The direct health care costs of obesity in the United States.
OBJECTIVE
Recent estimates suggest that obesity accounts for 5.7% of US total direct health care costs, but these estimates have not accounted for the increased death rate among obese people. This article examines whether the estimated direct health care costs attributable to obesity are offset by the increased mortality rate among obese individuals.


METHODS
Data on death rates, relative risks of death with obesity, and health care costs at different ages were used to estimate direct health care costs of obesity from 20 to 85 years of age with and without accounting for increased death rates associated with obesity. Sensitivity analyses used different values of relative risk of death, given obesity, and allowed the relative costs due to obesity per unit of time to vary with age.


RESULTS
Direct health care costs from 20 to 85 years of age were estimated to be approximately 25% lower when differential mortality was taken into account. Sensitivity analyses suggested that direct health care costs of obesity are unlikely to exceed 4.32% or to be lower than 0.89%.


CONCLUSIONS
Increased mortality among obese people should be accounted for in order not to overestimate health care costs.
Allison
D B
DB
Obesity Research Center, St. Luke's/Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA. dba8@columbia.edu
Zannolli
R
R
Narayan
K M
KM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D017059:Models, Econometric; D009765:Obesity / Q000191:economics* / Q000453:epidemiology; D015995:Prevalence; D012306:Risk; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology