The costs of body mass index levels in an employed population

We studied 3,066 First Chicago NBD employees by using health risk appraisals and personnel data to determine the direct and indirect costs (in 1996 dollars) associated with varying levels of body mass index (BMI). The BMI is the most widely used measure of weight adjusted by height. We found that as BMI increases, so do the number of sick days, medical claims and health care costs and that the mean annual health care costs for the BMI "at risk" population (men with a BMI of > or = 27.8 kg/m2, women > or = 27.3 kg/m2) was $2,274 versus $1,499 for the "not at risk" group. Major differences in health care costs were observed for employees 45 years old and older, particularly among the women in this age group. Analysis was completed for those employees with and without a risk for BMI. A "J-shaped" curve between medical claims costs and BMI exists, with the low point occurring at about 25 to 27 kg/m2. We conclude that indirect and direct costs to an employer increase with increasing BMI. Employers may benefit from helping employees achieve a healthier weight. The initial target population should be those who are at highest risk of complications from obesity.