"Adults with obesity in the United States compared with those with normal weight experienced higher annual medical care costs by $2,505 or 100%, with costs increasing significantly with class of obesity, from 68.4% for class 1 to 233.6% for class 3. The effects of obesity raised costs in every category of care: inpatient, outpatient, and prescription drugs. Increases in medical expenditures due to obesity were higher for adults covered by public health insurance programs ($2,868) than for those having private health insurance ($2,058)."
I don't think that study (coincidentally from the maker's of semaglutide!) is answering quite the same question I'm asking, since it only looked at people aged 20-65 that were still alive without considering the difference in average lifespan.
If an obese person's healthcare costs an extra $2,000 annually for each of the age years covered in the study, that's $90,000 over their lifetime (ignoring inflation/time value of money to keep the numbers simple). But older people tend to have disproportionately higher healthcare costs.
To be kinda crass: If hypothetically obese people die at the age of 70 instead of 75, those 5 years of health care they don't need might have cost more than $90,000. Just a few ER or ICU visits can exceed that $90,000 amount, and the gap gets even starker if you take into account things like long term care and assisted living.
Another way to look at it, even staying within the 20-65 age group, is as a form of survivorship bias (or maybe there's a better term? Seems kinda bayesian but my stats days are well behind me)
For an extreme example, pretend that some adults take up the hobby of BASE jumping, and I have a study showing that their healthcare costs $10,000 per year, vs only $5,000/yr for non-base jumpers. A non-basejumping adult only needs $225k of healthcare before they become a senior citizen, but a basejumper needs $450k! So basejumping increases overall costs in the healthcare system, right?
But wait! BASE jumping is a dangerous activity (hence the medical bills), and many BASE jumpers die young. Let's say that every year 5% of BASE jumpers have fatal accidents, which means that the average base jumper dies around the age of 33. A BASE jumper who only needs medical care for 13 years doesn't cost the full $450k, they would only use $130k of healthcare. Which actually makes their lifetime medical bills much cheaper than that of a non-jumper!
I am well aware of what you're saying and was before this comment. The smoker data is not applicable to obesity. Smokers die younger, but do not have extended and sustainably increased healthcare costs over their entire life span. They also don't have as many negative externalities such as simply consuming more resources; even gasoline and jet fuel consumption is increased due to obese passengers.
> Smokers die younger, but do not have extended and sustainably increased healthcare costs over their entire life span.
A popular furphy spread from questionable assumptions.
FYI
> A major report published in 2016 by the National Cancer Institute and World Health Organization concluded that in high-income countries, lifetime health care costs are greater for smokers than for non-smokers, even after accounting for the shorter lives of smokers.
Tobacco issues and health care costs (with reference to some world class epidemiology studies) discussed at length here:
https://pubmed.ncbi.nlm.nih.gov/33470881/
"Adults with obesity in the United States compared with those with normal weight experienced higher annual medical care costs by $2,505 or 100%, with costs increasing significantly with class of obesity, from 68.4% for class 1 to 233.6% for class 3. The effects of obesity raised costs in every category of care: inpatient, outpatient, and prescription drugs. Increases in medical expenditures due to obesity were higher for adults covered by public health insurance programs ($2,868) than for those having private health insurance ($2,058)."