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Posted: February 19, 2008

Here's a Switch: Health Costs Are Lower for Fat People than Thin Patients

If you think you’ve heard the last word about the health hazards of obesity, here’s a fact that may whet your appetite: while avoiding obesity and stopping smoking saves lives, it doesn’t save a dime on healthcare expenditures, despite the common assumption that it does, according to a new study.
In fact, the Dutch study reported, it costs more to care for healthy people, in general, who live longer than their unhealthy – too often overweight, or obese – counterparts, thus upsetting a generally held belief that preventing obesity would provide governments with huge financial savings through lower public-health costs.
The study, led by Pieter van Baal, an economist at the Netherlands' National Institute for Public Health and the Environment, found that the healthcare costs of smokers or obese patients were less than costs for trim healthy people. Conclusions were based on 2003 cost-of-illness data in the Netherlands that was tested against a simulated costing model built by van Baal and colleagues.
The economists reported in the journal Public Library of Science Medicine that from age 20 to 56, health costs were the steepest for those who were obese.  The reasons were varied, but they included the fact that both smokers and the obese in the model died sooner than the healthy group, cutting the long-term health costs in comparison to the healthier, longer-living group.
Data showed that, on average, healthy people lived 84 years, while smokers lived about 77 years, and obese people lived 80 years. Smokers and overweight subjects in the model also tended to have more heart disease than those who were healthy.
In dollars and cents, the comparison stacked up this way: lifetime medical care for those who were trim and healthy cost the most, about $417,000, after age 20 until death; obese people cost $371,000 in medical care and smokers averaged about $326,000.
While the statistics provided economists and government officials with interesting data points on healthcare costs, van Baal said his research remained a “bookkeeping exercise” and that governments should look beyond the data points to the medical benefits of attacking and preventing both smoking and obesity in the population.
The study, which was underwritten by the Dutch Ministry of Health, Welfare and Sports, did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs.
"We are not recommending that governments stop trying to prevent obesity," van Baal said. "But they should do it for the right reasons."

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