Wolf A M, Colditz G A
Harvard Medical School, Channing Laboratory, Boston, MA 02111, USA.
Am J Clin Nutr. 1996 Mar;63(3 Suppl):466S-469S. doi: 10.1093/ajcn/63.3.466.
Given that overweight is clearly associated with increased risk of many major chronic diseases, the United States could have saved approximately $45.8 billion or 6.8% of health care expenditures in 1990 alone if obesity were prevented. The question then arises, economically and socially, what is a healthy body weight? Using a prevalence-based approach to cost of illness, we estimated the economic costs (1993 dollars) associated with illness at different strata of body mass indexes (BMIs, in kg/m2) and varying increments of weight gain to address the questions: At what body weight do we initiate preventive services? What are the direct costs associated with weight gain? Second, using the 1988 National Health Interview Survey (NHIS), we evaluated the marginal increase in certain social indexes reflective of functional impairment and morbidity (ie, restricted-activity days, bed days, and work-loss days) as well as physician visits associated with different strata of BMI. With respect to economic and social indexes, a healthy body weight appears to be a BMI < 25, and weight gain should be kept to < 5 kg throughout a lifetime.
鉴于超重显然与许多主要慢性病风险增加相关，如果在1990年预防肥胖，美国仅在该年就可能节省约458亿美元，即医疗保健支出的6.8%。那么问题就来了，从经济和社会角度来看，什么是健康体重呢？我们采用基于患病率的疾病成本计算方法，估算了与不同体重指数（BMI，单位：kg/m²）分层以及不同体重增加幅度相关的疾病经济成本（以1993年美元计），以回答以下问题：我们在什么体重水平开始提供预防服务？体重增加带来的直接成本是多少？其次，我们利用1988年全国健康访谈调查（NHIS），评估了反映功能障碍和发病率的某些社会指标（即活动受限天数、卧床天数和误工天数）以及与不同BMI分层相关的医生诊疗次数的边际增加情况。就经济和社会指标而言，健康体重似乎是BMI<25，且一生中体重增加应保持在<5kg。
