People who are obese have higher demands for medical care than those of the normal weight people. However, in view of their shorter life expectancy, it is unclear whether obese people have higher lifetime medical expenditure. We examined the association between body mass index, life expectancy and lifetime medical expenditure.
Prospective cohort study using individual data from the Ohsaki Cohort Study.
Miyagi Prefecture, northeastern Japan.
The 41 965 participants aged 40–79 years.
Primary and secondary outcome measures
The life expectancy and lifetime medical expenditure aged from 40 years.
In spite of their shorter life expectancy, obese participants might require higher medical expenditure than normal weight participants. In men aged 40 years, multiadjusted life expectancy for those who were obese participants was 41.4 years (95% CI 38.28 to 44.70), which was 1.7 years non-significantly shorter than that for normal weight participants (p=0.3184). Multiadjusted lifetime medical expenditure for obese participants was £112 858.9 (94 954.1–131 840.9), being 14.7% non-significantly higher than that for normal weight participants (p=0.1141). In women aged 40 years, multiadjusted life expectancy for those who were obese participants was 49.2 years (46.14–52.59), which was 3.1 years non-significantly shorter than for normal weight participants (p=0.0724), and multiadjusted lifetime medical expenditure was £137 765.9 (123 672.9–152 970.2), being 21.6% significantly higher (p=0.0005).
According to the point estimate, lifetime medical expenditure might appear to be higher for obese participants, despite their short life expectancy. With weight control, more people would enjoy their longevity with lower demands for medical care.
Obese people have higher needs and demands for medical care.
Obesity is associated with an increased risk of mortality.
In view of the decreased life expectancy in obese participants, it is unclear whether lifetime medical expenditure increases or decreases as a result.
In spite of their short life expectancy, obese men and women had approximately 14.7% and 21.6% higher lifetime medical expenditure in comparison with normal weight participants, respectively.
With better weight control, more people would enjoy their longevity with lower needs and demands for medical care.
Strengths and limitations of this study
This is the first study to have investigated the association between body mass index, life expectancy and lifetime medical expenditure calculated from individual medical expenditure and mortality data over a long period in a general population.
There was a limit to the accurate estimation of life expectancy and lifetime medical expenditure for obese participants because the Japanese population has a low prevalence of body mass index≥30.0 kg/m2.