James Lightwood ^1*, Kirsten Bibbins-Domingo ², Pamela Coxson ², Y. Claire Wang ³, Lawrence Williams ⁴, Lee Goldman ⁵

¹ School of Pharmacy, University of California, San Francisco
² Department of Medicine, University of California, San Francisco
³ Columbia Mailman School of Public Health, New York, NY
⁴ Partners Health Organization
⁵ Columbia University Medical Center, New York, NY

^* To whom correspondence should be addressed. E-mail: lightwoodj{at}pharmacy.ucsf.edu.

	Abstract

Objectives. We predicted the future economic burden attributable to high rates of current adolescent overweight.

Methods. We constructed models to simulate the costs of excess obesity and associated diabetes and coronary heart disease (CHD) among adults aged 35–64 years in the US population in 2020 to 2050.

Results. Current adolescent overweight is projected to result in 161 million life-years complicated by obesity, diabetes, or CHD and 1.5 million life-years lost. The cumulative excess attributable total costs are estimated at $254 billion: $208 billion because of lost productivity from earlier death or morbidity and $46 billion from direct medical costs. Currently available therapies for hypertension, hyperlipidemia, and diabetes, used according to guidelines, if applied in the future, would result in modest reductions in excess mortality (decreased to 1.1 million life-years lost) but increase total excess costs by another $7 billion (increased to $261 billion total).

Conclusions. Current adolescent overweight will likely lead to large future economic and health burdens, especially lost productivity from premature death and disability. Application of currently available medical treatments will not greatly reduce these future burdens of increased adult obesity.

Key Words: Cardiovascular Disease, Diabetes, Health Policy, Obesity, Overweight, Underweight, Prevention