Lifetime health and economic consequences of obesity

Citation
D. Thompson et al., Lifetime health and economic consequences of obesity, ARCH IN MED, 159(18), 1999, pp. 2177-2183
Citations number
25
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Journal title
ARCHIVES OF INTERNAL MEDICINE
ISSN journal
00039926 → ACNP
Volume
159
Issue
18
Year of publication
1999
Pages
2177 - 2183
Database
ISI
SICI code
0003-9926(19991011)159:18<2177:LHAECO>2.0.ZU;2-S
Abstract
Background: Obesity is an established risk factor for several chronic disea ses. The lifetime health and economic consequences of obesity for individua l patients have not been documented. Objective: To estimate the lifetime health and economic consequences of obe sity. Methods: We developed a dynamic model of the relationship between body mass index and the risks and associated costs of 5 obesity-related diseases: hy pertension, hypercholesterolemia, type 2 diabetes mellitus, coronary heart disease, and stroke. The model was estimated using data from the Third Nati onal Health and Nutrition Examination Survey, the Framingham Heart Study, a nd other secondary sources. We used this model to estimate (1) risks of hyp ertension, hypercholesterolemia, and type 2 diabetes mellitus at future age s; (2) lifetime risks of coronary heart disease and stroke; (3) life expect ancy; and (4) expected lifetime medical care costs of these 5 diseases for men and women aged 35 to 64 years with body mass indexes of 22.5, 27.5, 32. 5, and 37.5 kg/m(2) (nonobese and mildly, moderately, and severely obese, r espectively). Results: Disease risks and costs increase substantially with increased body mass index. The risk of hypertension for moderately obese 45- to 54-year-o ld men, for example, is roughly 2-fold higher than for their nonobese peers (38.1% vs 17.7%), whereas the risk of type 2 diabetes mellitus is almost 3 -fold higher (8.1% vs 3.0%). Lifetime risks of coronary heart disease and s troke are similarly elevated (41.8% vs 34.9% and 16.2% vs 13.9%, respective ly), whereas life expectancy is reduced by 1 year (26.5 vs 27.5 years). Tot al discounted lifetime medical care costs for the treatment of these 5 dise ases are estimated to differ by $10 000 ($29 600 vs $19 600). Similar resul ts were obtained for women. Conclusions: The lifetime health and economic consequences of obesity are s ubstantial and suggest that efforts to prevent or reduce this problem might yield significant benefits.