Obesity Boosts Hospitalization RatesTuesday, February 10, 2009
Excess weight markedly increases the risk for a wide range of health problems including diabetes, heart disease, gall bladder stones, back pain, hip and knee problems and certain cancers. It is therefore reasonable to hypothesize that obesity is associated with increased need for hospitalization. This question is important because hospitalization accounts for a substantial proportion of health care costs.
Han and colleagues from the University of North Carolina, Chapel Hill, NC examined the relationship between obesity and hospitalization in the around 15,000 participants of the ARIC (Atherosclerosis Risk in Communities) Study, prospectively followed for 13 years – the results were published online in the International Journal of Obesity last week.
The study examined associations between weight status and all-cause and cause-specific hospitalizations (for cardiovascular and a few selected non-cardiovascular conditions). Analyses were adjusted for numerous factors including race, gender, age, physical activity, education level, smoking status, alcoholic beverage consumption and health insurance at baseline.
The average number of all-cause hospitalizations increased from 1316 per 1000 in normal weight individuals to 1543 in overweight and 2025 in obese participants. While normal weight women had significantly fewer hospitalizations than normal weight men (1173 versus 1515 per 1000), but the increase associated with being obese on the number of all-cause hospitalizations was larger in women than men (791 versus 589 per 1000).
While obesity was associated with increased hospitalization rates for all cardiovascular disease-related primary causes (e.g. myocardial infarction, congestive heart failure, stroke, etc.), the biggest relative impact of obesity was seen on hospitalization for osteoarthritis (9 per 1000 in normal weight vs. 79 per 1000 – an almost 8-fold increase!).
Based on this clear evidence that overweight and obesity substantially increases the number of hospitalizations, the authors emphasize that continued research on obesity treatment and prevention (I would add: as well as increasing access to obesity treatments) is essential.