The Financial Burden of Overweight and Obesity among Elderly Americans: The Dynamics of Weight, Longevity, and Health Care Cost

Abstract

Objective. To investigate the financial burdens attributed to overweight and obesity on the U.S. health care system among elderly Americans. Data Source. Longitudinal Cost and Use files of the Medicare Current Beneficiary Survey from 1992 to 2001. Study Design. We constructed a simultaneous equation system to model the dynamic relationship between changes in body weight, chronic diseases, functional status, longevity, and health care expenditures using maximum likelihood estimation. Based on the estimation, we conducted a simulation of one cohort with different baseline weights at age 65 and followed to death or up to age 100 of their health outcomes and lifetime health care expenditures. Principal Findings. The elderly men who were overweight or obese at age 65 had 6-13 percent more lifetime health care expenditures than the same age cohort within normal weight range at age 65. Elderly women who were overweight or obese at age 65 spent 11-17 percent more than those in a normal weight range. Both elderly men and women who were overweight or obese at age 65 had worse health outcomes than the normal weight cohorts. The average body mass index among survivors decreased by age. Conclusion. Overweight and obesity could place significant financial burdens on the U.S. health care system.

Body Mass Index and Survival in Men and Women Aged 70 to 75

“…1 In industrialized countries, the prevalence of overweight and obesity in older people is a growing public health concern, particularly because sustained aging of their populations is expected to continue for many decades, and obesity and aging represent large components of healthcare spending. 1 Based on the latest available data involving clinical measurements, Australia has the third highest prevalence of adult obesity of the Organisation for Economic Co-operation and Development countries (21.7% in 1999), behind the United States (34.3% in 2006) and the United Kingdom (24% in 2006). 2,3 Of older Australians, 28% of men and 38% of women aged 55 to 64 are obese, as are 22% of men and 32% of women aged 65 to 74 and 14% of men and 17% of women aged 75 and older.…”

Is there a Wealth Dividend of Aging Societies?

“…Elderly women who were overweight or obese at age 65 spent 11 to 17 percent more than those in a normal weight range. 67 Other studies, again using data from the US, also had different results from the Dutch, finding somewhat higher lifetime medical expenditures for smokers. [68][69][70] Moreover, a major recent UK report forecasts a significant increase in obesity-related healthcare expenditures in its "business-as-usual" scenario up to the year 2050.…”

Health Maintenance in Very Old Age : Medical Conditions, Functional Outcome and Nutritional Status

“…The associations between being overweight or obese and different aspects of health, such as disease burden [96,97], functional limitations [98], poorer HRQoL [99], and higher consumption of health services [100,101], have been widely studied. However, many of these studies rely on data from younger elderly or mixed age groups.…”

“…In younger age populations, overweight and obesity as a health care burden often result in greater health service use [165,166] and higher costs [100,167]. What is less clear is why normal weight individuals with multimorbidity had higher health care costs than obese individuals.…”