Obesity in Late Adolescence and Healthcare Costs in Young to Mid-Adulthood

The global prevalence of obesity has more than doubled between 1990 and 2022, making it a significant public health concern. Obesity is associated with an increased risk of various complications, including cardiovascular diseases, type 2 diabetes, as well as increased risk for all-cause mortality. Existing research also indicates that higher BMI is linked to increased healthcare costs, but most evidence comes from cross-sectional studies and older populations. The present study aims to estimate the direct healthcare cost of obesity from late adolescence through mid-adulthood.

The study included a national cohort of 496 404 conscripts for mandatory military service that underwent medical evaluation at age 17. Study participants were retrospectively followed for hospitalization days and total healthcare costs at ages 35, 45 and 55 using data from a large national healthcare provider. Direct medical costs were standardized using gross domestic product (GDP) inflation rates and purchasing power parity. Analyses were adjusted for sex and socioeconomic status.

Higher BMI categories in adolescence were associated with increased hospitalization rates and total healthcare costs across all follow-up ages. At age 45, individuals with obesity class I and class II/III had 1.65-fold and 1.62-fold higher costs, respectively, compared to those with normal BMI. This association was stronger among males.

The correlation between obesity in adolescence and higher medical costs is evident already in early-and-mid-adulthood. The study underscores the need for comprehensive approaches targeting adolescents to reduce long-term healthcare costs and improve population health outcomes.