Counting the lifetime cost of obesity: Analysis based on national England data
Authors' conclusion
The expected increases in annual HCRU because of obesity, when considered over a lifetime, are being mitigated by the increased mortality of obese individuals. Our data suggest that simple short-term HCRU reduction brought about through BMI reduction will be insufficient to fund additional specialist weight reduction interventions. The HRCUs associated with BMI are not in most cases related to short-term health conditions. They are a cumulative result over a number of years, so for age 16-49 years reducing BMI from ≥40 to 30-39.9 kg/m2 might show an annual decrease in HCRU/person by £325/year for women and £80/year for men but this might not have immediately occurred within that year. For those aged >70 years reducing BMI from ≥40 to 30-39.9 kg/m2 might show an annual decrease in HCRU/person by £777/year for women and £796/year for men but also may not be manifest within that year. However, for the morbidly obese men and women, the potential QALY value lost was £2864 per person per year with the potential for these funds to be applied to intensive weight management programmes, including pharmacotherapy.
Study context
- Population
- Population aged >16 years in England (2019 data; 2022/23 health care resource use (HCRU) values), by age, sex, deprivation and 42 integrated care boards (ICBs)51% female
- Participants
- 45.4 million participants
- Comparison
- BMI classes vs all population at BMI <25 kg/m²
- Outcome
- Lifetime costs of obesity (mortality, life years lost and lifetime HCRU) by demographic group/geographic area
Methodological detailsnational England data, benchmarking against all population BMI <25 kg/m², 42 integrated care boards
- National England data
- Benchmarking against all population BMI <25 kg/m²
- 42 integrated care boards
Main finding
As reported in the abstract
- BMI ≥30 (28% of adult population)
- 13.7 million
- BMI ≥40
- 1.50 million (12%)
- Fall in deaths if BMI <25 kg/m² in all (from 518K/year to 455K/year; 12% reduction)
- 63K
- Predicted reduction in deaths, BMI ≥40 kg/m² (54% lower)
- 12K deaths
- Deaths linked to obesity, age 16-49 years with BMI ≥40 kg/m²
- 72%
- Future life years lost, BMI 30-39.9 kg/m²
- 2.5 years
- Future life years lost, BMI ≥40 kg/m²
- 6.7 years
- Future life years lost, age 16-49 years with BMI ≥40 kg/m²
- 8.3 years
- Annual HCRU decrease from BMI ≥40 to 30-39.9 kg/m²
- £342 per person
- Annual HCRU reduction from BMI 30-39.9 to 25-29.9 kg/m²
- £316/person
- Future life years lost related to excess weight, BMI ≥25 kg/m² (13.1% of all)
- 791 689
- Potential quality adjusted life years (QALY) value lost at NICE £30 000 per QALY
- £24 billion/year or £522/person in the obese population
- Potential QALY value lost, morbidly obese men and women
- £2864/person/year
Further findings
Variation across 42 ICBs
- Prevalence of BMI ≥40
- 1.8%-4.3%
- Excess mortality
- 11.6%-15.4%
- HCRU linked to higher BMI
- 7.2%-8.8%
- Greatest HCRU impact in north-west, north-east and Midlands; less in the south
BMI ≥40 kg/m² subgroup characteristics
- Female (68%)
- 1.0 million
- Women aged 16-49 years (40%)
- 0.6 million
- In top deprivation quintile
- 35%
Original publication
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