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Will Obesity Break the Medicare Bank?

Older, overweight Americans have much higher medical bills, study says

TUESDAY, Dec. 7, 2004 (HealthDayNews) -- Severely obese people wrack up almost twice the annual medical expenses as those who aren't overweight by the time they reach their golden years.

That's the conclusion of a new study in the Dec. 8 issue of the Journal of the American Medical Association that followed the health of more than 17,000 men and women of various sizes from middle-age until they were on Medicare for at least two years.

Men who were normal weight at the start of the study had annual Medicare expenses of $7,205, compared to $13,672 for men who were severely obese at the study's start. Severely overweight women also had significantly higher yearly costs than normal weight women -- $12,342 vs. $6,224.

Study author Dr. Martha Daviglus said she was very surprised by the enormity of the cost differences.

"Every year Americans' weight is increasing and it's worrisome because the population is also aging at a faster rate. There's never enough money in Medicare, so what will happen if we don't do something about this problem now?" Daviglus said.

"It's not only worrisome in terms of money, but also in terms of health. Everybody looks at retirement and thinks of enjoying their golden years, but if the obesity trend doesn't change, they will be disabled and won't have a good quality of life," added Daviglus, a professor of preventive medicine at Northwestern University's Feinberg School of Medicine.

About 130 million Americans are currently overweight or obese, according to the study. Excess weight is associated with heart disease, high blood pressure, diabetes, high cholesterol and some cancers.

The researchers compared Medicare data gathered from 1984 through 2002 to information collected for the Chicago Heart Association Detection Project in Industry from 1967 through 1973.

They were able to gather information on 9,978 men and 7,623 women. The average age at the start of the study was 46 years for men and 48.4 years for the women.

Slightly more than 55 percent of the men were overweight and 14.3 percent were obese at the start of the study. Just over 30 percent of the women were overweight, and 8.7 percent were obese at the start.

Blood pressure and cholesterol readings tended to be higher in those men with higher body mass indexes. A body mass index of 25 to 29.9 is considered overweight and over 30 is obese.

Overall, yearly Medicare charges were 84 percent higher for severely obese men and 88 percent higher for severely obese women compared to their slimmer counterparts.

The average annual costs were $6,224 for non-overweight women, $7,653 for overweight women, $9,612 for obese women and $12,342 for severely obese women. In men, those costs were $7,205, $8,390, $10,128 and $13,674, respectively.

"What this study found is not a surprise, but it makes it stark and clear. The cost of taking care of a severely overweight person is double the cost of caring for a normal weight person," said Dr. Marc Bessler, director of the New York Presbyterian Center for Obesity Surgery at Columbia University Medical Center in New York City.

"We have to have an increased national focus on this problem," said Bessler, who pointed out that it's never too late to lose weight. He said even if you're older, losing weight can improve a number of medical conditions and enhance your quality of life.

Daviglus agreed that people need to lose weight, but said all the responsibility can't rest on individuals. She said government and industry have to support education and prevention programs. She also said people must relearn what proper portion sizes are, and they need more education about how to live a healthy lifestyle.

More information

This American Heart Association offers this primer on healthy foods and portion sizes.

SOURCES: Martha Daviglus, M.D., professor, preventive medicine, Northwestern University, Feinberg School of Medicine, Chicago; Marc Bessler, M.D., director, New York Presbyterian Center for Obesity Surgery at Columbia University Medical Center, New York City; Dec. 8, 2004, Journal of the American Medical Association
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