The Economic Burden of Obesity in Germany: Results from the Population-Based KORA Studies

Abstract

Objective: To estimate the excess costs of obese compared to normal-weight persons in Germany based on self-reported resource utilisation and work absence. Methods: Five cross sectional surveys of cohort studies in southern Germany were pooled resulting in 9,070 observations for 6,731 individuals (31-96 years). BMI was measured in the study centre. Self-reported health care utilisation and work absence was used to estimate direct and indirect costs for the year 2011 based on unit costs. Using regression analyses, adjusted costs for different BMI groups were calculated. Results: Overweight and obese people showed significantly higher odds of health care utilisation and productivity losses compared with normal-weight people in most categories. Total direct/indirect costs were significantly higher with increasing severity of obesity (pre-obese (1.05 (0.90-1.23) / 1.38 (1.11-1.71)), obesity level I (1.18 (1.00-1.39) / 1.33 (1.02-1.73)), obesity level II (1.46 (1.14-1.87) / 1.77 (1.18-2.65)) or level III (2.04 (1.40-2.97) / 1.99 (1.20-3.30)) compared to normal-weight participants. In particular, higher obesity classes were significantly associated with increased costs for medication, general practitioner utilisation and work absence. Conclusion: Our results show that overweight and obesity are associated with enormous societal direct and indirect costs in Germany. This supports the evidence from previous top-down studies, but provides important new information based on a large pooled data set and measured BMI.

Baseline risk factors determine lack of biochemical response after SVR in chronic hepatitis C patients treated with DAAs

“…Among the potential differential diagnoses like autoimmune disorders, alcoholism and non‐alcoholic fatty liver disease (NAFLD), the prevalence of NAFLD is particularly increasing, paralleling the increasing prevalence of obesity, type 2 diabetes and the metabolic syndrome worldwide . In this regard, the prevalence of overweight was 35% and of obesity was 17% in our cohort, thereby in line with the reported overweight prevalence (~35%) but slightly lower compared to the reported obesity (~23%) prevalence in Germany …”

The effect of bariatric surgery on health care costs: A synthetic control approach using Bayesian structural time series

“…On account of the high economic cost of overweight and obesity for health care providers (Tsai et al, ; Yates et al, ), the economic aspects of bariatric surgery also need to be considered. In Germany, absorption of the costs of bariatric surgical procedures is currently not included in the standard benefit catalog of statutory health insurance (SHI).…”

“…(Consensus Development Conference Panel, 1991) Surgical procedures enable substantial and long-term weight loss (Sjöström et al, 2004), leading to a reduction in the incidence of diabetes , cardiovascular events (Sjöström et al, 2012), and neoplasms. (Narbro et al, 2002) On account of the high economic cost of overweight and obesity for health care providers (Tsai et al, 2011;Yates et al, 2016), the economic aspects of bariatric surgery also need to be considered. In Germany, absorption of the costs of bariatric surgical procedures is currently not included in the standard benefit catalog of statutory health insurance (SHI).…”

The Non-Linear Relationship between BMI and Health Care Costs and the Resulting Cost Fraction Attributable to Obesity

“…Several studies have examined the costs of obesity by comparing the costs of persons with obesity to those without obesity, thus estimating excess costs, according to BMI groups [ 5 ]. In an earlier study, we estimated the excess costs of overweight and obese (classes I–III) compared to normal weight persons in southern Germany based on self-reported resource utilisation and measured BMI of 6731 individuals (31–96 years old) with 9070 observations [ 6 ]. Results showed that, compared to normal weight participants (18.5 kg/m 2 ≤ BMI < 25 kg/m 2 ), direct costs started to increase significantly at the obesity level II (35 kg/m 2 ≤ BMI < 40 kg/m 2 ), and indirect costs at the overweight level (25 kg/m 2 ≤ BMI < 30 kg/m 2 ).…”