For adults with employer-sponsored insurance, it is estimated that a 5% reduction in BMI would result in a 7% reduction in cost, and a 25% reduction in BMI would result in a 30% reduction in costs.
In a recent study published in JAMA network openresearchers estimated the amount of health care spending for overweight or obese adults with employer-sponsored Medicare or insurance and the effect of body mass index (BMI) on spending.
They found evidence of significant savings associated with weight loss for people with both forms of insurance, especially those with other health conditions.
background
Obesity rates among adults in the United States increased from 31% to 42% between 2000 and 2020. Approximately 73% of adults need to lose weight to meet the recommended BMI level. Excess weight is associated with an increased risk of chronic diseases such as lung disease, osteoarthritis, cancer, heart disease, high blood pressure, and type 2 diabetes.
Obesity-related diseases contribute significantly to increased healthcare costs, with obesity associated with over $260 million in healthcare costs in 2016 and expected to increase to $385 billion by 2024 . Most costs are paid for by insurance through employment, with Medicaid and Medicare covering about 25%. .
In the workforce, obesity among employees is known to lead to poor health and an increase in workplace accidents. Obese workers have twice as many workers’ compensation claims, three times as many workers’ compensation days, seven times as much to pay for medical claims, and 11 times as much to pay for compensation claims.
People with a BMI over 35 have a more than 70% increased risk of developing type 2 diabetes over their lifetime, while a 5-point increase in BMI increases the odds of heart failure by about 30%. Excess weight also increases the risk of high blood pressure by 65% to 78%.
Interventions such as lifestyle programs are cost-effective and can reduce body weight by 5-7%. Bariatric surgery, on the other hand, although effective, is expensive and involves risks and revision surgery. Medicare covers the latter for individuals with a BMI greater than 35 and comorbidities and for individuals with a BMI greater than 40.
A new treatment is the use of glucagon-like peptide-1 (GLP-1) drugs, which can reduce body weight by up to 12%. Approximately 25% of users lose 20% or more.
About research
In this study, researchers evaluated the reduction in health care spending savings from weight loss, including Medicare spending. It includes data from cross-sectional surveys conducted from 2001 to 2016 and 2018 to 2020, focusing on adults who were insured through employment or Medicare. This dataset was nationally representative and included self-reported information on health care utilization, insurance, and medical conditions.
The researchers focused on adults ages 24 to 64 with a BMI of 25 or higher. This includes households with children ages 11 to 45 but with spending over $506,000, those with missing data, adults with a BMI over 80, and pregnant women. Medical conditions analyzed include arthritis, heart disease, asthma, mental health disorders, hypertension, hyperlipidemia, and diabetes.
Using this information, researchers adjusted for household composition, region, education, race, gender, and age, and found that spending was associated with a decrease in BMI level of 25%, 20%, 15%, 10%, and 5%. We calculated medical spending by focusing on how it changes. .
Survey results
The study analyzed health spending among 13,435 adults with insurance through employment and 3,774 Medicare beneficiaries, all with a BMI of 25 or higher. The results showed a clear association between BMI and increased medical costs in both groups.
For employer-provided insurance, each 1% increase in BMI above 30 increases your annual expenses by $326. For Medicare, the increase was $633. Racial disparities were observed, with Hispanic and non-Hispanic black adults spending less than non-Hispanic white adults.
Weight loss was associated with significant reductions in health care costs. A 5% weight loss resulted in savings of $670 (8%) on employer-provided insurance and $1,262 on Medicare. An even larger 25% reduction resulted in savings of $2,849 (34%) for employer-sponsored insurance and $5,442 (31%) for Medicare.
These savings were more pronounced in individuals with higher baseline BMI, especially those with chronic conditions. For example, a 15% weight loss for an employer-sponsored plan member with arthritis saved $4,950, while a Medicare enrollee with high blood pressure saved $3,709.
Overall, this study shows that lowering BMI, especially in individuals with high baseline BMI and chronic conditions, can lead to significant health care cost savings in both employer-sponsored insurance and Medicare populations. It turned out that.
conclusion
For both Medicare and employer-based insurance, weight loss can result in significant annual savings, especially for people with high baseline BMI levels. However, this study did not take into account the potential savings from preventing symptoms associated with excess weight. Improving access to weight loss treatments and medications could lead to lower healthcare costs associated with obesity.
