Obesity in Younger Adults Means Higher Medicare Costs in Older Age

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Daviglus ML, Liu K, Lijing LL, et al.: Relation of body mass index in young adulthood and middle age to Medicare expenses in older age. JAMA22:2743-2749, 2004.

What is the problem and what is known about it so far?

Obesity is a major risk factor for heart disease. Obesity also increases the risk of getting high blood pressure, diabetes, and some cancers. Some 130 million adults in the U.S. are overweight or obese. In addition, the U.S. population is getting older.

This may mean that Medicare faces big increases in future spending.

Who was studied?

Participants were taken from an earlier study of working adults in Chicago. At the start of that study, participants' ages ranged from 33 to 64 years. A total of 9,978 men and 7,623 women were followed. None of them had heart disease or diabetes. All were eligible for Medicare for at least 2 years during 1984-2002.

How was the study done?

In the Chicago study, height, weight, blood pressure, and total cholesterol (the amount of fat in the blood) were measured. Participants filled out medical questionnaires. Each participant had an electrocardiogram (ECG, a test that measures the rate and regularity of a person's heartbeat).

Researchers calculated body mass index (BMI), which is a measurement of overweight and obesity.

Researchers looked at Medicare claims for each participant. Claims included hospital care, outpatient care, medical equipment, home health care, and hospice care.

What did the researchers find?

For all adults, the higher the BMI, the higher their annual and total Medicare charges.

For example, for normal to overweight women the annual cost was $6,224 and total cost was $76,866. The annual cost for obese women was $9,612 and total cost was $125,470.

The annual cost for normal to overweight men was $7,205 and total cost was $100,431. The annual cost for obese men were $10,128 and total cost was $119,318.

What were the limitations of the study?

Long-term nursing home costs were not included. Prescription drug costs were not included. Veterans Health Administration costs were not included, nor were out-of-pocket costs.

What are the implications of the study?

Obesity in young adulthood and middle age leads to higher health care costs in older age.