The association between body mass index and health and economic outcomes in Brazil

Abstract

BackgroundObesity is associated with significant physical, psychosocial and economic burden globally. In Brazil, almost 50% of the population is either overweight or obese. The prevalence of morbid obesity increased by 255% between 1975 and 2003. The current study sought to quantify the relationship between weight status and health outcomes.MethodsData from three waves (2011, 2012, and 2015) of the Brazil National Health and Wellness Survey, an Internet-based survey administered to a demographically diverse sample of Brazilian adults, were used. Body mass index category was calculated based on self-reported height and weight and respondents were categorized into five groups (normal, overweight, obese class I, obese class II, obese class III; n = 34,254). Multivariable analyses, controlling for sociodemographic variables and health history, tested the association with body mass index group and outcomes including health status (Medical Outcomes Study Short Form 12-Item Health Survey version 2/Medical Outcomes Study Short Form 36-Item Health Survey version 2), work productivity (Work Productivity and Activity Impairment-General Health Questionnaire), and costs associated with work impairment (indirect costs), self-reported healthcare resource use and associated direct costs.ResultsOverall, 53.6% of the surveyed Brazilian population reported being overweight or obese. In virtually all the analyses, increasing body mass index group was associated with significant and progressively worse outcomes. Most notable was the finding that hospitalization costs were over twice as high (R$3141.84 vs. R$1349.60) and indirect costs were nearly double (R$1656.80 vs. R$884.15) for obesity class III than for normal body mass index respondents.ConclusionsObesity rates in Brazil are considerable and, from a patient and societal perspective, increasingly burdensome, thereby highlighting the need for stakeholders to prioritize strategies for weight management interventions.

Heterogeneous Impacts of Body Mass Index on Work Hours

“…Several studies around the globe also found significant relationships between BMI in the obesity range and work-related limitations including absenteeism and presenteeism. DiBonaventura et al [27], Finkelstein et al [11] and Gates et al [14] examined workers in the US, Bustillos et al [13] for Canada and Kudel et al [28] for Brazil to document the negative impact of BMI or obesity on workplace productivity. This study's findings have several implications.…”

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“…Severe obesity is occurring globally with increasingly high prevalence [1,2], contributes to reduced functional and health status [3][4][5], and is associated many common medical comorbidities, including type-2 diabetes [6,7], hypertension and cardiovascular disease [8], and sleep disorders [9]. Though less widely recognized by the general public, obesity is also associated with reduced cognitive performance and an increased prevalence of neurocognitive deficits [10,11].…”

Perceptions of patients in the waiting line for bariatric surgery: contributions from the experience of an educational process

“…However, this challenge is still far from being faced. Increased obesity has become a worldwide concern due the costs involved and the subsequent effects on health, reduced life expectancies and high prevalence rates 1,2 . Bariatric surgery has been seen as the main treatment for severe obesity, since it can lead to important weight losses in one year and guarantees that comorbidities are reduced 3 .…”