The influence of obesity and overweight on medical costs: a panel data perspective

Abstract

This paper estimates the increase of direct medical costs of both severe and moderate obesity and overweight with respect to a normal-weight individual using a two-part generalised linear model and a longitudinal dataset of medical and administrative records of patients in primary and secondary healthcare centres followed up over seven consecutive years (2004)(2005)(2006)(2007)(2008)(2009)(2010) in Spain. Our findings indicate that severe and moderate obesity imposes a substantial burden on the Spanish healthcare system. Specifically, being severely obese is associated with increases in medical costs of 26 % (instrumental variables (IV) estimate, 34 %) compared to a normal-weight individual. The effects of moderate obesity and overweight are more modest, raising medical costs by 16 % (IV estimate, 29 %) and 8.5 % (IV estimate, 23 %), respectively. These changes in costs are slightly higher for those patients below the median age and for the women. Notwithstanding, the effects found in this study are comparatively much lower than that reported for the USA, based basically on a private healthcare system and characterised by a more obese population.

Economic Burden of Obesity: A Systematic Literature Review

“…We included twenty-three studies in this review [29,30,31,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54]. Detailed characteristics of these studies are presented in Table 1.…”

Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

“…There is large variation in cost estimates for obesity based on population sample studies, ranging from an additional €160 per year for severe obesity compared with normal weight, 124 to US$2741 for any obesity compared with normal weight. 123 Our findings estimated an increase of £146 per year for mild obesity in comparison with normal weight, and £456 for morbid obesity.…”

“…Previous studies investigating health-care costs relating to obesity using patient cohorts have attempted to estimate the marginal effect of obesity on costs. 123,124 Understanding the causal association between BMI and health-care utilisation is important; however, in the context of treating patients in a clinical environment there is little benefit in divorcing obesity from related morbidities and socioeconomic factors.…”

“…The economics literature has moved towards using an instrumental variables approach to examine the causal effect of obesity on medical costs by using the weight of a biological relative as an instrument. 123,124 The argument for this method is that the instrument predicts the participants' weight, but not their morbidity status, meaning that the effect of weight on costs can be isolated. Such papers have found higher health-care costs for obesity than non-instrumented methods, so it is possible that our models underestimate the magnitude of the relationship.…”

Taxation of Unhealthy Consumption of Food and Drinks: An Updated Literature Review

“…Second, due to the importance of the obesity-related diseases obese population tend to cause a negative externality on the non-obese in the form of higher utilization of healthcare resources and associated costs (Cawley, 2011;Mora, Gil and Sicras-Mainar, 2014). Although some costs are internalised by the obese employees (lower wages or labour market discrimination) other costs are externalised in the form of extra taxes or insurance premiums, since the latter are not based on obesity status 2 .…”