The Additional Costs and Health Effects of a Patient Being Overweight or Having Obesity: A Computational Model

OBJECTIVE: This paper estimates specific additional disease outcomes and costs that could be saved from helping a patient go from obese to overweight to normal weight category at different ages. This information could help physicians, other health care workers, patients, and third party payers determine how to prioritize weight reduction. METHODS: We developed a computational Markov model that represented the BMI status, chronic health states, health outcomes, and associated costs (from various perspectives) as an adult ages throughout his/her lifetime. RESULTS: We calculated incremental costs of adult patients with obesity or overweight (versus normal weight) at different starting ages. For example, for a metabolically healthy 20-year old, being obese (versus normal weight) added lifetime third-party payer costs averaging $14,059(95% range: $13,956–$14,163), productivity losses of $14,141($13,969–$14,312), and total societal costs of $28,020($27,751–$28,289); being overweight versus normal weight added $5,055($4,967–$5,144), $5,358($5,199–$5,518), and $10,365($10,140–$10,590). For a metabolically healthy 50-year old, being obese added $15,925($15,831–$16,020), $20,120($19,887–$20,352), and $36,278($35,977–$36,579); being overweight added $5,866($5,779–$5,953), $10,205($9,980–$10,429), and $16,169($15,899–$16,438). CONCLUSIONS: Incremental lifetime costs of a patient with obesity or overweight (versus normal weight) increased with the patient’s age, peaking at age 50, and decreasing with older ages. However, weight reduction even in older adults still yielded incremental cost savings.