Wednesday, Oct. 20, 2004, 12:01 a.m EDT

Jon Gardner
Health Affairs

Obesity Accounts For Nearly 30 Percent Of Overall
Health Spending Increase Since 1987, Health Affairs Analysis Says

Heart Disease, Diabetes, Hyperlipidemia Drive Costs For Obese Patients;
One-Tenth Of Spending Due To Higher Obesity Rates Alone

BETHESDA, MD — Health care spending on obese Americans accounted for 27 percent of the growth in overall health care spending between 1987 and 2001, making obesity a priority condition for clinicians and policymakers to address if health care costs are to be brought under control, according to a new analysis published today on the Health Affairs Web site.

Costs incurred by the obese were 37 percent higher than those incurred by people of normal weight, largely because of a higher prevalence of such conditions as heart disease, hyperlipidemia, and diabetes, writes Kenneth E. Thorpe, professor and chairman of the Department of Health Policy and Management at Emory University’s Rollins School of Public Health, and three colleagues. In 1987 per capita spending on obese people was just 15 percent higher than spending on normal-weight people.

Analyzing federal health and spending data, Thorpe shows that over the fourteen-year period analyzed, inflation-adjusted per capita spending increased $1,100, to $3,298. Had obesity rates remained at 1987 levels, inflation-adjusted per capita spending would have increased $809, to $2,997. According to Thorpe, the additional $301 is attributable to a combination of increased obesity rates and increases in spending on obese people compared to normal-weight people.

Over that period, the normal-weight U.S. population dropped by 13.0 percentage points to 38.6 percent, while the share of the population categorized as obese rose 10.3 percentage points to 23.8 percent. That increased prevalence of obesity alone accounted for 12 percent of inflation-adjusted per capita spending growth, Thorpe says.

“Obesity has a sizable impact on the U.S. health care system,” Thorpe says. “It is associated with higher rates of mortality, even among those without other risk factors such as smoking or a previous medical condition.

“To date, there is no evidence that the rise in the share of the U.S. population that is obese is abating,” he says. “These results suggest that future cost containment efforts need to attack the rising prevalence and costs of obesity head on. This will require a focus on developing effective interventions to promote weight loss among obese people.”

The increase in obesity-related spending attributable to heart disease was most pronounced. The overall inflation-adjusted per capita spending increase for heart disease was $81, of which $33 (or 41 percent) was attributable to obesity. Thirty-eight percent of the inflation-adjusted per capita spending growth on diabetes, and 22 percent of that of hyperlipidemia, was attributable to obesity, Thorpe writes.

Thorpe’s coauthors are Curtis S. Florence and David Howard, both assistant professors at Emory; and Peter Joski, a research associate.

You can read the article at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.480.

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research.


©2004 Project HOPE–The People-to-People Health Foundation, Inc.