Health care cost of severe obesity and obesity-related comorbidities: A retrospective cohort study from Alberta, Canada.

Abstract

Estimates of health care costs associated with severe obesity, and those attributable to specific health conditions among adults living with severe obesity are needed. Administrative data was used to identify adults who previously received a procedure, and had (investigational cohort) or did not have (control cohort) a body mass index ≥35kg/m2. Two-part models were used to estimate the incremental health care cost of severe obesity and related health conditions during a 1-year observation period. Adjusting for potential confounders, the total health care cost ratio was higher in the investigational (n=220,190) versus control (n=1,955,548) cohort (1.32 [95% CI: 1.32, 1.33]) with a predicted incremental cost of $2221 (95% CI $2184, $22,265) per person-year; costs were less when obesity-related health conditions were controlled for (1.13 [95% CI: 1.13, 1.14]; $1097 [95% CI: $1084, $1110] per person-year). Among those living with severe obesity, incremental costs associated with specific health conditions ranged from $737 (95% CI: $747, $728) lower (dyslipidemia) to $12,996 (95% CI: $12,512, $13,634) higher (peripheral vascular disease) per person-year. Adults living with severe obesity had greater costs than those without, largely driven by obesity-related health conditions. For the Alberta adult population with a severe obesity prevalence of 11%, severe obesity may account for an estimated additional $453-918 million in health care costs per year. Findings of this study provide rationale for resources and strategies to prevent and manage obesity and its complications.