Future direct and indirect costs of obesity and the influence of gaining weight: Results from the MONICA/KORA cohort studies, 1995-2005

Over the last two decades, the prevalence of obesity has risen worldwide. As obesity is a confirmed risk factor for a number of diseases, its increasing prevalence nurtures the supposition that obesity may present a growing and significant economic burden to society.The objective of this study is to analyse the correlation between body mass index (BMI) and future direct and indirect costs, as well as the correlation between changing BMI and future in(direct) costs. Health care utilisation and productivity losses were based on data from 2581 participants aged 25-65 years (1994/95) from two cross-sectional, population-representative health surveys (MONICA/KORA-survey-S3 1994/95 and follow-up KORA-survey-F3 2004/05) in Augsburg, Germany.The predicted average adjusted total direct costs per year and per user were estimated to be €1029-(healthy weight), €1093-(overweight) and €1040-(obesity). There are significantly greater future costs in the utilisation of general practitioners per user and per year at higher obesity levels (€72; €75; €96).The average total direct costs per person for those who stay in the same BMI class are €982, €1000 and €973. An overweight participant who becomes obese incurs significant costs of internists of €160 compared with those who remain overweight (€124). An overweight user incurs indirect costs of €2474, compared with €2136 for those who remain a healthy weight.There is a trend for higher predicted (in)direct costs when people are overweight or obese compared with healthy weight persons 10 years earlier. Potential cost savings could be attained if preventive programs effectively targeted these individuals.

► This study analyses the correlation between (1) body mass index (BMI) and future (in)-direct costs, as well as the correlation between (2) changing BMI and future in(direct) costs. ► Health care utilisation and productivity losses were based on two German cross-sectional, population-representative health surveys. ► (1) Predicted (in)direct costs of an overweight or obese person are higher than the costs of a previously healthy weight person. ► (1) The average future costs of GP utilisation estimates are significantly larger depending on the higher weight category. ► (2) There is a trend of higher (in)direct costs when people gain weight and switch from one weight category to the next higher weight category.