Maastricht Centre

ECO2022: The Burden of Neglecting Obesity Care

One of the most interesting obesity conferences of the year is getting started this week. ECO2022 brings together a nice mix of science and policy with a balance that’s refreshing. So it’s fitting that the opening story is all about the burden of neglecting clinical care for obesity.

In this case, the headline research from the meeting illustrates a basic understanding of human outcomes – the 80/20 rule. In many different domains, 20 percent of inputs account for roughly 80 percent of outcomes. Thus, it’s illuminating, but not surprising, to learn that research from ECO2022 shows that three quarters of the economic burden of obesity comes from the 20 percent of the cases that are most costly.

This is the burden of systemic bias that denies people access to good obesity care.

Five Analyses of U.S. Obesity Costs

Marc Evans and Jonathan Pearson-Stuttard are presenting the findings of five studies regarding health costs arising from obesity. They examined data from 28,583 U.S. patients living with obesity. They obtained their data from IQVIA medical records and administrative claims databases. Their analyses include subjects with continuous data from eight years – as early 2007 and as recent as 2020. They excluded patients with pregnancy or cancer at baseline. All of them had a BMI over 30, ranging up to 70.

Their findings were quite clear and consistent with the 80/20 rule:

“We found that at least three quarters of the total direct healthcare costs in people with obesity in US clinical practice came from 20% of individuals. People in the high-cost category of obesity had substantially more obesity related-complications than people in the low-cost category, suggesting a clear association between obesity-related complications and economic burden.”

The Stupidity of a Systemic Bias to Deny Care

People living with obesity live in a world that systematically discounts their health and their lives. It is so pervasive that many people learn to ignore it for the sake of their mental health. It’s not so different from living next to an airport. Beyond a certain point, one doesn’t hear the planes anymore. Background noise.

But that background noise has a cost. In fact, that’s the cost showing up in the data of Evans and Pearson-Stuttard. Pay now or pay later. The cost of neglecting and actually denying access to good clinical care for obesity is a crushing burden of chronic diseases.

This is a dysfunctional system that needs repair. Without that, we will never overcome the health burden of obesity.

Click here and here for further perspective on this important research.

Maastricht Centre, painting by Philippe van Gulpen / Wikimedia Commons

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


May 3, 2022