Holiday Stuffing May Increase Your Need for Health
Care but Are Elderly Immune?
Duke Medical researchers find health care costs climb
steadily with body mass index increase - but are seniors 75 up immune
24, 2013 – Before throwing self-control aside and diving into all the
goodies that abound during the holiday season, you may want to consider
a shocking research report from Duke Medicine researchers. They have
found that health care costs increase in relation to the increase in
body mass measurements – the more weight you gain the more healthcare
Editor's Note: Another study this year
says senior citizens at 75 and older seem to be immune from the dangers
associated with obesity - see sidebar.
According to the study published in the journal
Obesity, the researchers found that costs associated with medical
and drug claims rose gradually with each unit increase in body mass
index (BMI). Notably, these increases began above a BMI of 19, which
falls in the lower range of the healthy BMI category.
Are Senior Citizens Immune from Dangers of Obesity?
even suggest there may be survival benefits associated with overweight,
mild obesity among the elderly - Jan. 15, 2013
"Our findings suggest that excess fat is
detrimental at any level," said lead author Truls Østbye, M.D., Ph.D.,
professor of community and family medicine at Duke and professor of
health services and systems research at Duke-National University of
A study published earlier this year in the
Journal of the American Medical Association, using death data from
several large population studies, concluded that while higher degrees of
obesity were associated with higher mortality rates, being overweight or
even slightly obese was actually linked with lower mortality.
Since these findings questioned the general belief
that high body mass leads to poor health outcomes, Østbye and his
colleagues sought to better understand the rates of obesity-related
disease, or morbidity, by measuring health care utilization and costs.
Radiographic imaging exposes relationship between
obesity and cancer in aging population; women with more overall fat
mass, more visceral fat had a higher risk of cancer; fat puts older men
at risk even with healthy BMI
Using health insurance claims data for 17,703 Duke
employees participating in annual health appraisals from 2001 to 2011,
the researchers related costs of doctors' visits and use of prescription
drugs to employees' BMIs.
BMI is a measurement of a person's weight adjusted
for his or her height, and can be used to screen for possible
weight-related health problems. A healthy or normal BMI is 19-24, while
overweight is 25-29 and obese is 30 and above.
For example, a 5-foot-6-inch person who weighs
117.5 pounds has a BMI of 19, while a person of the same height weighing
279 pounds has a BMI of 45. Underweight individuals (who reported a BMI
less than 19) were excluded from this analysis, as very low weight may
be a result of existing illness.
Measuring costs related to doctors' visits and
prescriptions, the researchers observed that the prevalence of
obesity-related diseases increased gradually across all BMI levels. In
addition to diabetes and hypertension - the two diseases most commonly
associated with being overweight or obese - the rates of nearly a dozen
other disease categories also grew with increases in BMI. Cardiovascular
disease was associated with the largest dollar increase per unit
increase in BMI.
The average annual health care costs for a person
with a BMI of 19 was found to be $2,368; this grew to $4,880 for a
person with a BMI of 45 or greater. Women in the study had higher
overall medical costs across all BMI categories, but men saw a sharper
increase in medical costs the higher their BMIs rose.
The study did not find a change in the relationship
between levels of obesity and health care costs from 2001 to 2011. In
contrast to the recent evidence relating to mortality, which concluded
that only more obese people were at a higher risk of death, the current
findings suggest that the occurrence of obesity-related illnesses and
related costs begin increasing at a healthy weight.
Given the growing health costs associated with
excess weight, the researchers stressed the importance of implementing
effective health and weight-loss programs.
"The fact that we see the combined costs of
pharmacy and medical more than double for people with BMIs of 45
compared with those of 19 suggests that interventions on weight are
warranted," said Marissa Stroo, a co-investigator on the study.
The researchers also noted that the workplace is a
good setting for implementing weight loss programs, given that employers
can target the more than 100 million Americans who spend most of their
waking hours at work. The Affordable Care Act recognizes this advantage,
and has created new incentives to promote employee wellness programs.
"Employers should be interested in these findings,
because, directly or indirectly, they end up paying for a large portion
of these health care costs," Østbye said.
The researchers are currently working to evaluate
the impact of employer-sponsored weight and health management programs
on health care costs.
In addition to Østbye and Stroo, study authors
include Eric L. Eisenstein, Bercedis Peterson and John Dement. The study
was supported by the Centers for Disease Control, National Institute for
Occupational Safety and Health (R01 OH009468).
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