Nearly two out of three (64.5%) U.S. adults are overweight or obese. (National Health and Nutrition Examination Survey, National Center for Health Statistics, Centers of Disease Control and Prevention, 1999.)

The percentage of U.S. adults classified as obese doubled between 1980 and 2000, from 15% to 31%. (National Health and Nutrition Examination Survey, National Center for Health Statistics, Centers for Disease Control and Prevention, 1999.)

Obesity and overweight conditions contribute as much as $93 billion to the nation’s yearly medical bill, according to a study conducted by economists from RTI International and the Centers for Disease Control and Prevention. (Project HOPE – The People-to-People Health Foundation, Inc., 2003.)

An obese 70-year-old incurs $38,000 in additional medical costs in old age compared with costs for a non-obese peer. And, although obese 70-year-olds will live as long as those of normal weight, they will spend 40 percent more time disabled than their non-obese counterparts. (Health Affairs, September 26, 2005).

Obesity is a greater trigger for health problems and increased health spending than smoking or drinking. Individuals who are obese have 30% to 50% more chronic medical problems than those who smoke or drink heavily. (Roland Sturm, UCLA/RAND Managed Care Center for Psychiatric Disorders, The Effects of Obesity, Smoking and Drinking on Medical Problems and Costs, Health Affairs, March/April 2002.)

The effects of obesity are similar to 20 years of aging. (Roland Sturm, UCLA/RAND Managed Care Center for Psychiatric Disorders, The Effects of Obesity, Smoking and Drinking on Medical Problems and Costs, Health Affairs, March/April 2002.)

The total cost of obesity to U.S. companies is estimated at $13 billion per year. Health insurance costs related to obesity comprise the largest percentage of the total ($8 billion), followed by paid sick leave ($2.4 billion), life insurance ($1.8 billion), and disability insurance ($1 billion). (Prevention Makes Common Cents: Estimated Economic Costs of Obesity to U.S. Business, DHHS, 2003.)

Inactivity costs between $670-$1,125 per person, per year. (Economic Costs of Obesity and Inactivity, Medicine and Science in Sports and Exercise, 1999.)

Obesity accounts for approximately 9.1% of total annual medical care expenditures. (Eric A. Finkelstein, Ian C. Fiebelkorn, Guijing Wang, National Medical Spending Attributable to Overweight and Obesity: How Much and Who’s Paying? Health Affairs, Web Exclusive, May 2003.)

Some 8% of private employer medical claims are due to overweight and [obese employees]. (Eric A. Finkelstein, Ian C. Fiebelkorn, Guijing Wang, National Medical Spending Attributable to Overweight and Obesity: How Much and Who’s Paying? Health Affairs, Web Exclusive, May 2003.)

Obesity-related disabilities cost employers an average of $8,720 per claimant per year for wage indemnity. (UnumProvident, 2004.)

Obese individuals have higher health care utilization rates:

Obesity is associated with 39 million lost work days; 239 million restricted activity days; 90 million bed days; and 63 million physician visits. (Current Estimates of the Economic Cost of Obesity in the United States, Obesity Research, 1998.)

Obesity drove 27% of medical cost increases between 1987 and 2001. (Kenneth E. Thorpe, Curtis S. Florence, David H. Howard, Peter Joski, The Impact of Obesity on Rising Medical Spending, Health Affairs, Web Exclusive, October 20, 2004.)

Despite the high number of morbidly obese Virginians, weight-loss surgery is not currently utilized by a significant portion of the morbidly obese population. Only 0.1 percent of the morbidly obese typically meet the weight-loss surgery selection criteria, only 3,690 Virginians (0.1% of 369,000) are estimated to have been medically eligible in 2004.

 Because morbid obesity disproportionately afflicts the poor and weight-loss surgery is expensive, a lack of coverage results for most eligible Virginians, mainly the working poor.  Morbid obesity is a condition disproportionately affecting the poor and ethnic/racial populations. Patients without insurance coverage for weight-loss surgery face physician and hospital costs of up to $30,000 out-of-pocket (National Business Group on Heath, 2004). 

 Lack of coverage for morbid obesity results in unreasonable financial hardship for insured Virginians due to: a) higher out-of-pocket costs for co-morbidities; and b) lost days of work. The average cost of a weight-loss surgery procedure is $30,000 (National Business Group on Health, 2004).Because 30 percent of the morbidly obese make less than $20,000 annually, the low-income insured have no access to weight-loss surgery unless their carrier covers the procedure. Any insured individual with less than $35,000 in discretionary income arguably has no access to weight-loss surgery unless insurance coverage is available.

 The Commonwealth already mandates the availability of coverage as an option for policyholders. Unfortunately, mandated offers of coverage result in artificially high costs to the policyholders because of adverse selection. Adverse selection occurs when only those people likely to utilize a benefit actually purchase that benefit. As a result, the total costs are spread across a much smaller population, the costs are significantly higher because the risk is not broadly spread, and the savings of weight-loss surgery do not accrue to the policyholders.