For more information, contact:
Jon Gardner, Health Affairs, 301-656-7401, ext. 230
Robin Strongin, 202- 408-6889

Tuesday, March 12, 2002


Washington, DC - Obesity is a greater trigger for health problems and increased health spending than smoking or drinking, according to a new study released today by the journal Health Affairs. The problem is significant given the fact that obesity has increased dramatically in the past 25 years and is now approaching epidemic proportions.

The study reveals that more people are classified as obese (23%) than as daily smokers (19%) or heavy drinkers (6%). To be clinically classified as obese, a person must have a body mass index greater than 30-for example, somebody who is five feet, eight inches tall and weighs 197 pounds or more.

Obesity, smoking, and heavy drinking are known behavioral causes of such chronic health conditions as cancer, diabetes, and heart disease. Yet according to the study, the effects of obesity on the number of chronic conditions a person has are significantly larger than the effects of current or past smoking or problem drinking. Those who are obese have 30% to 50% more chronic medical problems than those who smoke or drink heavily. The effects of obesity are similar to twenty years of aging (from age 30 to age 50).

A similar picture emerges for obesity's impact on physical health-related quality of life, with obesity contributing to a decline in quality of life at nearly four times the rate for problem drinking and smoking.

The study, conducted by Roland Sturm of the UCLA/RAND Managed Care Center for Psychiatric Disorders, was based on a national household telephone survey with about 10,000 adult respondents. It follows on the heels of a report released by the U.S. Surgeon General in December. The report warned that health problems resulting from overweight and obesity could reverse many of the health gains achieved in the U.S. in recent decades.

"Smoking and drinking, which are on the decline, have been the focus of research and policy work for years. Yet obesity, which can have far more serious health consequences, has received far less interest," said Sturm. "Given that obesity rates have increased nearly 60 percent in the last decade, prevention and treatment must be a higher public health priority for the health care profession and policymakers."

Obesity Has Significant Impact On Health Care Costs

Obesity is associated with a 36 percent increase in inpatient and outpatient spending and a 77 percent increase in medication costs, compared to a 21 percent increase in health care spending and a 28 percent increase in medication costs for current smokers and smaller effects for problem drinkers. In terms of absolute dollar increases for inpatient and ambulatory care, obesity is associated with an average increase of $395 annually, while smoking raises costs by $230 and heavy drinking is associated with a $150 annual increase.

"Excess weight has long been acknowledged as a serious and very costly health risk but it needs more attention from health professionals, the insurance industry and the government," said Sturm. "If obesity was treated as a greater public health concern, like smoking and drinking, perhaps we would be able to help more people avoid this disease."

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. Copies of the March/April 2002 issue will be provided free to interested members of the press. To obtain a copy, or to get an advance copy of this article, contact Jon Gardner at Health Affairs, 301/656-7401, ext. 230, or via email, Selected articles from the March/April issue are available free on the journal's Web site,


©2002 Project HOPE–The People-to-People Health Foundation, Inc.