Obesity imposes high costs on health care

Community recommendations show ways to reduce burden.

The annual economic burden of obesity in the United States may be as high as $147 billion — 37% higher than the cost in 1998, according to new data presented at the CDC’s Weight of the Nation conference in Washington.

“The average American is now 23 lb overweight and collectively we are 4.6 billion lb overweight,” Thomas R. Frieden, MD, MPH, director at the CDC and administrator for the Agency for Toxic Substances and Disease Registry, said during a media conference. “Reversing obesity will not be done successfully with individual effort; it will be done successfully as a society only with societal effort. We got to this stage of our epidemic because of a change in our environment and only a change in our environment again will allow us to get back to a healthier place.”

Eric A Finkelstein, PhD, associate director of the Research Triangle Institute Center for Health Promotion Economics, said, “Obesity certainly raises the risk for many preventable health conditions and as a result obesity increases annual medical expenditures because ultimately public or private payers are responsible for financing the cost for treatment for these conditions.”

As a follow-up to a 2003 study by Finkelstein and colleagues, the researchers assessed data from the Medical Expenditure Surveys during 1998 and 2006 for 32,474 adults aged 18 years and older.

The proportion of annual medical costs due to obesity increased from 6.5% during 1998 to 9.1% during 2006.

Per capita medical spending during 2006 was 42% higher for obese people when compared with normal weight people. The per capita percentage increase in costs due to obesity during 2006 was about 36% for Medicare, 47% for Medicaid and 58% for private payers.

“Clearly, obesity is costly and the only real way to show savings in health expenditure in the future is to reduce the prevalence of obesity and health-related conditions such as diet and physical activity,” Finkelstein said.

Evidence-based recommendations

To address obesity on a community level in the United States, the CDC has issued a set of evidence-based recommendations including 24 strategies divided into six categories:

Strategies to promote the availability of affordable healthy food and beverages.
Strategies to support healthy food and beverage choices.
A strategy to encourage breast-feeding.
A strategy to encourage communities to organize for change.
Strategies to encourage physical activity or limit sedentary activity among children and youth.
Strategies to create safe communities that support physical activity.

“A significant challenge remains before us — that is how intense these need to be and how many of these need to be employed,” William Dietz, MD, PhD,director of the division of Nutrition and Physical Activity in the Center for Chronic Disease Prevention and Health Promotion at the CDC, said during the media advisory. “It is quite clear that we are moving from the ‘what’ and the ‘why’ to the ‘how’. These recommendations set the foundation for the community intervention necessary to reverse this problem in the United States.”

Finkelstein EA. Health Aff. 2009;5:822-831.

Khan LK. MMWR Rcomm Rep. 2009 Jul 24;58:1-26.