities, studies have also demonstrated that BMI is directly associated with healthcare cost [11,12]. A study by Li et al [11] (2015) assessed the economic burden of 21 obesityrelated disorders among 56,895 subjects and found that the costs associated with one prevalent obesity related condition (ORC), when all other ORCs were adjusted for, ranged from $120 (for angina) to $1665 (for pulmonary embolism) per person per year.…”

“…A study by Li et al [11] (2015) assessed the economic burden of 21 obesityrelated disorders among 56,895 subjects and found that the costs associated with one prevalent obesity related condition (ORC), when all other ORCs were adjusted for, ranged from $120 (for angina) to $1665 (for pulmonary embolism) per person per year. In addition, a study by Attella et al [12] evaluated net health costs (the sum of indirect and direct costs) among 557,145 individuals, based on seven obesityrelated chronic diseases across BMI groups, and demonstrated a J-shape association between BMI and net health costs. The magnitude of this healthcare cost and how co-morbidities distribute across the population with obesity is unknown.…”