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Research Article

Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure

  • Pieter H. M van Baal mail,

    To whom correspondence should be addressed. E-mail: pieter.van.baal@rivm.nl

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Johan J Polder,

    Affiliations: National Institute for Public Health and the Environment, Centre for Public Health Forecasting, Bilthoven, The Netherlands, Tilburg University, Department Tranzo, Tilburg, The Netherlands

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  • G. Ardine de Wit,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Rudolf T Hoogenveen,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Talitha L Feenstra,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Hendriek C Boshuizen,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Peter M Engelfriet,

    Affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands

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  • Werner B. F Brouwer

    Affiliation: Erasmus University, Medical Center, Rotterdam, The Netherlands

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  • Published: February 05, 2008
  • DOI: 10.1371/journal.pmed.0050029

Reader Comments (8)

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Are average cost figures correct in this context?

Posted by plosmedicine on 31 Mar 2009 at 00:19 GMT

Author: Thomas Mittendorf
Position: Dr.
Institution: Leibniz University Hannover
E-mail: tm@ivbl.uni-hannover.de
Submitted Date: February 05, 2008
Published Date: February 5, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

It seems that the study has a major flaw in the inclusion of cost. The authors incorporated average health care costs in the model. These costs of course are higher the older the individual gets. But, as they are taking a prospective incidence orientated approach analyzing what happens to 20 year olds in the rest of their individual life it is not correct to use average costs. The average cost figures have to be differentiated between those costs that are incurred by persons that die and those who survive in the respective year. This has to be done for all cohorts. If the healthy people get older healthy and die five years later than the rest, dying gets cheaper. On the other hand dying is more expensive in younger cohorts. The higher costs for dying younger being obese easily can be outweighed by a 5 year later death being healthy. The discussion was started by Verbrugge and Fries and cannot be ignored.

No competing interests declared.