Alarm about the increasing prevalence of overweight and obesity in the United States in recent years (54, 55) centers on the link between obesity and increased health risks (42, 56), which translates into increased medical care and disability costs. (46, 57). The total cost attributable to obesity amounted to $99.2 billion in 1995. Approximately $51.6 billion of these dollars were direct medical costs associated with diseases attributable to obesity. The direct costs also associated with obesity represent 5.7 percent of the national health expenditure within the United States (58). The indirect costs attributable to obesity are $47.6 billion and are comparable to the economic costs of cigarette smoking (58, 59). Indirect costs represent the value of lost output caused by morbidity and mortality, and may have a greater impact than direct costs at the personal and societal levels (58).
Although a comprehensive cost analysis of obesity is beyond the scope of this panel, a systematic review of the literature identified studies estimating the current economic burden of obesity in several Western countries (57, 60-63). Published estimates of the economic costs of obesity such as those noted above use the prevalence-based approach, assuming that obesity is causally related to a range of chronic illnesses. Estimating the economic benefits of weight loss requires details of long-term weight maintenance and the time course of risk reduction following weight loss, and ultimately must also consider the costs of treatment to reduce weight.