Preventing Obesity and Its Consequences: Highlights of RAND Health Research

How Does Obesity Affect Health— and Health Spending? Extensive research has shown that obesity increases the risk—or worsens the prognosis— for a variety of diseases, including diabetes, heart disease, cancer, and arthritis. Indeed, in 2002, RAND research showed that the health consequences of obesity are worse than those of smoking and problem drinking (Sturm, 2002). Obesity increases health care costs by 25 to 100 percent over the costs of persons of normal weight (Sturm, 2002; Andreyeva, Sturm, and Ringel, 2004). A recent RAND study showed that lowering obesity rates to their 1978 level by 2030 would decrease rates of diabetes, hypertension, and heart disease; increase longevity and years of disability-free life; and decrease Medicare and Medicaid costs (Goldman et al., 2010). Several recent RAND studies have looked at other health implications of obesity or its treatment. Obesity has been associated with poorer breast cancer survival. RAND Health researchers found that obese women who develop breast cancer risk receive inadequate treatment with adjuvant chemotherapy—the drug doses are supposed to be adjusted for body weight but often are not adjusted adequately (Griggs et al., 2007). More recently, some of the same team found that obese women who develop invasive breast cancer are at higher risk than thinner women for invasion of the lymph nodes, which worsens the prognosis (Gillespie et al., 2010). Researchers in the Southern California Evidence-Based Practice Center at RAND conducted an exhaustive review of how weight loss surgery affected the health of women of childbearing age. Obese women have a more difficult time getting pregnant than thinner women, have more pregnancy complications (such as gestational diabetes), and face greater risks of having babies with congenital problems. The researchers expected the surgery to have negative health consequences for infants, and possibly mothers as well, because the surgery reduces nutrient intake. Instead, they found that the women had healthier babies and a lower risk of gestational diabetes (Maggard et al., 2008).