James P. Moriarty, MSc, and colleagues of the Mayo Clinic in Rochester, Minn., analyzed the incremental costs of smoking and obesity among Mayo Clinic employees and retirees who had continuous health insurance coverage between 2001 and 2007. They found that both obesity and smoking were associated with excess health care costs.
Smokers, for example, carried average health costs that were $1,275 higher than those for non-smokers. But the incremental costs associated with obesity were even higher: $1,850 more than for normal-weight individuals. For those with morbid obesity, the excess costs added up to $5,500 per year. (According to the Mayo Clinic, individuals with a body mass index, or BMI, of 30 or higher are obese; those with a BMI of 40 and higher suffer from extreme, or morbid, obesity.)
Furthermore, the additional costs associated with obesity appeared lower after adjustment for other accompanying health problems.
"This may lead to underestimation of the true incremental costs, since obesity is a risk factor for developing chronic conditions," Moriarty and colleagues explained.
According to the World Health Organization (WHO), obesity worldwide has more than doubled since 1980. Smoking and obesity place a growing strain on an already stretched healthcare system, which is causing some employers to consider wellness programs – including smoking cessation and fitness programs – in an attempt to lower costs by reducing health risk factors.
The study, which was published in the March issue of Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM), provides new insights into the long-term costs of obesity and smoking, showing that both risk factors lead to persistently higher health costs throughout a 7-year follow-up period.
