title: Direct medical cost of overweight and obesity in the USA: a quantitative systematic review.
abstract: To estimate per-person and aggregate direct medical costs of overweight and obesity and to examine the effect of study design factors. PubMed (1968-2009), EconLit (1969-2009) and Business Source Premier (1995-2009) were searched for original studies. Results were standardized to compute the incremental cost per overweight person and per obese person, and to compute the national aggregate cost. A total of 33 US studies met review criteria. Among the four highest-quality studies, the 2008 per-person direct medical cost of overweight was $266 and of obesity was $1723. The aggregate national cost of overweight and obesity combined was $113.9 billion. Study design factors that affected cost estimates included use of national samples vs. more selected populations, age groups examined, inclusion of all medical costs vs. obesity-related costs only, and body mass index cut-offs for defining overweight and obesity. Depending on the source of total national healthcare expenditures used, the direct medical cost of overweight and obesity combined is approximately 5.0% to 10% of US healthcare spending. Future studies should include nationally representative samples, evaluate adults of all ages, report all medical costs and use standard body mass index cut-offs.
authors.affiliation: Division of General Internal Medicine and Center for Human Nutrition, University of Colorado Denver, Denver, CO, USA. adam.tsai@ucdenver.edu
authors.forename: A G
authors.initials: AG
authors.lastname: Tsai
authors.forename: D F
authors.initials: DF
authors.lastname: Williamson
authors.forename: H A
authors.initials: HA
authors.lastname: Glick
mesh_terms: D015992:Body Mass Index; D003365:Costs and Cost Analysis; D017048:Health Care Costs; D006801:Humans; D009765:Obesity / Q000191:economics*; D014481:United States