Ten-year cost-consequence analysis of weight loss on obesity-related outcomes in privately insured adults with obesity in Saudi Arabia

Figures & data

Figure 1. Risk modeling weight change in the retrospective cohort.

Table 1. Obesity-related outcomes – average annual costs per patient in USD.

Outcome	Private
Asthma	$3,133.31
Hypertension	$3,143.23
Angina	$3,719.84
Sleep apnoea	$4,505.92
Atrial Fibrillation	$4,533.48
Osteoarthritis	$5,887.35
CKD	$6,622.72
T2DM	$6,842.12
Dyslipidaemia	$7,752.78
Heart Failure	$9,414.25

Abbreviations: USD, United States Dollars; T2DM, Type 2 Diabetes Mellitus; CKD, Chronic Kidney Disease.

Table 2. Baseline characteristics of all patients and the cohort with BMI measurement.

	All Patients		BMI Measurement
	n	%	n	%
	3,131,189	100%	1,537,070	49.1%
Gender
Male	1,793,402	57.3%	810,721	52.7%
Female	1,337,787	42.7%	726,349	47.3%
Age category
≤19 years	929,875	29.7%	491,980	32.0%
20–29 years	491,560	15.7%	233,172	15.2%
30–39 years	719,899	23.0%	338,179	22.0%
40–49 years	386,881	12.4%	176,383	11.5%
50–59 years	227,470	7.3%	110,184	7.2%
60–69 years	106,571	3.4%	57,379	3.7%
>70 years	268,933	8.6%	129,793	8.4%
BMI categories (only age ≥20)
<18.4			25,733	2.5%
18.5–24.9			253,191	24.2%
25–29.9			403,268	38.6%
30–34.9			233,951	22.4%
35–39.9			86,857	8.3%
40–50			42,090	4.0%
Nationality
Saudi	1,752,511	56.0%	956,352	62.2%
Non-Saudi	1,378,678	44.0%	580,718	37.8%
Geographical area
Riyadh	1,028,054	32.8%	741,588	48.2%
Eastern Region	532,156	17.0%	409,532	26.6%
Al-Qassim	25,048	0.8%	19,957	1.3%
Al Madinah Al Munawwarah	82,051	2.6%	53,708	3.5%
Tabuk	18,615	0.6%	2,249	0.1%
Jazan	9,195	0.3%	4,749	0.3%
Aseer	35,879	1.1%	24,963	1.6%
Makkah al-Mukarramah	410,009	13.1%	279,500	18.2%
Hail	19,114	0.6%	773	0.1%
Others	971,022	31.0%	0	0.0%
Obesity-related outcomes
Type 2 diabetes	261,191	8.3%	143,834	9.4%
Sleep apnoea	8,757	0.3%	5,868	0.4%
Asthma	225,619	7.2%	135,718	8.8%
Osteoarthritis	78,064	2.5%	43,188	2.8%
Chronic kidney disease	11,416	0.4%	7,479	0.5%
Hypertension	241,417	7.7%	128,918	8.4%
Dyslipidaemia	293,528	9.4%	158,767	10.3%
Atrial fibrillation	6,153	0.2%	3,878	0.3%
Heart failure	12,374	0.4%	7,552	0.5%
Angina	7,588	0.2%	4,793	0.3%

Table 3. Characteristics of patients with BMI ≥ 30 kg/m² and aged 20–69 years (study cohort).

	Total	Age 20–29	Age 30–39	Age 40–49	Age 50–59	Age 60–69	p-value
n	314,097	56,103	112,723	70,026	49,080	26,165
Gender
Male	162,474 (51.7%)	24,408 (43.5%)	60,159 (53.4%)	41,656 (59.5%)	24,475 (49.9%)	11,776 (45.0%)	ns
Female	151,623 (48.3%)	31,695 (56.5%)	52,564 (46.6%)	28,370 (40.5%)	24,605 (50.1%)	14,389 (55.0%)	ns
BMI categories
BMI 30–34.9	204,817 (65.2%)	36,847 (65.7%)	74,409 (66.0%)	45,974 (65.7%)	31,432 (64.0%)	16,155 (61.7%)	<.001
BMI 35–39.9	66,301 (21.1%)	11,450 (20.4%)	23,054 (20.5%)	14,670 (20.9%)	11,030 (22.5%)	6,097 (23.3%)	<.001
BMI 40–50	33,483 (10.7%)	6,179 (11.0%)	11,851 (10.5%)	7,324 (10.5%)	5,150 (10.5%)	2,979 (11.4%)	ns
Obesity-related comorbidities
Type 2 diabetes	56,429 (18.0%)	2,523 (4.5%)	10,515 (9.3%)	13,945 (19.9%)	17,105 (34.9%)	12,341 (47.2%)	<.001
Sleep apnoea	2,635 (0.8%)	218 (0.4%)	823 (0.7%)	697 (1.0%)	555 (1.1%)	342 (1.3%)	<.001
Asthma	21,698 (6.9%)	2,931 (5.2%)	7,121 (6.3%)	5,131 (7.3%)	3,984 (8.1%)	2,531 (9.7%)	<.001
Osteoarthritis	17,826 (5.7%)	752 (1.3%)	3,013 (2.7%)	3,966 (5.7%)	5,732 (11.7%)	4,363 (16.7%)	<.001
Chronic kidney disease	2,079 (0.7%)	91 (0.2%)	304 (0.3%)	360 (0.5%)	567 (1.2%)	757 (2.9%)	<.001
Hypertension	51,034 (16.2%)	1,455 (2.6%)	8,449 (7.5%)	13,391 (19.1%)	16,288 (33.2%)	11,451 (43.8%)	<.001
Dyslipidaemia	59,885 (19.1%)	2,555 (4.6%)	12,693 (11.3%)	16,656 (23.8%)	17,454 (35.6%)	10,527 (40.2%)	<.001
Atrial fibrillation	1,188 (0.4%)	25 (0.0%)	138 (0.1%)	185 (0.3%)	350 (0.7%)	490 (1.9%)	<.001
Heart failure	2,567 (0.8%)	58 (0.1%)	285 (0.3%)	556 (0.8%)	764 (1.6%)	904 (3.5%)	<.001
Angina	1,681 (0.5%)	42 (0.1%)	263 (0.2%)	487 (0.7%)	545 (1.1%)	344 (1.3%)	<.001

Abbreviation: ns, not significant.

Table 4. Cost consequence of relative reductions in obesity-related outcomes by weight change scenarios over 10 years.

	Baseline		Weight Loss – 10 Year
	Current		0% Loss			5% Loss			10% Loss			15% Loss
Obesity-related outcomes	Prev.	Cost (mil)	Prev.	Cases	Cost (mil)	Rel. Reduc.	CCR	Savings (mil)	Rel. Reduc.	CCR	Savings (mil)	Rel. Reduc.	CCR	Savings (mil)
Type 2 diabetes	18.0%	386,094	27.5%	86,211	589,865	13.7%	22,773	155,815	26.5%	43,771	299,486	38.1%	62,840	429,959
Sleep apnoea	0.8%	11,873	2.9%	9,552	43,040	21.8%	7,850	35,371	39.3%	14,207	64,016	53.5%	19,311	87,014
Asthma	6.9%	67,986	10.1%	31,761	99,516	6.5%	3,638	11,399	12.9%	7,231	22,657	19.1%	10,791	33,811
Osteoarthritis	5.7%	104,948	10.1%	31,586	185,960	5.2%	3,661	21,554	10.9%	7,759	45,680	17.4%	12,208	71,873
CKD	0.7%	13,769	5.8%	17,226	1,14,083	2.9%	2,453	16,246	5.0%	4,347	28,789	6.7%	5,791	38,352
Hypertension	16.2%	160,411	37.5%	118,134	371,323	6.2%	24,162	75,947	12.7%	48,942	153,836	19.3%	74,120	232,976
Dyslipidaemia	19.1%	464,275	38.1%	119,456	926,120	4.1%	14,286	110,756	8.5%	29,965	232,312	13.4%	46,909	363,675
AF	0.4%	5,386	3.4%	10,098	45,779	4.2%	1,916	8,686	7.0%	3,229	14,639	8.6%	4,009	18,175
Heart failure	0.8%	24,166	2.6%	8,343	78,541	4.7%	1,375	12,945	7.0%	2,031	19,120	6.9%	1,998	18,810
Angina	0.5%	6,253	3.2%	10,758	40,019	0.5%	203	755	0.7%	297	1,105	0.7%	313	1,164
Total		1,245,162			2,494,247			449,474			881,639			1,295,809

Abbreviations: Prev., Prevalence; Rel, Reduc., Relative Reduction; CCR: Cumulative Cases Reduced; CKD, Chronic kidney disease; AF, Atrial fibrillation.

Figure 2. One-way sensitivity analysis results – cumulative savings (15% weight loss, 10 years).