The 25-Year Health Care Costs of Women Who Remain Overweight After 40 Years of Age

Previously published reports strongly suggest that being overweight is a risk factor for coronary heart disease, hypertension, diabetes, gallstones, and osteoarthritis in women. Substantial health care and medication costs are associated with these chronic health conditions. We used an incidence-based analysis to estimate the excess costs associated with women maintaining an overweight status during the 25-year period from age 40 to 65 years. The health care costs of three hypothetical cohorts of 10,000 40-year-old women were extrapolated to age 65. The non-overweight cohort maintained a body mass index (BMI; weight [kg]/height [m2]) of 21 to 24.9; the moderately overweight cohort maintained a BMI of 25 to 28.9; the severely overweight cohort maintained a BMI of >29. The number of fatal and nonfatal health outcomes in each cohort for heart disease, hypertension, diabetes mellitus, gallstones, anti osteoarthritis was calculated with their associated costs. We estimated that when compared with the nonoverweight cohort of 10,000 women, the cohort of 10,000 women who had a BMI of >29 incurred excess costs of $53 million over a 25 year period (discounted at 3% per year) and 497 excess deaths. The cohort of 10,000 women who had a BMI of 25-28.9 incurred excess costs of $22 million (discounted at 3% per year) and 212 excess deaths, compared with the nonoverweight cohort. The results of this study indicate that an estimated $16 billion will be spent during the next 25 years treating health outcomes associated with overweight in middle-aged women in the United States. Thus, a substantial health burden is associated with the increasing prevalence of overweight women in the United States. Preventing excess coronary heart disease, gallstones, osteoarthritis, hypertension, and diabetes through prevention of weight gain, particularly among reproductive-aged women, may be a cost-effective strategy.