Treating Severe Obesity Saves Lives and Money
By Robert J. Kelly, Jr, MD
According to the Centers of Medicare and Medicaid Services, health care cost in 2015 exceeded 3 trillion dollars or approximately $10,000 dollars per person in the United States. Due to the continued increase in health care expenditures, controlling rising health care cost has become a major focus in our present day medical system. Most, if not all areas of health care, have been evaluated to find potential for cost savings and some of these include prescription drug prices, malpractice costs, insurance company profits, bundling of payments, administration of accountable care, and the improved management and prevention of chronic disease.1 Of all those areas listed above, the argument may be made that preventing the development or improving the management of chronic diseases such as kidney disease, coronary artery disease, diabetes and congestive heart failure, would make the greatest impact on reducing the national health care cost.2
The strong correlation between severe obesity and the development of comorbidities such as hypertension, diabetes and obstructive sleep apnea which can lead to the development of chronic diseases and thus rising health care costs make the prevention or improved management of morbid obesity extremely important. While exercising, eating healthy, getting adequate sleep, and taking medications are all important, the most effective treatment of morbid obesity with either improvement or resolution of associated comorbidities remains bariatric surgery. 3 A significant number of weight loss patients have demonstrated a dramatic improvement and/or resolution of chronic disease which may translate into health care cost savings.
Relative to normal weight patients, severe obesity (BMI > 40) increases medical costs per patient by almost 81%.4 This is secondary to the associated comorbidities and development of chronic disease as described above. With rising medical care costs, dramatic savings in health care may be found with the prevention, improved treatment and resolution of those chronic diseases.
1) Emanuel EJ. Where Are the Health Care Cost Savings?. JAMA. 2012; 307(1):39-40. doi:10.1001/jama.2011.1927.
2) Agency for Healthcare Research and Quality. The high concentration of US health care expenditures. Research in Action. 2006:19. http://www.ahrq.gov/research/ria19/expendria.pdf.
3) Buchwald, Consensus Conference Statement Bariatric Surgery for Morbid Obesity: Health implications for patients, health professionals, and third-party payers. Surg Obes Rel Dis. 2005; 1: 371-381
4) Arterburn DE, Maciejewski ML, Tsevat J. Impact of morbid obesity on medical expenditures in adults. Int J Obes, 29(3): 334-339, 2005.