The Cost of Overweight and Obesity to Society and the Employer Anne M' Wolf, MS, RD Department of Pu

1
The Cost of Overweight and Obesityto Society and
the EmployerAnne M. Wolf, MS, RDDepartment of
Public Health SciencesUniversity of Virginia
School of Medicineamw6n_at_virginia.edu
2
The Impact of Overweight Obesity

• Chronic Diseases (CHD, DM, HTN)
• Other Health Conditions
• Lifespan
• Quality of Life
• Healthcare Utilization Cost

Productivity Disability
3
The doubling of obesity between 1987 and today
accounts for nearly 30 of the rise in health
care spending
Percent of U.S. Adults Who are Obese, 2007
If the prevalence of obesity was the same today
as 1987, health care spending in the US would be
10 percent lower per personabout 200 billion
less
No Data lt10 1014
1519 2024 2529
30
Thorpe, KE et al. Health Affairs, 2005W5-317-325
4
Obesity Trends and Cost in 1998
1998 Cost of overweight obesity using MEPS and
NHA (with nursing home costs) databases,
respectively
No Data lt10 1014
1519 20
Source of costs Finkelstein EA et al. Obes Res.
200412.
5
The Direct Cost of Overweight Obesity in 2007
Cost of overweight obesity using MEPS database
(without nursing home costs)
Source of costs Finkelstein EA et al. Obes Res.
200412. Inflated to 2007 using the medical
component of the CPI
6
Direct Cost of Chronic Diseases in the United
States (2007)
120
116
102.8
100
85.2
80
60
Direct Cost (Billions )
45.9
40
20
Type 2 Diabetes
Obesity
Hypertension
Coronary Heart Disease
1 ADA. Diabetes Care. 200831596-615. 4.
Hodgson TA et al. Med Care 200139599 2
Finkelstein EA, Obes Res 200412 3 Hodgeson TA
et al. Medical Care 199937994.
7
Obesity Outranks Smoking and Problem Drinking in
Annual Increases in Health Care Costs
Sturm R. Health Affairs 200221245-253
8
Annual Per Capita Cost of Obesity Increases with
Age (Men)
Wee CC, American Journal of Public Health
200595(1)159-165.
9
Annual Per Capita Cost of Obesity by Race (Women)
Wee CC, American Journal of Public Health
200595(1)159-165.
10
Who is Paying and How Much is being Paid for
Overweight and Obesity?
Insurance Category
Out-of-Pocket
Private
Medicaid
Medicare
Total
51.5
9.1
Finkelstein et al. Health Affairs.May 2003219
11
Where Things Are

• ? Medical Cost
• ? Absenteeism
• ? Disability
• ? Productivity

Impact to Employer
12
Workers Compensation Expenses Appear Correlated
to Obesity
12
10
8
6
4
2
0
Østbye T, et al. Arch Intern Med. 2007
167766-773.
13
Per Capita Costs to the Employer are Substantial
Source Finkelstein, EA. et al. Am J Health
Promot 20052045-51
14
Does Treatment Impact Health Care Costs,
Productivity or Disability?
15

Modest Weight Loss Prevents Diabetes in
Overweight and Obese Persons With Impaired
Glucose Tolerance
Lifestyle (n1079)
Lifestyle 58 Reduction in Development of
Diabetes
40
Metformin (n1073)
Placebo
Placebo (n1082)
30
Metformin
Cumulative incidence ()
20
Lifestyle
10
0
0

1

2

3

4
Years from randomization
Diabetes Prevention Program Research Group. N
Engl J Med. 2002346393.
16
ICAN Lifestyle Intervention

• Randomized Controlled Trial
• Intervention Lifestyle Intervention
• Multi-modal program Individual, Group, email,
  phone
• One year duration
• -Control Usual Medical Care
• High Risk Population Obese, type 2 diabetics
• Modest priced moderate intensity intervention
• -325 per person per year

17
Impact on Body Weight
5
4
3
2
plt 0.001
plt 0.001
p0.014
plt 0.001
1
Change from Baseline Weight (kg)
0
-1
-2
-3
Usual Care
-4
Lifestyle Intervention
-5
-2
0
2
4
6
8
10
12
14
Months
Wolf, AM. Diabetes Care, 2004271570
18
Impact on Quality of Life
20
Lifestyle
Usual care
15
10




5
0
-5
Average
Bodily pain
Mental health
-10
Physical function
Social functioning
-15
plt0.05 Adjusted for baseline differences. Based
on SF-36
Wolf, AM. Diabetes Care, 2004271570
19
Mean annual health care cost for medical,
pharmacy lifestyle care
Dollars, thousands
Medical
Pharmacy
Lifestyle
Usual Care
Lifestyle
plt 0.05
Source Wolf AM. JADA 20071071365-1373.
20
Cumulative Work Days Lost, by group


plt 0.01


21
Conclusion

• Obesity increases health care cost and impairs
  productivity.
• A refocus towards prevention of disease, health
  and wellness through healthy lifestyles can
  prevent chronic disease, improve health, improve
  peoples quality of life and save .