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Study: Healthcare costs rise in parallel with BMI

Saturday December 28, 2013
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Healthcare costs increase in parallel with body mass measurements, even beginning at a recommended healthy weight, according to a study.

Researchers with Duke Medicine in Durham, N.C., found that costs associated with medical and drug claims rose gradually with each unit increase in body mass index. Notably, these increases began above a BMI of 19, which falls in the lower range of the healthy BMI category, the researchers reported in a study published Dec. 9 on the website of the journal Obesity.

“Our findings suggest that excess fat is detrimental at any level,” lead author Truls Østbye, MD, PhD, professor of community and family medicine at Duke and professor of health services and systems research at Duke-National University of Singapore, said in a news release.

Using health insurance claims data for 17,703 Duke employees participating in annual health appraisals from 2001 to 2011, the researchers related costs of doctors’ visits and use of prescription drugs to employees’ BMIs. Underweight individuals (with a BMI of less than 19) were excluded from this analysis because very low weight may be a result of existing illness, the researchers said.

Measuring costs related to doctors’ visits and prescriptions, the researchers observed that the prevalence of obesity-related diseases increased gradually across all BMI levels. In addition to diabetes and hypertension — the two diseases most commonly associated with being overweight or obese — the rates of nearly a dozen other disease categories also grew with increases in BMI. Cardiovascular disease was associated with the largest dollar increase per unit increase in BMI.

The average annual healthcare costs for a person with a BMI of 19 was found to be $2,368, and grew to $4,880 for a person with a BMI of 45 or greater. Women in the study had higher overall medical costs across all BMI categories, but men saw a sharper increase in medical costs the higher their BMIs rose.

The study did not find a change in the relationship between levels of obesity and healthcare costs from 2001 to 2011. In contrast to recently published evidence relating to mortality, which concluded that only more obese people were at a higher risk of death, the findings suggest that the occurrence of obesity-related illnesses and related costs begin increasing at a healthy weight.

Given the growing health costs associated with excess weight, the researchers stressed the importance of implementing effective health and weight-loss programs.

“The fact that we see the combined costs of pharmacy and medical more than double for people with BMIs of 45 compared with those of 19 suggests that interventions on weight are warranted,” Marissa Stroo, a co-investigator on the study, said in the news release.

The researchers noted the workplace is a good setting for implementing weight loss programs, given that employers can target more than 100 million Americans who spend most of their waking hours at work. The Affordable Care Act has created new incentives to promote employee wellness programs. “Employers should be interested in these findings, because, directly or indirectly, they end up paying for a large portion of these healthcare costs,” Østbye said.

The researchers are working to evaluate the impact of employer-sponsored weight and health management programs on healthcare costs.

Study abstract: http://onlinelibrary.wiley.com/doi/10.1002/oby.20669/abstract


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