Overweight, obesity at midlife linked to greater morbidity, health care costs later in life

Having overweight or obesity in midlife was associated with significantly higher cumulative morbidity and thousands of dollars in additional health care costs during older adulthood, data show.

The findings were published in JAMA Network Open.

“The greater proportion of life lived with morbidity translated to higher adjusted cumulative and mean annual health care expenditures during older adulthood, which will have substantial consequences for health care costs as the aging population intersects with the obesity epidemic,” Sadiya S. Khan, MD, MSc, an assistant professor of cardiology and epidemiology medicine at the Feinberg School of Medicine at Northwestern University, and colleagues wrote.

Khan and colleagues conducted a prospective cohort study of participants from the Chicago Heart Association Detection Project in Industry. The participants underwent baseline in-person examinations between November 1967 and January 1973. These data were linked to Medicare data that were collected between January 1985 and December 2015. The final analysis included 29,621 Medicare beneficiaries who were followed for more than 40 years; 57.1% were men, 9.1% were Black and the mean age was 40 years.

At baseline, 46% of participants had a normal BMI, 39.6% were overweight and 11.9% had classes I and II obesity. Khan and colleagues reported a higher cumulative morbidity burden in older adulthood among participants with overweight (7.22 morbidity-years) and classes I and II obesity (9.8 morbidity years) compared with those with a normal BMI (6.1 morbidity years) in midlife (P < .001). The mean age at death was similar between those who were overweight (82.1 years; 95% CI, 81.9-82.2) and those who had normal BMI (82.3 years; 95% CI, 82.1-82.5). However, participants with classes I and II obesity died at a younger age (80.8 years; 95% CI, 80.5-81.1), on average.

The cumulative median per-person health care costs in older adulthood were $12,390 (95% CI, 10,427-14,354) higher among participants with overweight and $23,396 (95% CI, 18,474-28,319) higher among those with classes I and II obesity compared with participants with a normal BMI (P < .001).

“Resources and strategies are urgently needed at the individual and population level to address the growing public health challenge of excess weight in the context of an aging population,” Khan and colleagues wrote.