The cost of obesity: How much can patients save by losing weight?

Key takeaways:

• Body weight is connected to health care cost; losing more weight is associated with greater savings.
• One presenter evaluated this relationship in the context of anti-obesity medications.

DENVER — Losing weight is good for patients’ wallets as well as their health, according to a presenter at the Obesity Medicine Association’s annual conference.

Data from Google search trends show that “the level of interest in weight loss has reached an all-time high,” David Arterburn, MD, MPH, FACP, FTOS, FASMBS, a general internist, senior research investigator at Kaiser Permanente Washington Health Research Institute and affiliate professor at the University of Washington’s Department of Medicine, said in his presentation.

“We're aware of what's happening right now in obesity treatment, and it's being led by this ushering in of this highly effective group of these anti-obesity medications, which have unprecedented levels of efficacy and tolerability,” Arterburn said. “And there's this large pipeline of new medications which promises a really bright future for us in terms of our armamentarium of therapy that we can bring to patients to help improve their long-term health.”

When considering anti-obesity treatments, Arterburn said “we need to think about the whole budget impact.”

In what he described as “our best available data on the cost of obesity on the national scale,” there is a clear relationship between BMI and health care cost, he said.

“As BMI increases over a BMI of 25, health care costs erupt,” he said. “They go up substantially for patients with a BMI over 35.”

When translated into 2023 dollars, health care costs are 26% higher for patients with a BMI between 30 and 34.9 — approximately $1,907 higher per year — compared with those who had a BMI of 18.5 to 24.5.

“On the other hand, for patients with BMI over 35, they’re 43% higher,” he said. “That’s $3,900 per year in total health care spending in the United States.”

With this in mind, Arterburn estimated just how much a patient can save each year by reducing their weight.

For example, consider a patient who is 5’6” and 202 pounds, meaning a BMI of 32.5. This puts them in the “class one obesity” category. Losing five BMI units — about 15% total weight loss — and dropping into the “overweight” category would save them $1,107 each year.

“The question is, when you move from one category to the next, do those cost savings follow?” he said.

It seems they do. If the aforementioned patient lost 10 BMI units — 30% total weight — and moved to the “normal weight” class, they would save an estimated $1,907 per year, he said.

“So, for medications or any other therapies to be cost saving among adults with a BMI in obesity class one, it’s going to cost less than $1,900,” Arterburn said. “It’s going to have to reduce body weight by 15 to 30% and it’s going to have to lower health care costs for adults with a BMI in the normal range.”

For patients who have higher BMI — 35 and over — a five-unit loss equates to a 13% weight loss. Again, “this is associated with a larger decrease in cost” — potentially $2,080 per year, he said.

If that patient were to lose 10 total units, or 26% of their weight, they could save $3,187 every year.

“If we went all the way to normal weight, a 40% weight loss is required, and that would be associated with about $4,000 included in health care costs,” Arterburn said. “So, for anti-obesity medication to be cost saving in the BMI over 35, it could cost more — $3,100 — [but] still needs to reduce body weight by 13 to 26% and lower cost of care to the overweight category patients.”

References:

• Arterburn D. Paradigm shifts and price wars: The bright and bumpy future of obesity treatment. Presented at: Obesity Medicine 2024. April 24-28, 2024; Denver.
• Ward ZJ, et al. PLoS One. 2021;doi: 10.1371/journal.pone.0247307.