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Weight reduction results in lifetime cost savings

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September 29, 2017

Bruce Lee
Bruce Y. Lee

Adults who reduce their weight category from obese to overweight experience decreases in direct medical costs, indirect medical costs and lifetime societal costs, and cost savings are greater when adults achieve normal BMI, study data show.

“Over half the costs of being overweight can be from productivity losses, mainly due to missed workdays but also productivity losses,” Bruce Y. Lee, MD, MBA, executive director of the Global Obesity Prevention Center at Johns Hopkins University Bloomberg School of Public Health, said in a press release. “This means that just focusing on medical costs misses a big part of the picture, though they’re a consideration, too. Productivity losses affect businesses, which in turn affects the economy, which then affects everyone.”

Lee and colleagues developed a computational simulation model representing U.S. adults to determine lifetime costs and health effects in adults aged 20 to 80 years with obesity, overweight or healthy weight. Data for the model were collected from the Coronary Artery Disease Risk Developing in Young Adults (CARDIA) and Atherosclerosis Risk in Communities (ARIC) studies.

Compared with normal-weight participants, those with obesity and overweight had increasing incremental yearly third-party payer costs with the largest values for participants with obesity. Reducing weight from obesity to overweight could avert 64% of third-party payer costs in participants aged 20 years with obesity, 61% in those aged 30 years, 57% for those aged 40 years, 51% for those aged 50 years, 40% for those aged 60 years, 26% for those aged 70 years and 21% for those aged 80 years.

Incremental indirect costs could be averted by 62% in participants aged 20 years when reducing their weight from obesity to overweight; 57% could be averted in those aged 30 years, 53% in those aged 40 years, 49% in those aged 50 years, 41% in those aged 60 years, 36% in those aged 70 years and 30% in those aged 80 years.

Reducing weight from obesity to overweight could avert 63% of incremental lifetime societal costs in participants aged 20 years, 60% in those aged 30 years, 58% in those aged 40 years, 55% in those aged 50 years, 46% in those aged 60 years, 41% in those aged 70 years and 37% in those aged 80 years.

“More research is needed to show and understand the economic value of specific obesity prevention and control measures, which can then help guide the decision making and show the value of supporting these measures,” Lee told Endocrine Today. by Amber Cox

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Bruce Y. Lee, MD, MBA, can be reached at

Disclosures: The authors report no relevant financial disclosures.

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Matthew Maciejewski

Fallah-Fini and colleagues put together a very detailed Markov model to simulate health care costs and productivity associated with having normal weight, overweight or obesity over a lifetime. The results were interesting and would be more compelling if they had validated their work against some existing cost-of-obesity results. The projected benefits of weight loss, which they represent as a sort of “mirror image” of costs of overweight or obesity are likely highly overstated for three reasons. First, less than 100% of people attempting behavioral, pharmacologic or even surgical weight loss maintain clinically significant weight loss in the long term. Second, weight loss does not automatically translate into lower health care costs as they assume, so the expected economic benefits of weight loss are likely positive, but not as large as they suppose here. Third, there are health care costs to losing weight and keeping it off, which are not captured here, as noted by the authors. Nonetheless, clinicians should continue to offer interventions for effective weight loss to their patients who express an interest and commitment to losing weight. This is especially true for their obese patients and younger patients who may derive the greatest health and economic benefits of effective weight loss.

Matthew Maciejewski, PhD

Professor in Medicine,
Division of General Internal Medicine,
Department of Medicine,
Duke University School of Medicine

Disclosure: Maciejewski reports he owns Amgen stock, has a contract to Duke University from The National Committee for Quality Assurance and has grants from the National Cancer Institute, the National Institute on Drug Abuse, NIDDK and the VA Health Services Research and Development.