Costs of obesity, obesity-related complications, and weight loss in the United States: A systematic literature review
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".