Estimated Reduction in Health Care Spending Associated With Weight Loss in Adults

Recent data from federal surveys show that more than 70% of adults have either overweight or obesity. Overweight and obesity are associated with several expensive chronic conditions, such as type 2 diabetes, heart disease, hypertension, and hyperlipidemia. The prevalence of chronic disease is a key driver of rising health care spending among employers and the Medicare program.

To estimate health care spending among adults with overweight or obesity and have employer-sponsored insurance or Medicare and examine the association of higher and lower body mass index (BMI).

This cross-sectional study included privately insured adults and adult Medicare beneficiaries with a BMI of 25 and higher. Data from the Medical Expenditure Panel Survey-Household Component were used to tabulate total annual health care spending. Data were analyzed from April 1 to June 20, 2024.

The primary intended measures were total annual health care spending, controlling for patient demographics, income, education, and BMI. The baseline health care spending as a percentage reduction in BMI. An instrumental variable regression model with estimated total spending at various levels of BMI was used.

This study included 3774 adults who were insured with Medicare (mean [SD] age, 63.1 [11.1] years; mean [SD] percentage female, 50.4% [49.7%]; mean [SD] percentage non-Hispanic Black adults, 17.4% [37.7%]; mean [SD] percentage non-Hispanic White adults, 61.3% [48.4%]). The study also included 13 435 adults who had employer-sponsored insurance (mean [SD] age, 46.3 [6.9] years; mean [SD] percentage female, 47.6% [48.9%]; mean [SD] percentage non-Hispanic Black adults, 11.1% [30.7%]; mean [SD] percentage non-Hispanic White adults, 73.1% [43.4%]). Overall, adults with employer-sponsored insurance with a weight loss of 5% were estimated to spend a mean of $670 (95% CI, $654-$686) less on health care (8% less), and those with a weight loss of 25% spent an estimated mean of $2849 (95% CI, $2783-$2916) less on health care (34% less). Among adults with Medicare who had 1 or more comorbid conditions, a 5% weight loss was estimated to reduce spending by $1262 (95% CI, $1217-$1306) (7% less) and a 25% weight loss was estimated to reduce health care spending by a mean of $5442 (95% CI, $5254-$5629) (31% less).

In this cross-sectional study, projected annual savings from weight loss among US adults with obesity were substantial for both Medicare and employer-based insurance.