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Am J Prev Med. 2011 Mar;40(3):338-44. doi: 10.1016/j.amepre.2010.11.020.

Weight loss and lifetime medical expenditures: a case study with TRICARE prime beneficiaries.

Author information

1
The Lewin Group, Falls Church, Virginia, USA. tim.dall@ihs.com

Abstract

BACKGROUND:

TRICARE's Prime (managed care) plan spends more than $1 billion annually in medical expenditures attributed to overweight and obesity.

PURPOSE:

This study estimates change in lifetime disease prevalence and medical expenditures associated with weight loss for beneficiaries in TRICARE's Prime plan.

METHODS:

This 2010 analysis uses Markov Chain Monte Carlo simulation with demographics, biometrics, health behavior, and disease presence for 857,200 overweight and 521,800 obese beneficiaries aged 18-64 years in 2008 to model future onset of diseases linked to excess weight. Prediction equations in the simulation come from multiple sources: (1) regression analysis with longitudinal (2007-2008) TRICARE medical claims and electronic health records for 2.1 million beneficiaries; (2) regression analysis with Medical Expenditure Panel Survey (2002-2007) and National Health and Nutrition Examination Survey (1999-2008) data; (3) cancer and mortality risk from Surveillance, Epidemiology, and End Results data; and (4) published findings from clinical trials.

RESULTS:

Among overweight and obese beneficiaries, lifetime medical expenditures declined $440 (3% discount rate) for each permanent 1% reduction in body weight. This includes $590 in savings from improved health, offset by $150 in additional expenditures from prolonged life. Estimates range from $660 reduction for grossly obese adults aged <45 years to $40 gain from grossly obese adults aged 55-64 years (where expenditures from increased longevity exceed savings from improved health). If weight loss is temporary and regained after 24 months, lifetime expenditures decline by $40 per 1% reduction in body weight.

CONCLUSIONS:

Long-term benefits from weight loss are substantially greater than short-term benefits, underscoring the need for a societal perspective to combat obesity.

PMID:
21335267
DOI:
10.1016/j.amepre.2010.11.020
[Indexed for MEDLINE]
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