High BMI may be associated with health, economic outcomes of musculoskeletal disorders
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Published results showed a substantial amount of health and economic outcomes of musculoskeletal disorders may be attributable to high BMI.
“Developing effective policies and active participation from health professionals to prevent excessive weight gain are needed,” the authors wrote. “More available estimates are also needed to facilitate a global analysis.”
Using data from the Global Burden of Diseases, Injuries and Risk Factors study, WHO Global Health Expenditure, World Bank and International Labour Organization databases, researchers calculated prevalence, years lived with disability, health care costs and productivity losses due to morbidity from low back pain, gout and osteoarthritis attributable to high BMI in 2019 across 192 countries and territories. Researchers calculated prevalence and years lived with disability with the population attributable fracture approach, and quantified the economic burden, including health care costs and productivity losses due to morbidity. Researchers also estimated health care costs borne by the public, private and out-of-pocket sectors based on corresponding payment shares, while productivity losses were estimated based on the output per worker.
Results showed 36.3 million cases of low back pain, 16.9 million cases of gout and 73 million cases of OA were estimated to be caused by high BMI, which accounted for 7.3 million years lived with disability across 192 countries and territories in 2019. In the working-age population (aged 15 to 84 years), researchers found the years lived with disability of musculoskeletal disorders attributable to high BMI accounted for 1% of all-cause years lived with disability globally. Researchers noted the global total costs of musculoskeletal disorders attributable to high BMI reached $180.7 billion, which included $60.5 billion in health care costs and $120.2 billion in productivity losses. The public sector bore 58.9% of global health care costs vs. 24% in the private sector and 17.1% in the out-of-pocket sector, according to results. Researchers found total costs accounted for an average of 0.2% of global gross domestic product. Researchers also found great inequalities in the disease and economic burden across regions and countries, with 82.4% of global health care and 82.9% of morbidity-related costs paid by high-income countries, while 61.4% of global years lived with disability occurred in middle-income countries.
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This is yet another study that demonstrates the importance of considering BMI when caring for and counseling patients with musculoskeletal disorders. This cross-sectional study looked at the global health and economic outcomes associated with low back pain, gout and osteoarthritis. Excess weight is known to increase the load on the discs of the lumbar spine and increase lower back pain. Increased pressure on joints leads to OA. High BMI leads to increased inflammation and gout by elevating monosodium urate crystal deposits.
The authors concluded that BMI 25 kg/m2 or greater accounted for 7.3 million years lived with disability of musculoskeletal disorders with associated costs of $180.7 billion and productivity losses of $120.2 billion. Per capita morbidity-related costs were greatest in the Americas and high-income groups. By partnering with our patients and their caretakers to emphasize the benefits and orthopedic-related risks of elevated BMI, we can facilitate economic benefits to society and improve quality of life.
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The authors have compiled a massive amount of data and an analysis that takes time to digest (no pun intended). This study analyzes the impact of high BMI (25 kg/m2 or greater), a relatively inclusive criterion, without stratification for increasing levels of obesity. Other studies indicate a positive correlation between increasing BMI and increasing disability and socioeconomic costs. Regardless, weight management should be given a priority on the global health and economic agenda. The economics are well outside the prevue of an orthopedic surgeon. Most of us, however, recognize that weight management is more than a health care issue and requires more than the health care system to affect widespread improvement. The word “exercise” appears only once in this report. There are cultural and familial factors that influence lifestyle choices, beyond diet. Parents may not set a good example. Lifestyle choices start at an early age. The potential roles of primary education, and the general media, including social media, should not be underestimated.
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