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Annual health-care expenses are substantially higher for smokers and the obese, compared with nonsmokers and people of healthy weight, according to a recent report in the journal Public Health.
In fact, obesity is actually more expensive to treat than smoking on an annual basis, the study concluded.
And the cost of treating both problems is eventually borne by U.S. society as a whole, experts said.
Obese people run up an average $1,360 in additional health-care expenses each year compared with the non-obese. The individual obese patient is also on the hook for $143 in extra out-of-pocket expenses, according to the report.
By comparison, smokers require an average $1,046 in additional health-care expenses compared with nonsmokers, and pay an extra $70 annually in out-of-pocket expenses.
Yearly expenses associated with obesity exceeded those associated with smoking in all areas of care except for emergency room visits, the study found.
Study author Ruopeng An, assistant professor of kinesiology and community health at the University of Illinois at Urbana-Champaign, said it shouldn't be surprising that the obese tend to have higher medical costs than smokers.
"Obesity tends to be a disabling disease," An said. "Smokers die young, but people who are obese live potentially longer but with a lot of chronic illness and disabling conditions."
So, from a lifetime perspective, obesity could prove particularly burdensome to the U.S. health-care system, he said.
Those who weigh more also pay more, An found, with medical expenses increasing the most among those who are extremely obese. By the same token, older folks with longer smoking histories have substantially higher medical costs than younger smokers.
An also found that both smoking and obesity have become more costly to treat over the years. Health-care costs associated with obesity increased by 25 percent from 1998 to 2011 and those linked to smoking rose by nearly a third, he said.
To understand the financial impact of obesity and smoking, An analyzed data from nearly 126,000 participants in the 1996-2010 National Health Interview Surveys. The NHIS is the nation's largest annual in-person household health survey. The participants also took part in a subsequent survey on health-related expenses, An said.
The study focused solely on health-care expenditures: hospital inpatient and outpatient care, emergency room treatment, physicians' office visits, out-of-pocket expenses and prescription drug costs.
Between 1998 and 2011, estimated health-care expenses associated with obesity and smoking increased by 25 percent and 30 percent, respectively, according to An's findings.
The rising cost of prescription drugs appeared to fuel the increase in health-care expenses related to obesity and smoking, An found. Pharmaceutical expenses associated with obesity and smoking were 62 percent and 70 percent higher, respectively, in 2011 than in 1998.
Mayo Clinic health economist Bijan Borah said the new research documents something that has been understood for some time -- that obesity and smoking are very costly to treat.
"There is a cost to be paid for being obese or a smoker," Borah said. "In the U.S., what we have seen is that over time these costs have been increasing. It's time for people to be accountable for their behaviors that are modifiable. It's not only going to burden themselves, but society as well."
Although the study considered obesity and smoking separately, both An and Borah said it stands to reason that obese people who also smoke are apt to face even higher medical expenses.
Borah noted that the study only dealt with direct medical costs, and did not include costs to society like absenteeism and loss of productivity. "When you factor those in, the true cost would be even higher," he said.
An said his results show that obesity prevention and anti-smoking campaigns could go a long way toward reigning in rising medical expenses.
"In order to contain increasing health-care costs, we need to think more about how to prevent obesity rather than treating obesity, because treatment of obesity is much more expensive than prevention," he said.
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