Clinical and Economic Burden of Obesity Among Hospitalized Patients in the United States

OBJECTIVES: Obesity (body mass index [BMI] ≥ 30kg/m²) affects over one third of United States adult population and is associated with increased risk of cardiovascular diseases, cancer and diabetes. This study aimed to describe the clinical and economic burden of obesity among hospitalized patients.

METHODS: A retrospective cross-sectional study was performed for hospitalized adult patients discharged from geographically diverse US hospitals in the PINC AI Healthcare Database with a height and weight information and discharged between 01/01/2019 and 12/31/2023. Pregnant patients were excluded.

RESULTS: Among 1,476,205 patients, average age was 62 years, 49.6% were men, 77.3% were white, 12.6% were black, and 10.2% were Hispanic. Prevalences of patients with overweight and obesity were 29.5% (n=435,499) and 38.2% (n=564,403), respectively; among patients with obesity, 50.6% had class 1 (BMI between 30-35kg/m²), 25.7% had class II (BMI between 35-40kg/m²), and 23.7% had class III obesity (BMI ≥ 40kg/m²). Most common comorbidity among patients with obesity was diabetes (39.5%), followed by renal disease (30.3%) and chronic pulmonary disease (26.0%). Patients with obesity were younger (mean age 59.8 vs. 63.7 years) and more likely to be women (54.2% vs. 49.4%) compared to patients with normal weight (both p<0.001). Proportion of patients requiring an intensive care unit stay was higher among patients with obesity (19.6%) compared to patients with normal weight (18.0%, p<0.001) and a wider difference was observed among patients who were 75 years or older (19.1% vs. 16.2%, p<0.001). Median costs (in 2023 USD) during hospitalization ($12,510 vs. $11,253) and hospitalization plus 30-day follow-up ($13,856 vs. $12,693) were higher for patients with obesity compared to patients with normal weight (both p<0.001).

CONCLUSIONS: Obesity is a prevalent condition among hospitalized patients and is associated with a higher healthcare cost. Improved management of obesity can be beneficial for reducing healthcare cost.