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Annu Rev Public Health. 2012 Apr;33:409-23. doi: 10.1146/annurev-publhealth-031811-124652. Epub 2012 Jan 3.

The medicalization of chronic disease and costs.

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Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.


U.S. health care spending has increased dramatically in the past several decades, consuming 17.6% percent ($2.6 trillion) of GDP in 2010. Although historical spending drivers do not account for this recent increase, two major changes in population health--the rise in obesity and obesity-related chronic disease--provide a likely explanation. This article reviews the contribution that rising treated obesity-related chronic disease prevalence and its associated treatment (spending per treated case) has made to the growth in health care spending. We discuss trends in the clinical incidence of obesity and chronic disease as well as timely advancements in disease detection, treatment, and management. Evidence shows that rising obesity rates are influencing spending largely by increasing the treated prevalence of obesity-related chronic disease. Therefore, preventing individuals from becoming treated cases in the first place is one key way that our country can cut health care spending moving forward.

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