Body mass index and healthcare costs: a systematic literature review of individual participant data studies

Abstract

SummaryExcess weight is associated with increased total healthcare costs, but it is less well known how the associations between excess weight and costs vary across different types of healthcare service. We reviewed studies using individual participant data to estimate associations between body mass index and healthcare costs, and summarized how annual healthcare costs for overweight (body mass index 25 to <30 kg/m 2 ) and obese (≥30 kg/m 2 ) individuals compared with those for healthy weight individuals (18.5 to <25 kg/m 2 ). EMBASE and MEDLINE were searched from January 1990 to September 2016, and 75 studies were included in the review. Of these, 34 studies presented adequate information to contribute to a quantitative summary of results. Compared with individuals at healthy weight, the median increases in mean total annual healthcare costs were 12% for overweight and 36% for obese individuals. The percentage increases in costs were highest for medications (18% for overweight and 68% for obese), followed by inpatient care (12% and 34%) and ambulatory care (4% and 26%). Percentage increases in costs associated with obesity were higher for women than men. The substantial costs associated with excess weight in different healthcare settings emphasize the need for investment to tackle this major public health problem.

Rising prevalence of BMI ≥40 kg/m2: A high‐demand epidemic needing better documentation

“…Total health care costs in the United Kingdom rise linearly, and double, as BMI increases from 20 to 40. A recent systematic review of international health care costs and BMI found costs for people with BMI ≥40 to be 50% greater than for people with BMI 18.5 to 24.9 . Costing studies typically exclude underresearched wider care costs, such as social care and nursing home usage related to functional disability and often long‐term provision, so current estimates are likely to underestimate the full costs.…”

“…A recent systematic review of international health care costs and BMI found costs for people with BMI ≥40 to be 50% greater than for people with BMI 18.5 to 24.9. 27 Costing studies typically exclude underresearched wider care costs, such as social care 28 and nursing home usage related to functional disability and often long-term provision, 28,29 so current estimates are likely to underestimate the full costs. Forecasts indicate that increased resource usage will continue, including costs required to structurally adapt care facilities to the needs of people with BMI ≥40, alongside providing suitable equipment and training for staff, that is currently missing.…”

Association of Obesity with Health Care Costs: A Mendelian Randomization study

“…All costs were adjusted to 2011 prices in e. Table 1 presents an overview of the data set. Underweight individuals (BMI < 18.5, n = 10) were removed because this group is especially vulnerable to bias due to other pre-existing disease (Kent et al, 2017). Observations with missing or implausible information were also removed, resulting in a sample size of n = 2779.…”

Obesity and healthcare resource utilization: results from Clinical Practice Research Database (CPRD)

“…In the United States (USA) and United Kingdom (UK), overweight contributes to an increase of 12% in total annual healthcare costs and obesity contributes to an increase of 36% 3. This increase in cost is largely driven by the presence of obesity‐related comorbidities, primarily T2D 4.…”