title: Excess body weight increases the burden of age-associated chronic diseases and their associated health care expenditures.
abstract: Aging and excessive adiposity are both associated with an increased risk of developing multiple chronic diseases, which drive ever increasing health costs. The main aim of this study was to determine the net (non-estimated) health costs of excessive adiposity and associated age-related chronic diseases. We used a prevalence-based approach that combines accurate data from the Health Search CSD-LPD, an observational dataset with patient records collected by Italian general practitioners and up-to-date health care expenditures data from the SiSSI Project. In this very large study, 557,145 men and women older than 18 years were observed at different points in time between 2004 and 2010. The proportion of younger and older adults reporting no chronic disease decreased with increasing BMI. After adjustment for age, sex, geographic residence, and GPs heterogeneity, a strong J-shaped association was found between BMI and total health care costs, more pronounced in middle-aged and older adults. Relative to normal weight, in the 45-64 age group, the per-capita total cost was 10% higher in overweight individuals, and 27 to 68% greater in patients with obesity and very severe obesity, respectively. The association between BMI and diabetes, hypertension and cardiovascular disease largely explained these elevated costs.
authors.affiliation: Department of Economics and Finance, University of Rome "Tor Vergata", Rome, Italy.|Center for Health Policy, Stanford University, Stanford, CA 94305, USA.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Atella
authors.affiliation: Department of Economics and Finance, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Joanna
authors.initials: J
authors.lastname: Kopinska
authors.affiliation: Italian College of General Practitioners (SIMG), Florence, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Medea
authors.affiliation: Department of Economics and Finance, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Belotti
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Valeria
authors.initials: V
authors.lastname: Tosti
authors.affiliation: Department of Economics and Finance, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Andrea Piano
authors.initials: AP
authors.lastname: Mortari
authors.affiliation: Italian College of General Practitioners (SIMG), Florence, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cricelli
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.|Department of Clinical and Experimental Sciences, Brescia University, Italy.|CEINGE Biotecnologie Avanzate, Napoli, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Fontana
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002908:Chronic Disease / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics*; D055815:Young Adult
keywords: body mass index; cardiovascular disease; cost analysis; diabetes; disease burden; hypertension; obesity