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Obesity Prevalence Sex Differences in Adults Aged 20+ Years OBESITY PREVALENCE SEX DIFFERENCES IN ADULTS AGED 20+ YEARS 35.1% ADULTS Overall US 33.5% vs. 36.1% 46.44% vs. 65.38% Prevalence of Obesity1 16.9% Obesity Metabolic Syndrome 2 CHILDREN BMI ≥ 30 kg/m with abdominal obesity Overall US Prevalence of Obesity1 COST BURDEN 22.9% PER ADULT WITH OBESITY ANNUAL MEDICAL SPENDING PER CAPITA4 ADULTS $3,976 Overall US Prevalence of Metabolic 5 Syndrome2 MEAN 10-YEAR TOTAL MEDICAL COSTS FOR US ADULTS $40,873 vs. $33,010 4.5% WITH METABOLIC NO METABOLIC SYNDROME SYNDROME CHILDREN Overall US 1 Source: NHANES 2011-2012 Prevalence of Metabolic 2 Source: NHANES 2009-2010 Syndrome3 3 Source: NHANES 1999-2004 4 Source: Medical Expenditure Panel Survey, 2001 5 Source: Curtis et al., 2007 © 2015 The Endocrine Society. All rights reserved. Endocrine Society 2055 L Street NW, Suite 600 Washington, DC 20036 USA Phone: 202.971.3636 Fax: 202.736.9705 endocrine.org Mission Statement of the Acknowledgements For More Information Endocrine Society The production of Endocrine Facts For more information, updates, and The mission of the Endocrine and Figures would not have been the online version of this report, visit: Society is to advance excellence possible without the guidance of: endocrinefacts.org in endocrinology and promote its essential and integrative role Advisory Panel Suggested Citation in scientific discovery, medical Robert A. Vigersky, MD (Chair) The Endocrine Society requests that practice, and human health. Walter Reed National Military this document be cited as follows: Medical Center The Endocrine Society. Endocrine About Endocrine Facts Facts and Figures: Obesity. First and Figures Ursula B. Kaiser, MD Edition. 2015. Endocrine Facts and Figures is a Brigham and Women’s Hospital compendium of epidemiological Disclaimer data and trends related to a Sherita H. Golden, MD, MHS This publication summarizes spectrum of endocrine diseases. Johns Hopkins University current scientific information The data is organized into nine about epidemiology and trends chapters covering the breadth Joanna L. Spencer-Segal, MD, PhD data related to a spectrum of of endocrinology: Adrenal, Bone University of Michigan endocrine diseases. It is not a and Calcium, Cancers and practice guideline or systematic Neoplasias, Cardiovascular and R. Michael Tuttle, MD review. Except when specified, Lipids, Diabetes, Hypothalamic- Memorial Sloan Kettering this publication does not represent Pituitary, Obesity, Thyroid, and Cancer Center the official policy of the Endocrine Reproduction and Development. Society. William F. Young, Jr., MD, MSc All data is sourced from peer- Mayo Clinic © 2015 The Endocrine Society. reviewed publications, with an All rights reserved. This is an additional round of review by a Obesity Expert Reviewers official publication of The Endocrine group of world-renowned experts in George A. Bray, MD Society. No part of this publication the field. Additional oversight from Pennington Biomedical may be reproduced, translated, the Endocrine Facts and Figures Research Center modified, enhanced, and/or Advisory Panel ensured fair and transmitted in any form or by balanced coverage of data across Marc-Andre Cornier, MD any means without the prior the therapeutic areas. University of Colorado written permission of The Endocrine Society. To The first edition ofEndocrine Facts Endocrine Society Staff purchase additional reprints and Figures emphasizes data on the Alison M. Kim, PhD or obtain permissions, e-mail United States. Future updates to the [email protected]. report will include additional data for Lucia D. Tejada, PhD other countries. We also acknowledge the contributions of Nancy Chill, Wendy Sturley, Nikki Deoudes, Beryl Roda, Mary Wessling, and Thomson Reuters. © 2015 The Endocrine Society. All rights reserved. circumference, triglycerides, HDL-cholesterol, blood I OVERVIEW pressure or glucose, as outlined in the 2009 Joint Interim Statement of the International Diabetes Federation Obesity is a complex disease that is associated with Task force on Epidemiology; National Heart, Lung, and a number of comorbidities, increased mortality, and Blood Institute; American Heart Association; World Heart reduced quality of life. Abdominal obesity is one of the Federation; International Atherosclerosis Society; and 4 components of metabolic syndrome (MetS), a cluster of International Association for the Study of Obesity. risk factors that increases an individual’s risk for chronic conditions such as cardiovascular disease and diabetes. MetS in adolescents was defined using the International This chapter details the epidemiology of obesity and MetS Diabetes Federation’s 2007 definition for use in children 6 by age, race, and geographic location and includes data and adolescents. on the direct costs associated with obesity and MetS. 1.2 1.1 COST BURDEN OF DISEASE EPIDEMIOLOGY The direct costs associated with obesity and MetS The following tables summarize the most recently are for the most part estimated through services published data on the prevalence of obesity in US adults rendered, i.e., the costs of treating the attributable and children, and MetS in US adults. In all cases, data consequences of illnesses and comorbidities, as well from the National Health and Nutrition Examination Survey as those costs recorded by healthcare and insurance (NHANES) was used. providers. Importantly, there are additional costs that are more difficult to estimate, such as absenteeism MetS in adults is defined as abnormal values for three and lost productivity. or more of the harmonized criteria, including waist Table 1 Prevalence of adult overweight and obesity in the United States. OVERWEIGHT OBESITY EXTREME OBESITY SOURCE POPULATION BMI ≥ 25 KG/M2 BMI ≥ 30 KG/M2 BMI ≥ 40 KG/M2 NHANES 2011-2012 Age 20+ years 33.9% 35.1% 6.4% Source: Fryar et al. 20141 Table 2 Prevalence of childhood overweight and obesity in the United States. OVERWEIGHT OBESITY SOURCE POPULATION BMI FOR AGE ≥ 85TH PERCENTILE BMI FOR AGE ≥ 95TH PERCENTILE NHANES 2011-2012 Age 2-19 years 31.8% 16.9% Source: Ogden et al. 20142 Table 3 Table 4 Prevalence of metabolic syndrome in adults in the United States. Prevalence of metabolic syndrome in adolescents in the METABOLIC United States. SOURCE POPULATION SYNDROME METABOLIC NHANES 2009-2010 Age 20+ years 22.9% SOURCE POPULATION SYNDROME Source: Beltran-Sanchez et al. 20133 NHANES 1999-2004 Age 12-19 years 4.5% Source: Ford et al. 20085 © 2015 The Endocrine Society. All rights reserved. ENDOCRINE SOCIETY | 1 1.2.1 reliance on self-reporting by survey respondents.9 For Cost of Obesity in Adults comparison, an analysis of actual costs in the Medicare Patients with obesity are more susceptible to chronic population is provided in Table 7. illnesses, thus contributing to increases in medical spending. While the available estimates of cost burden With the rise in obesity among the older adult population, vary based on data sources used, assumptions made, the cost burden is predicted to increase substantially: and mathematical methods applied7, the vast majority of the combined medical costs associated with treatment studies agree that patients with obesity spend more on of obesity-related diseases, cardiovascular diseases, and medical care than their normal weight counterparts. diabetes in the US alone have been estimated to increase by $48-66 billion/year from 2010 through 2030.11 Apart Thorpe et al. reported that 27% of the overall growth in from medical costs, the associated losses in productivity per-capita spending between 1987-2001 was attributable need to be accounted for. According to a cross-sectional to increases in the prevalence of obesity (Table 5).8 analysis of the Agency for Healthcare Research and Alternative estimates have been posited by others, Quality’s 2006 MEPS and the 2008 Health and Wellness such as the incremental cost of overweight and obesity Survey that calculated the annual cost attributable to based on a systematic review of over thirty studies of US obesity among full-time employees, the cost of obesity populations (Table 6).7 in the workplace is estimated to be $73.1 billion.12 That increase in cost is attributed to increased health-related It has been suggested that the Medical Expenditure Panel work limitations: the time needed to complete tasks and Surveys (MEPS) underestimate spending due to their an inability to perform physical job demands.13 As a result, Table 5 Annual medical spending per capita in adults who are overweight or have obesity. ANNUAL MEDICAL SPENDING PER CAPITA DATA SOURCE POPULATION NORMAL OVERWEIGHT OBESITY National Medical Expenditure Survey, 1987 US adults age 19+ years $2,117 $2,154 $2,438 Medical Expenditure Panel Survey-Household Component, 2001 US adults age 19+ years $2,907 $3,247 $3,976 Source: Thorpe et al. 20048 Table 6 Estimated incremental cost of obesity in US adults (in 2008 US dollars). INCREMENTAL COST DATA SOURCE POPULATION OVERWEIGHT OBESITY Systematic review of 33 US-based studies published between 1992-2008 US adults age 18+ years $266-$498 $1,630-1,723 Source: Tsai et al. 20117 Table 7 Excess annual expenditures by US Medicare beneficiaries with overweight or obesity. ANNUAL INCREMENTAL MEDICARE EXPENDITURES COMPARED TO NORMAL-WEIGHT BENEFICIARIES DATA SOURCE POPULATION OVERWEIGHT OBESITY Medicare Current Beneficiary Survey, 1997-2006 US adults 65 years and older $108 $149 Source: Alley et al. 201210 2 | OBESITY © 2015 The Endocrine Society. All rights reserved. workers with obesity experienced a 4.2% health-related prescription drug, emergency room, and outpatient loss in productivity, 1.2% more than all other employees. visit costs annually.15 1.2.2 1.2.3 Cost of Obesity in Children Cost of Metabolic Syndrome Using these cost estimates multiplied by the number of Due to the complex nature of MetS, treatment costs 10-year-old children with obesity in May 2013, Finkelstein attributable to any one of its components are difficult et al. proposed a total direct medical cost of obesity of to quantify. Recent data suggest, however, that the $14 billion for this age group alone.
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