[Cost of obesity in France]

To estimate the costs associated with obesity in France.

We used data from the 2002 survey on health and social protection as well as health care consumption data from the EPAS sample of the national health insurance funds. After excluding those younger than 18 years, pregnant women and people diagnosed with cancer, we classified subjects as underweight, normal weight, or obese and then studied two subpopulations: (P1) obese patients (body mass index (BMI) >or= 30 kg/m2) and (P2) patients who were obese or overweight (BMI >or= 27 kg/m2) and had additional cardiovascular risk factors: hypertension, dyslipidemia, type 2 diabetes, myocardial infarction (present or history), transient ischemic attack, intermittent claudication or sleep apnea. The Heckman approach was used to adjust for several factors.

The study included 4651 individuals, with a mean age was 47 years. The obesity prevalence rate was estimated at 10.7% for P1; the P2 prevalence was 16.0%. Average healthcare costs for the entire study group were 1534 euro, 1105 euro for ambulatory care (72%) and 429 euro (28%) for inpatient care. Costs for obese subjects (P1 and P2) averaged 2500 euro, twice the costs for normal-weight people (1263 euro). After taking into account age, sex, socioeconomic status, alcohol consumption and smoking, the 100% reimbursement rate for chronic diseases (all else being equal), the extra cost of obesity, compared with normal weight, was estimated between 506 euro (P1) and 648 euro (P2).

The annual total cost of obesity was estimated to range from 2.1 to 6.2 billion euros in 2002 and account for 1.5 to 4.6% of total health expenditures in France.