The economic costs of obesity

Since 1975, worldwide obesity has nearly tripled and currently contributes to more than 5 million deaths each year. The disease, which is defined as “abnormal or excessive fat accumulation that presents a risk to health,” affects one of every three adults — or about 36% of the population. What’s more, a staggering 39 million children under the age of 5 had overweight or obesity in 2020.

There’s no doubt that obesity is a global epidemic that can have dire health consequences. But the disease also comes with increased costs that have the potential to paralyze the healthcare system and disrupt an industry that’s already on shaky ground. That’s why we must shed light on the direct and indirect costs associated with obesity and explore steps that can be taken to reduce the rate of obesity, and in turn, lower the economic stress caused by the disease.

Direct Costs of Obesity

The most obvious direct costs of obesity are related to comorbid conditions and the medications needed to treat these diseases. Currently, there are 236 diseases that are associated with obesity including type 2 diabetes, hypertension, and depression. Recent data found that the medical care costs of obesity are almost $150 billion per year in the U.S. More specifically, the cost of treating the five most common obesity-related conditions (stroke, coronary artery disease, diabetes, hypertension and elevated cholesterol) resulted in roughly $9,000 to $17,000 higher costs compared to normal-weight adults.

More data shows:

• The cost of medical claims for patients with obesity is double than those without obesity
• Healthcare costs triple and quadruple as the obesity severity worsens from Class 2 (BMI 35-39) to Class 3 obesity (BMI >40)

Additionally, costs associated with obesity will continue to rise as a result of inaccessibility and delay of treatment for obesity-related diseases. New data from the Association of American Medical Colleges estimates that there will be a shortage of 55,200 primary care physicians by 2033. The lack of primary care doctors combined with the prediction that obesity rates will increase 50% by 2030, will be a recipe for disaster. As a primary care physician who actively treats obesity, I am baffled at the lack of foresight and planning for the treatment of obesity.

Indirect Costs of Obesity

Besides actual healthcare costs, there is extensive data that suggests there are many indirect costs associated with the disease. Recent studies show that patients with obesity miss more days of work and have twice as many workers' compensation claims than those without obesity. Employers also pay higher life insurance premiums and less than 30% of employers choose to offer coverage for the two most effective treatments for obesity: anti-obesity medications and bariatric surgery.

Reducing the Economic Burden

Unfortunately, obesity and the costs the disease is having on the healthcare system will probably get worse before it gets better. But as providers, we have a vested interest to embrace proactive steps to help lower the rate of occurrence and decrease the economic burden obesity has on our healthcare system. Here are some steps that we can take to make an impact:

• Educate physicians and advanced practice providers. A recent survey found that half of U.S. medical schools reported that expanding obesity education was a low priority or not a priority at all. Of those surveyed, an average of only 10 hours was dedicated to obesity education. Physicians and APPs need to have a sound understanding of obesity, be comfortable discussing the disease with patients and prescribe medication that can help them achieve the best results.
• Mandate Medicare to cover anti-obesity medications and set the standard. If Medicare takes the lead and does this, private insurers will follow suit. Medicare covers the most effective treatment for obesity, bariatric surgery, but completely ignores the second most effective treatment, anti-obesity medications. The reasoning behind the exclusion of these medications is based on archaic and non-evidence-based data and needs to be revisited.
• Make anti-obesity medications accessible. There are remarkable anti-obesity medications on the market today. We need to make these clinical “game-changers” more available — they can’t do what they are designed to do sitting on a pharmacy shelf. By making this medication more accessible to patients who need it now, we can slow the occurrence of the disease and give patients the best drugs on the market to overcome obesity.

Obesity is a very complicated disease that affects patients’ health and the healthcare industry’s viability. There is not a simple path forward to solve the health implications on patients and the economic burdens on the healthcare system. However, with the right approach and understanding, we can make a difference in the lives of the overweight and obese as well as the economy.

Join us at the Obesity Medicine 2022 conference in April and become a member of the Obesity Medicine Association today.

Dr. Catherine Welford Varney, DO, is board-certified in family medicine by the American Board of Family Medicine and obesity medicine by the American Board of Obesity Medicine. She is currently serving on both the Medical-Surgical Bariatric committee and the Advocacy Committee for the Obesity Medicine Association. She has been a member of the American Society of Metabolic and Bariatric Surgery since 2019. She currently works with patients at the UVA Bariatric Surgery clinic to assist with prevention and treatment of weight regain following bariatric surgery. Additionally, she works in a primary care setting. She is an Assistant Professor with the University of Virginia Medical School Department of Family Medicine. She enjoys teaching medical students and Family Medicine residents and also performs research in the area of obesity.