According to background information, obesity is associated with increased risk of high blood pressure, diabetes, and certain cancers, and has been identified as a major risk factor for coronary heart disease (CHD). Approximately 130 million U.S. adults are currently overweight or obese, defined as having a body mass index (BMI: weight in kilograms divided by height in meters squared) of 25 29.9, or 30 and greater, respectively. The proportion of U.S. adults aged 65 years and older is estimated to increase from 12 percent currently to 20 percent by 2050. Obesity and this rising number of older persons in the U.S. is a concern to health care professionals, policy makers, and the U.S. public. However, little is known about the relation of overweight or obesity in young adults to long-term medical care expenditures.
Martha L. Daviglus, M.D., Ph.D., from the Feinberg School of Medicine, Northwestern University, Chicago, and colleagues examined the relationship between BMI in young adulthood and middle age to Medicare spending at ages 65 years and older. Between 1967 and 1973, BMIs and overall health were measured in 9,978 men (average age, 46 years) and 7,623 women (average age, 48 years) participating in the Chicago Heart Association Detection Project in Industry (CHA). Individuals were classified as being nonoverweight (BMI, 18.5 24.9), overweight (25 29.9), obese (30.0 34.9), or severely obese (35 and greater). The participants were free of coronary heart disease, diabetes, and major electrocardiographic abnormalities and were not underweight (BMI less than 18.5). Researchers then examined Medicare claims data for these participants from 1984 through 2002.
The researchers found that annual average Medicare char
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