Obesity has the attention of researchers and policy makers. It is associated with increased risk for many chronic conditions, such as hypertension, high cholesterol, cardiovascular disease, and cancer, among others. Obesity impacts nearly every major system in the body. It is, in itself, an outcome of several different behavioral and policy decisions; it is also an input into chronic disease.
Improved treatment for many of the conditions associated with obesity means that, in some sense, an obese person in 2010 is “healthier” than an obese person in 1950 or probably even 1980. That is good from a morbidity and health status point of view, but such improvements have been achieved often at increased health care cost. Statins to reduce cholesterol and other drugs to lower blood pressure, for example, are not cheap. Also, improved treatment may or may not lead to major changes in health outcomes such as mortality.
Does obesity shorten life expectancy? Trogdon summarized research he and colleagues conducted in which they calculated years of life lost associated with obesity using life tables by weight categories1 and smoking status. They found that overweight and moderate obesity (obese I) will not shorten a person’s life. Severe obesity (obese II and III) will take years off one’s life. At age 65, a typical age at which people enter the Medicare program, being an obese II person (about 40 pounds overweight) is associated with 3 years of life lost for whites, while being an obese III person (a little over 100 pounds overweight) is associated with 4 to 6 years of life lost across gender and race (Finkelstein et al., 2009a). These findings indicate that although rates of chronic conditions, such as diabetes and hypertension, are higher among obese people, they do not necessarily translate into a shorter life span.
How much does obesity increase health care costs at a given point in time? To answer this question, Trogdon reported on the findings from a recently published update of national estimates of annual medical spending attributable to obesity (Finkelstein et al., 2009b). Comparing a Medicare beneficiary who is obese to one who is not obese and controlling for other