Objectives People who are obese have higher demands for medical care than those of the normal weight people. However, in view of their shorter life expectancy, it is unclear whether obese people have higher lifetime medical expenditure. We examined the association between body mass index, life expectancy and lifetime medical expenditure.
Design Prospective cohort study using individual data from the Ohsaki Cohort Study.
Setting Miyagi Prefecture, northeastern Japan.
Participants The 41 965 participants aged 40–79 years.
Primary and secondary outcome measures The life expectancy and lifetime medical expenditure aged from 40 years.
Results In spite of their shorter life expectancy, obese participants might require higher medical expenditure than normal weight participants. In men aged 40 years, multiadjusted life expectancy for those who were obese participants was 41.4 years (95% CI 38.28 to 44.70), which was 1.7 years non-significantly shorter than that for normal weight participants (p=0.3184). Multiadjusted lifetime medical expenditure for obese participants was £112 858.9 (94 954.1–131 840.9), being 14.7% non-significantly higher than that for normal weight participants (p=0.1141). In women aged 40 years, multiadjusted life expectancy for those who were obese participants was 49.2 years (46.14–52.59), which was 3.1 years non-significantly shorter than for normal weight participants (p=0.0724), and multiadjusted lifetime medical expenditure was £137 765.9 (123 672.9–152 970.2), being 21.6% significantly higher (p=0.0005).
Conclusions According to the point estimate, lifetime medical expenditure might appear to be higher for obese participants, despite their short life expectancy. With weight control, more people would enjoy their longevity with lower demands for medical care.
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Review history and Supplementary material
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To cite: Nagai M, Kuriyama S, Kakizaki M, et al. Impact of obesity, overweight and underweight on life expectancy and lifetime medical expenditures: the Ohsaki Cohort Study. BMJ Open 2012;2:e000940. doi:10.1136/bmjopen-2012-000940
Contributors All authors contributed to the design of the study. MN, SK, MK, KO-M, TS and IT participated in data collection. MN, SK, AH, MK and SH participated in data analysis. MN, MK, KO-M, TS, AH, MK and SH participated in the writing of the report. SK and IT participated in critical revision of the manuscript. All authors approved the final version of the report for submission.
Funding This study was supported by a Health Sciences Research Grant for Health Services (H21-Choju-Ippan-001, H20-Junkankitou (Seisyu)-Ippan-013, H22-Junkankitou (Seisyu)-Ippan-012), Ministry of Health, Labour and Welfare, Japan. MN is a recipient of a Research Fellowships of the Japan Society for the Promotion of Science for Young Scientists.
Competing interests None.
Ethics approval The study protocol was approved by the Ethics Committee of Tohoku University School of Medicine. Participants who had returned the self-administered questionnaires and signed them were considered to have consented to participate.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.
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