Portal de Periódicos da CAPES

The High and Rising Costs of Obesity to the US Health Care System

2017; Springer Science+Business Media; Volume: 32; Issue: S1 Linguagem: Inglês

10.1007/s11606-016-3968-8

1525-1497

Adam Biener, John Cawley, Chad D. Meyerhoefer,

Bariatric Surgery and Outcomes

T he papers in this special issue examine behavioral, phar- macotherapy, and surgical interventions for weight loss, based on a 2016 conference on state-of-the-art weight management hosted by the Veterans Health Administration.The purpose of this editorial is to provide new information on the medical care costs of obesity that help motivate those interventions.We have a long-standing research agenda to measure the causal effect of obesity on medical care costs.The challenge is that obesity is not randomly distributed in society; as a result, the health care costs of the obese and nonobese may differ for reasons other than weight, such as differences in access to health care, income, or other dimensions of health.Our method for estimating the causal effect of obesity on medical care costs is to estimate instrumental variable (IV) models in which we exploit the heritability of weight as a natural experiment. 1,2The logic is that this variation in weight is not chosen by the individual or caused by earned income, injuries, or other events, and by estimating how medical care costs vary with such exogenous variation in weight, we can estimate the causal effect of obesity on medical care costs.Our past research, 1,2 which is based on data from the Medical Expenditure Panel Survey (MEPS), indicates that, between 2005 and 2010, the amount by which obesity raised medical costs per obese adult rose from $3070 to $3508 (both measured in year 2010 dollars), an increase of 14.3 percent.During that same period, the aggregate costs of obesity in the adult, noninstitutionalized population of the US rose from $212.4 billion to $315.8 billion (both in 2010 dollars), an increase of 48.7 percent; this large increase is due to three factors: (1) an increase in costs per obese individual; (2) an increase in the population, so even if the prevalence of obesity remained constant there would be more obese individuals; (3) an increase in the prevalence of obesity.In this editorial we re-estimate our IV models of the impact of obesity on medical care costs using MEPS data for 2006-2013, that is, after adding 3 more years of data (2011-2013) and removing older years of data (2000-2005) from our