Obesity, weight management, and health care costs: a primer.

Rational decision-making regarding health care spending for weight management requires an understanding of the cost of care provided to obese patients and the potential cost-effectiveness or cost savings of interventions. The purpose of this review is to assist health plans and disease management leaders in making informed decisions for weight management services. Among the review's findings, obesity and severe obesity are strongly and consistently associated with increased health care costs. The cost-effectiveness of obesity-related interventions is highly dependent on the risk status of the treated population, as well as the length, cost, and effectiveness of the intervention. Bariatric surgery offers high initial costs and uncertain long-term cost savings. From the perspective of a payor, obesity management services are as cost-effective as other commonly offered health services, though not likely to offer cost savings. Behavioral health promotion interventions in the worksite setting provide cost savings from the employer's perspective, if decreased rates of absenteeism are included in the analysis.