{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:13:30Z","timestamp":1789028010351,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to (1) identify characteristics of people with obesity or overweight that are predictive of health care costs; and (2) identify potential subgroups associated with weight reduction and cost savings following weight reduction interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study used the Optum MarketClarity database from 2014 to 2022. The primary objective was assessed among individuals \u226519\u2009years old with obesity\/overweight with \u226512\u2009months of continuous medical\/pharmacy enrolment (primary cohort; index date: date of body mass index [BMI] measure \u226527\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      closest to December 31, 2022). The secondary objective was assessed among individuals using obesity management medication (OMM cohort)\/bariatric surgery (surgery cohort). Generalised linear model (GLM) and random forest (RF) models were fitted to identify covariates predictive of total costs. Logistic regression, RF, and Lasso models were used to identify predictors of cost savings and \u226510% weight reduction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Outpatient visits, inpatient days, emergency room visits, and Charlson Comorbidity Index were main drivers of health care costs in GLM and RF models. Obesity\u2010related complications (ORCs) including gastroesophageal reflux disease, osteoarthritis\u2010knee and hip, coronary heart disease, hypertension, and heart failure were also influential predictors of cost, associated with approximately 2\u20134\u2010fold higher median costs. The strongest predictors of cost savings and \u226510% weight reduction were baseline costs, outpatient visits (OMM cohort) and metabolic syndrome (surgery cohort).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings underscore ORCs as key drivers of health care costs and highlight the need for targeted treatment strategies to effectively manage obesity, reduce the risk and severity of ORCs, and control health care costs. Furthermore, understanding baseline costs and treatment\u2010related cost trajectories across patient subgroups offers critical insights to inform both clinical decision\u2010making and health policy design.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70035","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T05:58:50Z","timestamp":1755583130000},"page":"6416-6427","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Understanding the clinical characteristics associated with health care costs and cost savings upon weight reduction in individuals with obesity or overweight"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6169-2640","authenticated-orcid":false,"given":"Xuan","family":"Li","sequence":"first","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Vallarino","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Denning","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa H.","family":"Gibble","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schapiro","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongju","family":"Liu","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Li","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Ward","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2175-9975","authenticated-orcid":false,"given":"Jonathan","family":"Pearson\u2010Stuttard","sequence":"additional","affiliation":[{"name":"Lane Clark &amp; Peacock LLP  London UK"},{"name":"Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"CDC.Obesity Trends Among U.S. Adults Between 1985 and 2010(cdc.gov)."},{"key":"e_1_2_11_3_1","unstructured":"CDC.Adult Obesity Facts. Accessed November 11 2024.https:\/\/www.cdc.gov\/obesity\/adult-obesity-facts\/index.html#:\u223c:text=The%20prevalence%20of%20obesity%20among%20U.S.%20adults%2020 more%20than%2022%20million%20adults%20have%20severe%20obesity"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2017.272450"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0247307"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41387\u2010024\u201000352\u20109"},{"key":"e_1_2_11_7_1","unstructured":"World Obesity Federation.Economic Impact of Overweight and Obesity\u2014United States. Accessed November 11 2024.https:\/\/data.worldobesity.org\/economic-impact-new\/countries\/US.pdf"},{"key":"e_1_2_11_8_1","volume-title":"Public Health Considerations Regarding Obesity","author":"Tiwari A","year":"2024"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.4158\/ep161365.Gl"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2020.20272"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-023-01376-4"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2024.0037"},{"key":"e_1_2_11_13_1","unstructured":"NIDDK.Health Risks of Overweight & Obesity. 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