Colditz G A
Channing Laboratory, Brigham and Women's Hospital, Boston, MA 02115-5899.
Am J Clin Nutr. 1992 Feb;55(2 Suppl):503S-507S. doi: 10.1093/ajcn/55.2.503s.
Approximately 34 million US adults were obese in 1980. Obesity is associated with increased risk of noninsulin-dependent diabetes mellitus (NIDDM), hypertension, cardiovascular disease, gallbladder disease and cholecystectomy, and colon and postmenopausal breast cancer. Using a prevalence-based approach to cost of illness, we estimated the economic costs in 1986 attributable to obesity for these medical conditions. Indirect costs due to morbidity and mortality were discounted at 4%. Overall, the costs attributable to obesity were $11.3 billion for NIDDM, $22.2 billion for cardiovascular disease, $2.4 billion for gall bladder disease, $1.5 billion for hypertension, and $1.9 billion for breast and colon cancer. Thus a conservative estimate of the economic costs of obesity was $39.3 billion, or 5.5% of the costs of illness in 1986. Addition of costs due to musculoskeletal disorders could raise this estimate to 7.8%. The costs of treatment for severe obesity must be weighed against the improved health status and quality of life.
1980年，美国约有3400万成年人肥胖。肥胖与非胰岛素依赖型糖尿病（NIDDM）、高血压、心血管疾病、胆囊疾病和胆囊切除术以及结肠癌和绝经后乳腺癌的患病风险增加有关。我们采用基于患病率的疾病成本计算方法，估算了1986年因肥胖导致的这些疾病的经济成本。因病残和死亡产生的间接成本按4%进行折现。总体而言，肥胖导致的成本分别为：NIDDM为113亿美元，心血管疾病为222亿美元，胆囊疾病为24亿美元，高血压为15亿美元，乳腺癌和结肠癌为19亿美元。因此，对肥胖经济成本的保守估计为393亿美元，占1986年疾病成本的5.5%。加上肌肉骨骼疾病导致的成本，这一估计可能会升至7.8%。严重肥胖的治疗成本必须与改善的健康状况和生活质量相权衡。
