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Impact of Waist Circumference Difference on Health-Care Cost among Overweight and Obese Subjects: The PROCEED Cohort

2010; Elsevier BV; Volume: 13; Issue: 4 Linguagem: Inglês

10.1111/j.1524-4733.2009.00690.x

1524-4733

Karen Pendergast, Anne Wolf, Beth Sherrill, Xiaolei Zhou, Louis J. Aronne, Ian D. Caterson, Nick Finer, Hans Hauner, James O. Hill, Luc Van Gaal, F Coste, Jean‐Pierre Després,

Chronic Disease Management Strategies

Objective: To estimate the incremental effect of waist circumference (WC) on health-care costs among overweight and obese subjects after adjusting for body mass index (BMI).Methods: A prospective study.The subjects were members of Internet panels in the United States (US) and Germany.10,816 individuals (United States: n = 5410; Germany: n = 5406) aged 30-70 years with BMI scores between 20 and 35 kg/m 2 were recruited and grouped by category: healthy weight (BMI 20-24.9kg/m 2 ), overweight (BMI 25-29.9kg/m 2 ), and obese (BMI 30-35 kg/m 2 ).Within the overweight and obese categories, the individuals were stratified by sex and within those subgroups, characterized as above or below the median WC.The subjects self-reported weight, WC, and health-care resource use at baseline, 3 months, and 6 months using online questionnaires.Over 65% of the recruited subjects completed all surveys.Resource utilization was translated into health-care costs by multiplying unit costs from national sources in each country.Annualized health costs were summarized for subjects with low and high WC within the overweight and obese categories.A two-part model generated predicted annual costs because of the WC difference controlling for BMI, demographic, and lifestyle variables among the overweight and obese subjects.Results: When BMI and other characteristics are constant, annual healthcare costs are 16% to 18% higher in Germany and 20% to 30% higher in the United States for the subjects with a high WC compared with subjects with a low WC.Conclusions: Targeting people with a high waist circumference for weight management whether they are overweight or obese may maximize cost-efficacy.