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Cited by 184Obesity, Physical Activity, DietObesity and Health PracticesHealthcare Policy and Management

Savings in medical expenditures associated with reductions in body mass index among US Adults with Obesity, by Diabetes Status

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Cawley, John, Meyerhoefer, Chad, Biener, Adam, Hammer, Mette, Wintfeld, Neil·2015·PharmacoEconomics
DOI 10.1007/s40273-014-0230-2PMC PMC4486410
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Abstract

BACKGROUND: The prevalence of obesity has more than doubled in the USA in the past 30 years. Obesity is a significant risk factor for diabetes, cardiovascular disease, and other clinically significant co-morbidities. This paper estimates the medical care cost savings that can be achieved from a given amount of weight loss by people with different starting values of body mass index (BMI), for those with and without diabetes. This information is an important input into analyses of the cost effectiveness of obesity treatments and prevention programs. METHODS: Two-part models of instrumental variables were estimated using data from the Medical Expenditure Panel Survey (MEPS) for 2000-2010. Models were estimated for all adults as well as separately for those with and without diabetes. We calculated the causal impact of changes in BMI on medical care expenditures, cost savings for specific changes in BMI (5, 10, 15, and 20 %) from starting BMI levels ranging from 30 to 45 kg/m(2), as well as the total excess medical care expenditures caused by obesity. RESULTS: In the USA, adult obesity raised annual medical care costs by $US3,508 per obese individual, for a nationwide total of $US315.8 billion (year 2010 values). However, the relationship of medical care costs over BMI is J-shaped; costs rise exponentially in the range of class 2 and 3 obesity (BMI ≥35). The heavier the obese individual, the greater the reduction in medical care costs associated with a given percent reduction in BMI. Medical care expenditures are higher, and rise more with BMI, among individuals with diabetes than among those without diabetes. CONCLUSIONS: The savings from a given percent reduction in BMI are greater the heavier the obese individual, and are greater for those with diabetes than for those without diabetes. The results provide health insurers, employers, government agencies, and health economists with accurate estimates of the change in medical care expenditures resulting from weight loss, which is important information for calculating the cost effectiveness of interventions to prevent and treat obesity.

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  • Reducing cardiovascular risk may reduce healthcare expenditures, which may unburden both patients and the U.S. health care system at large.

    “Moreover, reducing cardiovascular risk may reduce healthcare expenditures, which may unburden both patients and the U.S. health care system at large [49], [50], [51].”

    From Income disparity and utilization of cardiovascular preventive care services among U.S. adults (2021) · cites this paper as [49]

    The Background identifies obesity as a cardiovascular-disease risk factor, and the Conclusions estimate medical-expenditure savings from BMI reductions for individuals and society. The paper does not establish that reducing cardiovascular risk itself produces those savings or that patients’ own healthcare expenses fall. (LLM, conf=0.86)

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Authors
Cawley, J., Meyerhoefer, C., Biener, A., Hammer, M., & Wintfeld, N.
Affiliations
  • Cornell University (US)
  • Lehigh University (US)
Corresponding author
Cawley, John
ORCID
Venue
PharmacoEconomics
Publisher
Springer Science and Business Media LLC
Published
2014-11-09
Volume
33
Issue
7
Pages
707-722
ISSN
  • 1170-7690 (ISSN-L)
  • 1179-2027
DOI
10.1007/s40273-014-0230-2
PMC
PMC4486410
OpenAlex
W2135610518
Cited by
184
References
48
Citations by year
2026: 6 · 2025: 7 · 2024: 15 · 2023: 18 · 2022: 11 · 2021: 15 · 2020: 16 · 2019: 18 · 2018: 17 · 2017: 22 · 2016: 24 · 2015: 14 · 2013: 1
FWCI
19.90
Type
journal article
Language
en
Open access
Licence
Locations
  • PharmacoEconomics (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
Novo Nordisk
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords
obesity, body mass index, weight loss, health care costs, diabetes mellitus, cost reduction, Medical Expenditure Panel Survey
MeSH terms
Adult, Delivery of Health Care, Diabetes Mellitus, Type 2, Health Expenditures, Humans, Obesity, United States, Body Mass Index, Cost Savings, Models, Econometric, Young Adult

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