The obesity epidemic
Obesity is measured by body mass index (BMI), calculated as
weight in kilograms divided by height in meters squared. An
adult with a BMI over 30 is considered obese. A BMI over 40
constitutes morbid obesity. It is at this level—BMIs of 40 and
above—that we are seeing the greatest growth in American
adults (see Chart 1).
What some in the medical community have begun calling the obesity epidemic is having a profound impact both on
Americans’ health and the American health care system. The
percentage of morbidly obese American adults is growing rapidly, faster than obesity. To make matters worse, morbid obesity
carries even higher health care costs than obesity—as much as
47 percent more—because of the number of serious conditions
that often accompany it, including Type 2 diabetes and heart,
vascular, and joint disease.
A 2009 study on annual medical spending attributable to
obesity that was published in Health Affairs reported that the
United States spent nearly 10 percent of its health care dollars
on obesity-related illnesses. For private payers, the share was
nearly 13 percent. And that percentage was rising every year by
more than 9 percent.
For many people with morbid obesity, diet, exercise, and
behavior modification alone aren’t an effective route to achieve
and maintain a healthy weight. There’s clinical evidence,
ChAr T 1: growth in Prevalence of Obesity
in U.S. adults, 2000-2005
Body MASS INdeX (BMI)
however, that weight-loss surgery, with behavior modification,
can help morbidly obese patients shed excess pounds, reduce
the effects of obesity-related illness, and—most important for
health plan sponsors—lower future health care costs.
Weight-loss surgery, also called bariatric surgery, isn’t a new
idea. In 1998, the National Heart, Lung and Blood Institute recommended bariatric surgery as an effective treatment option,
not just for morbidly obese patients but also for those with a
lower BMI ( 35 or more) who had coexisting conditions and
were at high risk for obesity-related illness.