Economic costs of obesity to self-insured employers

OBJECTIVE:: To quantify the direct and indirect costs of obesity within a cohort of commercially insured employees in the United States. METHOD:: Health plan claims, self-reported health risk assessment, and productivity data (Thomson MarketScan) from 2003 to 2005 were used to identify employees. Two-part regression models were used to compare body mass index (BMI) groups to estimate the incremental direct and indirect costs, conditional on expenditure, associated with elevated BMI. RESULTS:: Regression-adjusted incremental direct medical costs associated with being overweight, obese, and severely obese were estimated to be $147.11, $712.34, and $1977.43, respectively. Adjusted incremental indirect costs due to paid absence associated with being overweight, obese, and severely obese were estimated at $1403.81, $1511.24, and $1414.09, respectively. CONCLUSIONS:: Overall adjusted direct and indirect costs were higher for workers with elevated BMI relative to those of normal weight.