Obesity Carries Huge Financial Weight

Study finds it costs up to $200 per taxpayer

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HealthDay Reporter

WEDNESDAY, Jan. 21, 2004 (HealthDayNews) -- Obesity cost the United States about $75 billion in 2003, and taxpayers footed about half the bill through Medicare and Medicaid programs.

"If you look at the costs of obesity that are financed by Medicare and Medicaid and divide them by the number of taxpayers, you're looking at essentially a tax of $150 to $200 per year just to pay for obesity among individuals," says Eric Finkelstein, lead author of a study appearing in the January issue of Obesity Research.

Researchers at RTI International and the U.S. Centers for Disease Control and Prevention say their study is the first state-by-state estimate of obesity-attributable medical costs.

The dramatic rise in obesity in this country and its health consequences are already well documented. According to the CDC's 1999-2000 National Health and Nutrition Examination Survey, almost two-thirds (64 percent) of American adults are either overweight (33 percent) or obese (31 percent). Obesity contributes to a number of chronic medical conditions, including type 2 diabetes, cardiovascular disease, various types of cancer and osteoarthritis.

"Obesity itself is not a reimbursable diagnosis," says Cathy Nonas, director of diabetes and obesity programs at North General Hospital in New York City and author of the book Outwit Your Weight. Yet lifestyle changes, including physical activity and a low-fat diet, have been shown to be successful in preventing people at high risk for diabetes from becoming diabetic. "If we don't get with it to prevent obesity, it's going to cost us much more," Nonas adds.

Previous studies have estimated that obese adults have 36 percent higher average annual medical expenditures than do normal-weight adults. What's been missing in this sea of numbers are state-level estimates, a gap this report attempts to fill.

The study authors used the 1998 Medical Expenditure Panel Survey linked to the 1996 and 1997 National Health Interview Surveys to develop a national model for predicting obesity-attributable medical expenditures.

The sparsely populated state of Wyoming spent the least total amount on obesity-attributable medical expenditures ($87 million), while California spent the most ($7.7 billion). Obesity-attributable Medicaid expenditure estimates ranged from $23 million in Wyoming to $3.5 billion in New York. Medicare expenditures ranged from $15 million in Wyoming to $1.7 billion in California.

The estimated percentage of annual medical expenditures attributable to obesity ranged from 4 percent in Arizona to 6.7 percent in Alaska and the District of Columbia. Medicare expenditures ranged from 3.9 percent in Arizona to 9.8 percent in Delaware. Medicaid expenditures took up a larger percentage of the total, and ranged from 7.7 percent in Rhode Island to 15.7 percent in Indiana.

Overall, obesity-attributable costs accounted for about 6 percent of adult medical expenditures, half of which was financed by Medicaid or Medicare.

"This paper shows that obesity is a financial problem," Finkelstein says. "The government bears the burden so clearly they have a right -- or certainly a cause -- for trying to reduce the prevalence and cost of obesity especially among their populations."

"This is not a society that pays for prevention. This is a society that pays for a heart attack once you have it," Nonas adds. "People are reticent about paying for [obesity], but the facts are very clear: Obesity is increasing and we have all the diseases that are associated with it . . .The big message is that obesity isn't even a reimbursable diagnosis, and it's costing them a fortune."

More information

For more on overweight and obesity, visit the U.S. Centers for Disease Control and Prevention or the U.S. Surgeon General.

SOURCES: Eric Finkelstein, Ph.D., health economist, RTI International, Research Triangle Park, N.C.; Cathy Nonas, R.D., director, diabetes and obesity programs, North General Hospital, New York City; January 2004 Obesity Research

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