Medical System Feels the Weight of Obesity, Heart Disease Link

Excess body fat costs the U.S. health system an estimated $31 billion in treatment for the millions of overweight and obese people who develop heart disease, according to a government study.

While the link between obesity and cardiovascular disease has been well documented, this study is the first to measure the economic impact of excess body weight on the disease in the United States. More than half of the Americans included in this study were overweight or obese.

"The contribution of excess body weight to cardiovascular disease is so large that by itself it warrants the development of population-based physical activity and nutrition strategies to reduce and prevent excess body weight," says lead author Guijing Wang, Ph.D., of the Centers for Disease Control and Prevention, writing in the American Journal of Preventive Medicine.

To study the contribution of obesity as a risk factor for cardiovascular disease, the researchers analyzed the direct medical costs from a nationally representative sample by linking two national health surveys.

They found that the prevalence of cardiovascular disease among obese individuals was twice that of those with normal weight. Twenty percent of the cardiovascular disease cases among overweight individuals were associated with excess body weight. Among obese individuals, 45 percent of the cardiovascular cases were associated with obesity.

The extra burden of overweight and obese individuals led to 7.75 million extra cases of heart disease and $22.17 billion in direct medical costs in 1996. This amounted to 17 percent of the total direct medical costs of treating cardiovascular disease. In 2001 dollars, the cost would have been $31 billion, the researchers say.

In 1998 cardiovascular disease claimed nearly 1 million lives and accounted for 40 percent of all U.S. deaths. Current estimates are that more than 60 million Americans have one or more types of cardiovascular disease. The total economic burden of cardiovascular disease was estimated at $498 billion for 2001, accounting for 61 percent of all health care spending.

The authors note that the study is limited and offers a conservative estimate of the cost of excess heart disease. It also does not include assessment of indirect costs such as lost productivity.

If the nation's obesity epidemic continues, excess body weight "will lead to even higher national health expenditures while deteriorating the nation's health through premature disability, suffering and death," the researchers warn.

They also point to recent studies showing that the prevalence of obesity continues to rise, threatening even higher costs in the future.