4.1 Article

Methodological Challenges in Estimating the Lifetime Medical Care Cost Externality of Obesity

Journal

JOURNAL OF BENEFIT-COST ANALYSIS
Volume 12, Issue 3, Pages 441-465

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/bca.2021.6

Keywords

cost-effectiveness; economic analysis; health policy; medical care; obesity; public health

Categories

Funding

  1. NIH
  2. NIA as a T32 training grant [T32AG000246]

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Estimations of the lifetime medical care cost externality of obesity vary greatly due to factors like age-related weight gain, differential life expectancy, identifiability, and cost model selection. This study emphasizes the importance of considering age-related weight gain in cost estimates and aims to provide future researchers with the best methods and data for estimating obesity's lifetime external medical care costs accurately.
There is a great deal of variability in estimates of the lifetime medical care cost externality of obesity, partly due to a lack of transparency in the methodology behind these cost models. Several important factors must be considered in producing the best possible estimate, including age-related weight gain, differential life expectancy, identifiability, and cost model selection. In particular, age-related weight gain represents an important new component to recent cost estimates. Without accounting for age-related weight gain, a study relies on the untenable assumption that people remain the same weight throughout their lives, leading to a fundamental misunderstanding of the evolution and development of the obesity crisis. This study seeks to inform future researchers on the best methods and data available both to estimate age-related weight gain and to accurately and consistently estimate obesity's lifetime external medical care costs. This should help both to create a more standardized approach to cost estimation as well as encourage more transparency between all parties interested in the question of obesity's lifetime cost and, ultimately, evaluating the benefits and costs of interventions targeting obesity at various points in the life course.

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