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.