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Christina C. Wee, MD, MPH, Russell S. Phillips, MD, Anna T. R. Legedza, ScD, Roger B. Davis, ScD, Jane R. Soukup, MS, Graham A. Colditz, MD, DrPH and Mary Beth Hamel, MD, MPH

Christina C. Wee, Russell S. Phillips, Anna T. R. Legedza, Roger B. Davis, Jane R. Soukup, and MaryBeth Hamel are with the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass. Graham A. Colditz is with the Channing Laboratory, Brigham and Women’s Hospital and Harvard Medical School.

Correspondence: Requests for reprints should be sent to Christina C. Wee, MD, MPH, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215 (email: cweekuo{at}bidmc.harvard.edu).

Objectives. We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender.

Methods. Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI.

Results. Overall, the mean per capita annual health care expenditure (converted to December 2003 dollars) was $3338 before adjustment. While the adjusted expenditure was $2127 (90% confidence interval [CI]=$1927, $2362) for a typical normal-weight White woman aged 35 to 44 years, expenditures were $2358 (90% CI=$2128, $2604) for women with BMIs of 25 to 29.9 kg/m², $2873 (90% CI=$2530, $3236) for women with BMIs of 30 to 34.9 kg/m², $3058 (90% CI=$2529, $3630) for women with BMIs of 35 to 39.9 kg/m², and $3506 (90% CI=$2912, $4228) for women with BMIs of 40 kg/m² or higher. Expenditures related to higher BMI rose dramatically among White and older adults but not among Blacks or those younger than 35 years. We found no interaction between BMI and gender.

Conclusions. Health care costs associated with overweight and obesity are substantial and vary according to race and age.

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