Obesity is a disease affecting more than 650 million people worldwide. People living obesity have a higher risk of developing numerous of diseases throughout lifetime (such as diabetes, hypertension, sleep apnoea, osteoarthritis and heart diseases) in comparison to people with normal weight, which further impacts public health, society and economy. With the presence of obesity growing across the world, so does the related cost burden to society, and it is well described that higher body mass index (BMI) is linked with increasing use of the healthcare system and healthcare costs.
In recent research, we showed beneficial effects of intentional weight loss (range 10-25% weight loss) on a number of obesity-related health outcomes among people with obesity compared to keeping the weight on. From studies of people with obesity, who undergo weight management in the form of bariatric surgery compared to those who do not undergo surgery, there are indications that clinical benefits of weight management do translate into less use of the healthcare system.
In this study, we aim to assess among people living with obesity the relation between intentional weight loss of >10% and the utilization of healthcare system and healthcare costs compared to keeping the weight on.
Technical summary
Obesity is a chronic disease with a considerable clinical, societal, public health and economic impact. A higher body mass index (BMI) has been shown to associate with higher risk of numerous obesity-related outcomes as well as higher healthcare resource utilization and costs.
In a recent observational, database study based on the UK CPRD:HES, we showed that intentional weight loss (range 10-25%) was associated with a reduced risk of developing a number of obesity-related outcomes, when compared to keeping a stable, high weight, among people with obesity. Evaluations of bariatric surgery among people with obesity indicate that clinical benefits of weight management may translate into less healthcare resource utilization, however this has not been well quantified for intentional weight loss among people with obesity, independent of type of weight management intervention.
The objective of this study is to evaluate the effect of >10% intentional weight loss on healthcare resource utilization and costs among people living with obesity (BMI>30), with the hypothesis that intentional weight loss (median over the range of 10-25%) among people living with obesity associates with lower health care resource utilization and reduced healthcare costs when compared to people with obesity and stable weight. This will be examined using a prospective observational cohort design. A variety of measures of healthcare resource utilization and costs will be included as outcomes to capture different aspects of healthcare use, e.g. short term (primary care visits, prescriptions) and longer term (hospitalizations). We will use adjusted general linear models to estimate the difference in rates and costs, respectively, in healthcare resource utilization and costs between groups over time.
The outcomes are rates or costs of healthcare resource utilization per year after start of follow-up as measured in eleven different ways:
• Total number of primary care practitioner (PCP) contacts per year
• Total number of outpatient clinic contacts per year
• Total number of prescriptions per year
• Number of inpatient hospital days per year
• Number of critical care bed days per year
• Total number of hospital admissions per year
• Total cost of PCP contacts per year
• Total cost of outpatient clinic contacts per year
• Total cost of prescriptions per year
• Total cost of hospitalizations per year
• Total cost of care per year
Christiane L Haase - Chief Investigator - Novo Nordisk A/S
Christiane L Haase - Corresponding Applicant - Novo Nordisk A/S
Camilla Morgen - Collaborator - Novo Nordisk A/S
Chris Bojke - Collaborator - University of Leeds
Jonathan Pearson-Stuttard - Collaborator - Imperial College London
Niels Væver Hartvig - Collaborator - Novo Nordisk A/S
Sandra Lopes - Collaborator - Novo Nordisk A/S
Tugce Kalayci Oral - Collaborator - Novo Nordisk A/S
Volker Schnecke - Collaborator - Novo Nordisk A/S
Sophie BIROT - Collaborator - Novo Nordisk A/S
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;Patient Level Index of Multiple Deprivation