@article {6917, title = {Increasing obesity rates and disability trends.}, journal = {Health Aff (Millwood)}, volume = {23}, year = {2004}, month = {2004 Mar-Apr}, pages = {199-205}, publisher = {23}, abstract = {

Are older Americans becoming more or less disabled? Unhealthy body weight has increased dramatically, but other data show that disability rates have declined. We use data from the Health and Retirement Study to estimate the association between obesity and disability, and we combine these data with trend estimates of obesity rates from the Behavioral Risk Factor Surveillance Survey. If current trends in obesity continue, disability rates will increase by 1 percent per year more in the 50-69 age group than if there were no further weight gain.

}, keywords = {Aged, Disabled Persons, Female, Humans, Male, Middle Aged, Obesity, Population Surveillance, United States}, issn = {0278-2715}, doi = {10.1377/hlthaff.23.2.199}, author = {Sturm, Roland and Ringel, Jeanne S. and Andreyeva, Tatiana} } @article {6977, title = {Moderate and severe obesity have large differences in health care costs.}, journal = {Obes Res}, volume = {12}, year = {2004}, month = {2004 Dec}, pages = {1936-43}, publisher = {12}, abstract = {

OBJECTIVE: To analyze health care use and expenditures associated with varying degrees of obesity for a nationally representative sample of individuals 54 to 69 years old.

RESEARCH METHODS AND PROCEDURES: Data from the Health and Retirement Study, a nationwide biennial longitudinal survey of Americans in their 50s, were used to estimate multivariate regression models of the effect of weight class on health care use and costs. The main outcomes were total health care expenditures, the number of outpatient visits, the probability of any inpatient stay, and the number of inpatient days.

RESULTS: The results indicated that there were large differences in obesity-related health care costs by degree of obesity. Overall, a BMI of 35 to 40 was associated with twice the increase in health care expenditures above normal weight (about a 50\% increase) than a BMI of 30 to 35 (about a 25\% increase); a BMI of over 40 doubled health care costs (approximately 100\% higher costs above those of normal weight). There was a difference by gender in how health care use and costs changed with obesity class. The primary effect of increasing weight class on health care use appeared to be through elevated use of outpatient health care services.

DISCUSSION: Obesity imposes an increasing burden on the health care system, and that burden grows disproportionately large for the most obese segment of the U.S. population. Because the prevalence of severe obesity is increasing much faster than that of moderate obesity, average estimates of obesity effects obscure real consequences for individuals, physician practices, hospitals, and health plans.

}, keywords = {Aged, Ambulatory Care, Body Mass Index, Body Weight, Female, Health Care Costs, Hospitalization, Humans, Male, Middle Aged, Obesity, Sex Characteristics}, issn = {1071-7323}, doi = {10.1038/oby.2004.243}, author = {Andreyeva, Tatiana and Sturm, Roland and Ringel, Jeanne S.} }