Background

Obesity imposes significant economic tolls on the US, incurring $1.72 trillion in direct and indirect cost. Although long-term value of weight loss (WL) is well documented, short-term value of WL and sustained WL remains understudied. We aim to assess short-term impact of nonsurgical WL and sustained WL on per-member-per-month (PMPM) healthcare cost in adults with obesity in the US.

Methods

We analyzed the Truven-Explorys Linked Claims-EMR Database (2012-2018). Adults aged 18-64 with a body mass index (BMI)≥30 kg/m2 on index date and BMIs measured at 12, 24, and 36 months were classified into weight gain (WG, ≥3%), weight maintenance (WM, within ±3%), and WL (3-5, 5-10, and 10-20% WL respectively) based on change from 1st to 2nd BMI (“baseline period”) and sustained WL (WL in baseline and <3% WG from 2nd to 3rd BMI). PMPM healthcare costs were calculated for baseline, 1st and 2nd year of follow-up (FU1, FU2). Generalized linear models were used to examine if PMPM cost change (ΔPMPM) from baseline to FU1 in WL groups and that from baseline to FU2 in sustained WL groups differed significantly from WM.

Results

The sample included 20,488 adults: 24.8% WG, 56.6% WM, and 8.2, 7.7, and 2.8% with 3-5, 5-10, and 10-20% WL respectively. Compared to WM, adjusted mean ΔPMPM cost from baseline to FU1 was lower in all WL groups (-$57.36, -$135.35, and -$193.54 for 3-5, 5-10, and 10-20% WL respectively, p<0.05 for the last two), and that from baseline to FU2 was lower in all sustained WL groups (-$26.38, -$157.41, and -$185.41 for 3-5, 5-10, and 10-20% WL respectively, p<0.05 for 5-10% WL). Larger cost reduction was seen in larger magnitude of WL and sustained WL.

Conclusions

Substantial healthcare cost savings were achieved with nonsurgical WL and sustained WL in adults with obesity. Greater magnitude of WL and sustained WL was associated with greater cost savings. Comprehensive solutions to chronic weight management including better access to obesity medications could be of value to employers and payers.