The continuing explosion in per capita health care spending in the United States at rates well above that of inflation or per capita GDP growth has lead to substantial analysis of what the cost drivers might be, in the hopes of being able to craft solutions to minimize those drivers. One of the most prominent of the causes being investigated is obesity, which appears to have strong links to a number of chronic diseases. The Congressional Budget Office has issued a report attempting to analyze the relationship between obesity and per capita health spending. (CBO Report)
Categories of weight are related to body mass index and include both overweight and the obese, a distinction which becomes relevant to the analysis. In the 20 years from 1987 to 2007, the percent of overweight Americans went from 31% to 35%, the obese proportion shockingly more than doubled, from 13% to 28%. In constant dollars, per adult spending overall rose by 78% in that time period, but for overweight persons it only rose 61%, actually less than for normal weight individuals. For obese persons it climbed 111% and for the 4% of the population in the morbidly obese category, the rise was 177%. So clearly obese persons, but not overweight, are contributing significantly to the increase in health spending. Is it because they are obese, or is it just a correlation?
CBO did an analysis looking at diseases linked to obesity such as diabetes, hypertension and heart disease and found that those diseases alone accounted for 50% of the excess health spending for obese Americans. It is likely that the overall affects of obesity on health mean it accounts for much more. CBO did not only an exploration of current cost differences but also examined three future scenarios–one in which the percent of obese individuals continues to grow, one in which it stays the same and one in which it declines. While a per capita analysis is presented, CBO cautions that total spending is affected in a different way by obesity in that obese persons tend to have shorter lives. If the nation were able to reduce the percent of obese persons, a substantial contribution to lower health spending would result.