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

Importance: 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. Objective: 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). Design, Setting, and Participants: 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. Main Outcomes and Measures: 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. Results: 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). Conclusions and Relevance: 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.