Burden of disease study of overweight and obesity; the societal impact in terms of cost-of-illness and health-related quality of life

Abstract

Background: Little is known about the burden that overweight and obesity impose on Dutch society. The aim of this study is to examine this burden in terms of cost-of-illness and health-related quality of life.

Method: A bottom-up, prevalence-based burden of disease study from a societal perspective was performed. Cost-of-illness information including healthcare costs, patient and family costs, and other costs was obtained via the Treatment Inventory of Costs in Patients with psychiatric disorders (TiC-P) questionnaire. Health-related quality of life was assessed through the EuroQol (EQ-5D-5L) and the BODY-Q instruments. Non-parametric bootstrapping was applied to test for significant differences in costs. Subgroup analyses were performed on all outcomes.

Results: A total of 97 people with overweight and obesity completed the survey. Per respondent, mean healthcare costs were €2907, patient and family costs were €4037, and other costs were €4519, leading to a total societal cost of €11,463 per respondent per year. Total costs were significantly higher for respondents with obesity versus overweight and between low & intermediate versus highly educated respondents. The mean utility score of our population was 0.81. A significantly lower utility score was found for respondents with obesity in comparison with respondents with overweight. BODY-Q results show that respondents with obesity scored a significantly lower Rasch-score than did respondents with overweight in three scales. Respondents with a high education level and having paid work scored significantly higher Rasch-scores in two scales than did those with a low education level and without having paid work. The age group 19-29 have significantly higher Rasch-scores in three scales than respondents in the other two age categories.

Conclusions: Overweight and obesity have a considerable impact on the societal costs and on health-related quality of life. The results show that the impact of overweight and obesity go beyond the healthcare sector, as the other costs have the biggest share of the total costs. Another interesting finding of this study is that obesity leads to significant higher costs and lower health-related quality of life than overweight. These findings draw attention to policy making, as collective prevention and effective treatment are needed to reduce this burden.

Keywords: Burden of disease; Cost of illness; Dutch population; Health-related quality of life; Obesity; Overweight.

Fig. 1

Bootstrapped subgroup analysis Cost-of-Illness (COI). *If CI includes 0, no significant difference is found. **Significant difference in costs between groups in subgroup

Fig. 2

Subgroup analysis of the mean utility score derived from the five-dimensional, five-level EuroQol (EQ-5D-5L). *If p < 0.05, a statistically significant difference is found. **Significant difference in utility score between groups in subgroup. a**Significant difference between age group 19–29 and 30–49 and age group 19–29 and 50+

Fig. 3

Subgroup analysis of the mean Rasch-scores derived from the BODY-Q. *If p < 0.05, a statistically significant difference is found. **Significant difference in Rasch-scores between groups in subgroup