Costs of obesity, obesity-related complications, and weight loss in the United States: A systematic literature review
Notice bibliographique
Résumé
BACKGROUND: One hundred million American adults are living with obesity; 75% also have obesity-related complications. Related medical spending exceeds $261 billion dollars. A contemporary synthesis of evidence on the average, per person cost for people living with obesity (PwO) and the impact of obesity-related complications in the United States is lacking. OBJECTIVE: To summarize estimates of direct medical costs among PwO by obesity severity and presence of obesity-related complications and to characterize the impact of weight loss on direct medical cost savings. METHODS: A systematic literature review was implemented in MEDLINE/EMBASE on February 21, 2023, identifying observational studies and economic models published since 2012 reporting on direct medical costs among US PwO. Identified studies were screened; outcomes including all-cause and obesity-specific direct medical costs were extracted. Direct medical costs data were summarized overall, by obesity severity (class I, II, or III), and by the presence of obesity-related complications. Impact on cost savings with weight loss was also summarized. Where possible, comparisons with normal weight cohorts, obesity-related complications subgroups, and treated and untreated groups were explored. RESULTS: From 9,725 records identified, 32 studies (6.0%) were deemed eligible, all reporting all-cause, direct medical cost estimates. For mean costs per person per year (PPPY) by obesity severity (n = 15 studies), findings relative to a normal weight cohort (n = 11 studies) indicated total costs among PwO ranged from 1.1-fold (class I) to 3.3-fold (class III) higher. For costs by the presence of obesity-related complications (n = 7 studies; relative to an "obesity-only" group) costs were up to 5-fold greater among PwO with both type 2 diabetes and hypertension. Substantial savings were associated with 5% weight loss over 1 year (n = 5 studies). When costs among PwO using obesity medications (OMs) were compared with those among eligible nonusers (n = 3 studies), in 1 study OM users incurred lower costs than nonusers after 2 years. When mean costs among adults undergoing weight loss surgery were compared with nonsurgery controls (n = 5 studies), there was no associated reduction in cumulative total costs across the study periods. CONCLUSIONS: Evidence from this review indicates that direct medical costs among PwO increase with increasing obesity severity and development of obesity-related complications. Although cost savings were observed with 5% weight loss, uncertainty surrounding cost savings accounting for the cost of more recently approved interventions remains. Furthermore, current evidence is lacking, and longitudinal studies considering a wider range and overlap of obesity-related complications are needed to help document and quantify the current direct cost burden of obesity.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,040 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,007 | 0,008 |
| Bibliométrie | 0,019 | 0,018 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».