Health Services Use and Health Care Costs of Obese and Nonobese Individuals

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Abstract
The prevalence of obesity is increasing. Data from the National Health and Nutrition Examination Surveys (NHANES II, NHANES III, and NHANES Continuous) show that the prevalence of obesity (body mass index [BMI; calculated as weight in kilograms divided by the square of height in meters] ≥30) increased between 1976 and 1980, 1988 and 1991, and 1999 and 2000 from 15.0% to 23.3% to 30.9% of adults aged 20 to 74 years.1,2 Almost 65% of adults in the United States aged 20 years or older are overweight (BMI≥25).2 The incidence of chronic diseases increases in persons who are overweight or obese.3,4 Obesity is a major risk factor for hypertension, hypercholesterolemia, type 2 diabetes mellitus, coronary artery disease, stroke, gallbladder disease, musculoskeletal disorders, and certain cancers, as well as all-cause mortality.4 Obesity in adulthood is associated with a shortened life expectancy.5,6 Peeters and colleagues5 found that in nonsmokers at age 40 years, obesity was associated with a 7-year decrease in life expectancy in women and a 6-year decrease in men. The decrease in life expectancy was 13 to 14 years in patients who were both obese and smokers compared with normal weight nonsmokers.5 Fontaine and colleagues6 found that for patients 20 to 30 years old with severe obesity (BMI≥45), the maximum estimated number of years of life lost was 13 for white men, 8 for white women, 20 for black men, and 5 for black women.