VARIATION IN OBESITY BURDEN, MULTIMORBIDITY, AND HEALTHCARE COSTS ACROSS OBESITY CLASS, SEX, AND RACE/ETHNICITY IN THE UNITED STATES
Author(s)
Molly A. Plotkin, MSc1, Briain O Hartaigh, PhD1, Michelle Cardel, PhD1, Grace Mountain, MSc2, Sara Holloway, DipHE2, Jonathan Pearson-Stuttard, MA, MSc, PhD, MD2.
1Kailera Therapeutics, Waltham, MA, USA, 2Lane Clark & Peacock LLP, London, United Kingdom.
1Kailera Therapeutics, Waltham, MA, USA, 2Lane Clark & Peacock LLP, London, United Kingdom.
OBJECTIVES: To quantify disparities in obesity burden, obesity-related complications (ORCs), and healthcare resource utilization (HCRU) costs by obesity class, sex, and race/ethnicity among US adults.
METHODS: We conducted an analysis of 2017-2020 National Health and Nutrition Examination Survey data. Obesity prevalence was estimated by body mass index (BMI) class I, II, and III overall and by sex and race/ethnicity. Nine ORCs were assessed. For each subgroup, we estimated ORC prevalence, ORC multimorbidity (MM; 0, 1, 2, or 3+ ORCs), and HCRU costs.
RESULTS: The weighted sample represented 101,342,006 US adults. Class III obesity was more prevalent among females than males (11.3% vs 6.3%) and was highest among Black adults (13.9%). ORC burden and MM increased with obesity class. Among males, all ORCs except prediabetes were more prevalent in class III obesity versus class I; the largest difference was observed for obstructive sleep apnea (OSA) (30.0% vs 15.7%). Among females, most ORCs were more prevalent in class III than class I, most notably OSA (14.9% vs 8.3%) and depression (15.1% vs 11.0%). In classes II and III, hypertension prevalence was highest among Black males (62.5%, 57.1%) and Black females (55.7%, 60.5%). MM 3+ ORC prevalence in males increased from 39.9% in class I to 51.9% in class III. Classes II and III accounted for a disproportionately larger share of HCRU costs, accounting for 51.8% of total cost ($1.05tn) while representing only 47.9% of the obesity population. The total cost of obesity class III among Black females was higher than class I ($35.5bn vs $34.6bn) despite the class III population being 16% smaller than class I.
CONCLUSIONS: Obesity burden varied substantially by obesity class, sex, and race/ethnicity. Higher obesity class was associated with greater ORC burden, MM, and disproportionate HCRU costs, particularly among Black females. These findings may inform targeted healthcare planning and resource allocation.
METHODS: We conducted an analysis of 2017-2020 National Health and Nutrition Examination Survey data. Obesity prevalence was estimated by body mass index (BMI) class I, II, and III overall and by sex and race/ethnicity. Nine ORCs were assessed. For each subgroup, we estimated ORC prevalence, ORC multimorbidity (MM; 0, 1, 2, or 3+ ORCs), and HCRU costs.
RESULTS: The weighted sample represented 101,342,006 US adults. Class III obesity was more prevalent among females than males (11.3% vs 6.3%) and was highest among Black adults (13.9%). ORC burden and MM increased with obesity class. Among males, all ORCs except prediabetes were more prevalent in class III obesity versus class I; the largest difference was observed for obstructive sleep apnea (OSA) (30.0% vs 15.7%). Among females, most ORCs were more prevalent in class III than class I, most notably OSA (14.9% vs 8.3%) and depression (15.1% vs 11.0%). In classes II and III, hypertension prevalence was highest among Black males (62.5%, 57.1%) and Black females (55.7%, 60.5%). MM 3+ ORC prevalence in males increased from 39.9% in class I to 51.9% in class III. Classes II and III accounted for a disproportionately larger share of HCRU costs, accounting for 51.8% of total cost ($1.05tn) while representing only 47.9% of the obesity population. The total cost of obesity class III among Black females was higher than class I ($35.5bn vs $34.6bn) despite the class III population being 16% smaller than class I.
CONCLUSIONS: Obesity burden varied substantially by obesity class, sex, and race/ethnicity. Higher obesity class was associated with greater ORC burden, MM, and disproportionate HCRU costs, particularly among Black females. These findings may inform targeted healthcare planning and resource allocation.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH216
Topic
Epidemiology & Public Health
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)