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Obesity Week 2013

Class III obesity increases cost by US$8,000 per patient

Costs for veterans with Class III obesity compared to normal weight veterans rose substantially from US$635 in 2002 to US$3,307 in 2011
Matthew Maciejewski

Class III obesity (BMI>40) is associated with significantly higher healthcare costs - US$8,138 over ten years - compared with normal weight (BMI<25), according to the first analysis of health expenditures attributable to obesity over 10 years. The authors from Duke University also found that the difference in healthcare costs for veterans with Class III obesity compared to normal weight veterans rose substantially from US$635 in 2002 to US$3,307 in 2011. The research was presented at the 30th Annual Meeting for the American Society for Metabolic and Bariatric Surgery (ASMBS) during ObesityWeek 2013, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity. The event was hosted by the ASMBS and The Obesity Society (TOS).

“This is the first study to examine healthcare costs attributable to obesity over a period longer than four years,” said study author Dr Matthew Maciejewski, of the Durham VA Medical Center and Duke University Department of Medicine. “Because we had such a large sample size, we were able to examine Veteran Affairs costs separately for veterans in clinically meaningful subclasses of obesity.”

The retrospective study, ‘Long-Term Healthcare Costs of Overweight and Obese Veterans’, estimated the association between BMI and VA healthcare expenditure trends from 2002 through 2011, and included a random sample of 263,568 veterans who obtained VA care and for whom height and weight data were available.

Veterans were grouped according to BMI class: Class I (BMI 30.0-34.9), Class II (35.0-39.9), and Class III, using a mixed model analysis adjusted for age, gender, race, marital and co-pay status. Veterans with Class III obesity had the highest risk for obesity-related health problems such as hypertension, dyslipidemia, diabetes, heart disease, and arthritis.

Patients in obese class III had the highest VA expenditures of all patients in every year, with excess 10-year costs equal to US$18,013 when compared to normal weight patients..

Leveraging longitudinal data from an integrated electronic health record that

captures longitudinal height and weight data on a large cohort of patients enables assessments not possible with cross-sectional data.

“Researchers often make the tie between obesity, poor health, and higher healthcare costs,” said Dr Emily Dhurandhar,  incoming TOS Advocacy Chair and post-doctoral researcher at the University of Alabama at Birmingham. “This study is unique because it illustrates the extent of this increase among a large cohort of veterans. The dramatic increase in healthcare costs over the 10-year period clearly demonstrates the need for effective obesity prevention and treatment measures.”

To access the posters and abstracts from Obesity Week, please click here

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