Severe Obesity Escalating, Costs are Too

A new study published online by the International Journal of Obesity found that the rate of severe obesity in the United States has increased dramatically since 2000. Defined as having a body mass index (BMI) of 40 or greater, severely obese people are roughly 100 pounds or more overweight. In the year 2000, about 4 percent of American adults were severely obese. This percentage jumped to 6.6 percent by 2010, translating to approximately 15.5 million people.  The study, which was based on results of a telephone survey of about 3 million people, found that women were more likely to be severely obese than men. Additionally, severe obesity was about twice as high among blacks as Hispanics and whites.

While there are certainly increased health risks with moderate obesity (BMI 30 to 40), the risks associated with severe obesity are far greater, says the study. An increase in obesity-related medical problems–such as diabetes, hypertension, arthritis and obstructive sleep apnea–drives up  national health care costs, as well. The study author explained that “moderate obesity drives up health care costs by 20 percent to 30 percent compared to those at a healthy weight, where severe obesity more than doubles health care costs.”

At the annual meeting of The Obesity Society, Dr. William Dietz MD, PhD, the Former Director of the Nutrition, Physical Activity and Obesity Division of the CDC presented detailed data on the costs of obesity. His study used data from Medical Panel Expenditure Survey (MEPS) and the National Health and Wellness Survey (NHWS). According to Dr. Dietz, the cost of obesity nearly doubled from 1998 to 2008, increasing from 78.5 billion per year to 147 billion per year. Using data from MEPS, Dietz found that as much as 40 percent of the costs are attributable to just 8 percent of the population, those who are severely obese.

Although there is a plateau in obesity, there is no plateau in severely obese (and they are the patients with the most complications). Dietz explained that one issue is that medical providers spend less time with obese patients and have less discussion. Additionally, obese patients are more likely to skip or delay medical services, including cancer screenings. “These are the very patients who need our care the most are the ones most likely to avoid medical care, because of bias,” said Dr. Dietz. “Costs of bias among medical providers may contribute to the costs of obesity through delayed identification and treatment of comorbidities,” he suggested.

With the prevalence of severe obesity on the rise, there will be significant economic and public health consequences. These studies highlight the need to engage those with extreme obesity in evaluating treatment options such as lap-band, gastric bypass, or gastric sleeve surgeries. We asked Dr. Brian Quebbemann of Newport Beach about the cost of obesity and losing weight. He said, “When considering the cost of obesity and potentially having surgery, people also need to include how much money they are going to spend on another failed diet program. Society won’t lose weight just because Jenny Craig’s wallet gets fatter. One study broke this last fact down further by showing that for each pound of weight loss at Weight Watchers, about $400 is spent! That’s $4000 to lose ten pounds! If you wonder if you can afford weight loss surgery, or if insurance can afford to cover the procedures… it’s time to ask can you afford to stay overweight? Can we afford for insurance not to be covering these important treatments?”

Related Reading: Cost of Obesity

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