Health status, hospitalizations, day procedures, and physician costs associated with body mass index (BMI) levels in Ontario, Canada

Figures & data

Table 1 Socio-demographic characteristics in adults (18 years and older)a

	Normal-weight n = 11,828	Underweight n = 2075	Overweight n = 10,033	Obese n = 4861
Age (SD)	43.1 (18.1)	39.9 (20.4)	47.5 (16.0)	47.4 (14.5)
18–39	40.9%	50.7%	29.8%	29.4%
40–59	32.4%	23.7%	38.3%	42.7%
60 and over	26.6%	25.6%	31.9%	27.9%
Gender
Male	46.1%	28.3%	58.8%	52.5%
Female	53.9%	71.7%	41.2%	47.5%
Marital status
Married and common law (living with partner)	61.0%	51.8%	71.4%	66.9%
Single, never married, and other (widowed, separated, divorced)	39.0%	48.2%	28.6%	33.1%
Place of birth
Born in Canada	67.0%	63.5%	69.9%	74.6%
Born elsewhere	33.0%	36.5%	30.1%	25.4%
Education
University degree	42.1%	39.3%	38.5%	29.6%
No University degree	57.9%	60.7%	61.5%	70.4%
Smoking Status
Current smoker	27.5%	30.1%	24.7%	24.2%
Former smoker	35.2%	29.7%	42.2%	43.5%
Never smoked	37.3%	40.2%	33.1%	32.3%
Physical activity
Active	22.7%	21.7%	21.1%	13.5%
Moderate	24.1%	19.5%	23.7%	22.2%
Inactive	53.2%	58.8%	55.2%	64.5%
Working status
Employed	86.6%	87.9%	84.1%	84.2%
Not employed	13.4%	12.1%	15.9%	15.8%
Income
Total personal income	$26,514	$34,614	$40,674	$34,777
Household income	$67,903	$62,005	$69,848	$63,134

a Notes: Based on complete data except for education (n = 16,702 out of 28,797) and working status (n = 24,564 out of 28,797); bold indicates statistical significance (ie, P < 0.05) compared to normal-weight.

Table 2 Medical characteristics for adults with a normal BMI level (18 years and older) and odds ratioa (confidence intervals) by BMI levels (reference: normal-weight)b

	Normal-weight (%)	OR and CIs underweight versus normal-weight	OR and CIs overweight versus normal-weight	OR and CIs obese versus normal-weight
At least 1 medical condition	64.1%	0.92 (0.8, 1.0)	1.2 (1.1, 1.3)	1.8 (1.6, 1.9)
≥3 medical conditions	21.1%	1.1 (1.0, 1.2)	1.3 (1.2, 1.4)	2.1 (2.0, 2.3)
Specific medical conditions
Allergies other than food	28.0%	1.0 (0.9, 1.1)	1.1 (1.0, 1.1)	1.2 (1.1, 1.3)
Back problems	17.6%	1.0 (0.8, 1.1)	1.2 (1.1, 1.3)	1.5 (1.4, 1.6)
Arthritis/rheumatism	15.1%	0.8 (0.7, 0.9)	1.3 (1.3, 1.5)	2.2 (2.0, 2.4)
High blood pressure	9.9%	0.7 (0.5, 0.8)	1.8 (1.7, 2.0)	3.6 (3.3, 4.0)
Other chronic condition	11.7%	1.0 (0.9, 1.2)	1.1 (1.0, 1.2)	1.3 (1.2, 1.5)
Migraine	9.4%	1.0 (0.9, 1.2)	1.2 (1.1, 1.3)	1.5 (1.4, 1.7)
Asthma	9.2%	1.1 (1.0, 1.4)	1.3 (1.1, 1.4)	1.8 (1.6, 2.0)
Food allergies	7.6%	1.1 (0.9, 1.3)	1.0 (0.9, 1.1)	1.0 (0.9, 1.2)
Heart disease	5.1%	1.0 (0.8, 1.2)	1.2 (1.0, 1.3)	1.7 (1.5, 2.0)
Thyroid	4.4%	0.9 (0.7, 1.1)	1.3 (1.1, 1.4)	1.7 (1.5, 1.9)
Diabetes	2.9%	0.6 (0.4, 0.9)	1.8 (1.6, 2.0)	3.8 (3.3, 4.3)
Cataracts	4.1%	0.9 (0.7, 1.1)	1.1 (1.0, 1.3)	1.3 (1.1, 1.6)
Stomach/intestinal ulcers	2.8%	1.2 (0.9, 1.5)	1.2 (1.0, 1.4)	1.6 (1.4, 1.9)
Bronchitis	2.4%	1.3 (1.0, 1.6)	1.0 (0.9, 1.2)	2.0 (1.7, 2.3)
Bowel disorder	2.5%	1.3 (1.0, 1.7)	1.2 (1.0, 1.4)	1.5 (1.2, 1.8)
Urinary incontinence	2.1%	1.2 (0.9, 1.6)	1.3 (1.1, 1.5)	2.4 (2.0, 2.9)
Cancer	1.7%	1.0 (0.7, 1.4)	1.0 (0.8, 1.2)	1.2 (0.9, 1.4)
Glaucoma	1.3%	1.2 (0.8, 1.6)	1.1 (0.9, 1.3)	1.1 (0.9, 1.5)
Fibromyalgia	1.2%	1.0 (0.7, 1.5)	1.4 (1.1, 1.8)	2.3 (1.8, 2.9)
Emphysema or COPD	1.1%	2.6 (1.8, 3.7)	0.9 (0.7, 1.1)	1.6 (1.2, 2.1)
Effects of a stroke	1.3%	1.2 (0.8, 1.8)	0.9 (0.7, 1.2)	1.5 (1.2, 2.0)
Chronic fatigue syndrome	0.9%	1.5 (1.0, 2.3)	1.0 (0.7, 1.3)	1.7 (1.3, 2.4)
Epilepsy	0.5%	1.8 (1.1, 2.9)	0.8 (0.6, 1.2)	1.6 (1.1, 2.4)
Alzheimer’s disease	0.3%	1.0 (0.3, 2.9)	0.7 (0.3, 1.3)	0.9 (0.4, 2.0)
Multiple sclerosis	0.3%	1.7 (0.9, 3.4)	0.5 (0.3, 1.0)	0.7 (0.4, 1.4)

a Notes: Adjusted by age, gender, personal income, physical activity and smoking status;

b based on complete data except for Emphysema or COPD (n = 23,038 out of 28,797 respondents); bold indicates statistical significance (ie, P < 0.05) compared to normal weight.

Abbreviations: BMI, body mass index; OR, odds ratio; CI, confidence interval; COPD, chronic obstructive pulmonary disease.

Table 3 Percentage of adults with specific medications and odds ratioa (confidence intervals) by BMI levels (reference: normal-weight)

	Normal-weight (%)	OR and CIs underweight versus normal-weight	OR and CIs overweight versus normal-weight	OR and CIs obese versus normal-weight
Pain relievers	67.9%	0.8 (0.7, 0.9)	1.1 (1.0, 1.2)	1.2 (1.1, 1.4)
Birth control pills	21.3%	1.1 (0.9, 1.3)	0.9 (0.7, 1.0)	0.9 (0.7, 1.1)
Cough/cold	18.0%	0.9 (0.8, 1.1)	1.1 (1.0, 1.2)	1.2 (1.1, 1.4)
Other	15.3%	1.0 (0.9, 1.2)	1.1 (1.0, 1.2)	1.4 (1.3, 1.6)
Hormones for menopause	13.9%	0.8 (0.6, 0.9)	1.2 (1.0, 1.3)	1.1 (0.9, 1.3)
Blood pressure	9.4%	0.7 (0.6, 0.8)	1.8 (1.6, 2.0)	3.5 (3.1, 3.9)
Stomach	10.4%	1.0 (0.8, 1.1)	1.3 (1.2, 1.4)	1.6 (1.4, 1.8)
Allergy medicine	9.4%	0.9 (0.7, 1.1)	1.0 (0.9, 1.1)	1.1 (1.0, 1.3)
Penicillin/other	8.0%	1.2 (1.0, 1.4)	1.0 (0.9, 1.1)	1.3 (1.1, 1.5)
Asthma medications	5.5%	1.3 (1.1, 1.6)	1.2 (1.1, 1.4)	1.8 (1.6, 2.1)
Codeine/demerol/morphine	5.5%	1.3 (1.1, 1.6)	1.2 (1.1, 1.4)	1.7 (1.4, 1.9)
Medicine for the heart	4.9%	1.0 (0.8, 1.3)	1.2 (1.1, 1.4)	2.0 (1.7, 2.3)
Antidepressants	5.0%	1.0 (0.8, 1.2)	1.2 (1.1, 1.4)	1.8 (1.6, 2.1)
Sleeping pills	4.8%	1.3 (1.0, 1.5)	1.0 (0.9, 1.1)	1.1 (0.9, 1.2)
Diuretics	3.6%	0.8 (0.6, 1.1)	1.5 (1.3, 1.7)	3.3 (2.9, 3.9)
Thyroid	4.1%	0.8 (0.6, 1.0)	1.2 (1.0, 1.4)	1.7 (1.4, 1.9)
Laxatives	3.9%	1.1 (0.9, 1.4)	0.9 (0.8, 1.1)	1.1 (0.9, 1.3)
Control diabetes	1.8%	0.4 (0.3, 0.8)	1.8 (1.5, 2.2)	3.7 (3.1, 4.6)
Tranquilizers	2.7%	1.7 (1.3, 2.2)	1.1 (0.9, 1.3)	1.5 (1.2, 1.8)
Steroids	1.3%	1.2 (0.8, 1.8)	1.2 (1.0, 1.6)	2.0 (1.6, 2.7)
Insulin	0.5%	0.9 (0.5, 1.8)	1.9 (1.4, 2.6)	3.3 (2.4, 4.6)

a Note: Adjusted by age, gender, personal income, physical activity and smoking status; bold indicates statistical significance (ie, P < 0.05) compared to normal weight.

Abbreviations: BMI, body mass index; OR, odds ratio; CI, confidence interval.

Table 4 Health-related quality of life for adults (18 years and older)a

	Normal-weight	Underweight	Overweight	Obese
Mean (SD) HUI3 utility index	0.89 (0.19)	0.85 (0.25)	0.87 (0.19)	0.83 (0.23)
18–39	0.91 (0.17)	0.90 (0.19)	0.91 (0.16)	0.89 (0.19)
40–59	0.88 (0.19)	0.85 (0.24)	0.88 (0.19)	0.82 (0.24)
60 and over	0.80 (0.22)	0.67 (0.31)	0.80 (0.21)	0.74 (0.24)
Self-reported health
Excellent/very good/good	89.7%	85.8%	87.7%	78.7%
Fair/poor	10.4%	14.2%	12.3%	21.2%
Compared to one year ago
Much better/somewhat/about same	89.3%	88.0%	88.3%	84.4%
Somewhat worse/much worse now than 1 year ago	10.7%	11.9%	11.7%	15.6%
Did something to improve health over last year
Yes	52.5%	48.9%	54.6%	55.5%
No	47.5%	51.1%	45.4%	44.5%

a Notes: Based on complete data except for the last question “Did something to improve health over the last year” (n = 27,265 out of 28,797 respondents); bold indicates statistical significance (ie, P < 0.05) compared to normal-weight.

Abbreviation: SD, standard deviation.

Table 5 One year physician, hospitalization, day procedure and total costsa according to BMI categories and cost differences (reference: normal-weight) (mean and 95% confidence intervals)b

	Normal-weight	Underweight	Overweight	Obese
Hospitalisation costs	$166.3 ($144.3, $190.3)	$206.1 ($150.3, $270.6)	$165.2 ($140.0, $190.5)	$233.3 ($192.7, $276.3)
Cost difference	Reference group	$39.8 (−$22.5, $110.6)	−$1.1 (−$35.3, $29.0)	$67.0 ($23.5, $114.2)
Day procedure costs	$57.6 ($49.9, $66.7)	$54.2 ($39.7, $69.1)	$60.1 ($53.6, $67.0)	$67.3 ($58.1, $76.8)
Cost difference	Reference group	−$3.4 (−$18.8, $13.0)	$2.5 (−$8.6, $12.9)	$9.7 (−$0.9, $20.7)
Physician costs	$476.8 ($457.6, $498.4)	$487.8 ($447.1, $530.3)	$463.4 ($441.8, $487.3)	$584.9 ($544.3, $630.8)
Cost difference	Reference group	$11.0 (−$34.3, $56.0)	−$13.4 (−$43.3, $14.1)	$108.1 ($63.9, $155.4)
Total costsa	$708.0 ($668.2, $752.4)	$746.0 ($652.0, $834.6)	$690.3 ($648.2, $736.4)	$884.1 ($806.1, $953.8)
Cost difference	Reference group	$38.0 (−$57.7, $138.9)	−$17.7 (−$74.2, $38.4)	$176.1 ($88.3, $252.8)
Total costs: male	$600.1 ($543.3, $659.8)	$691.3 ($521.6, $911.5)	$540.3 ($497.3, $581.5)	$671.2 ($585.3, $765.5)
Cost difference	Reference group	$91.2 (−$97.4, $312.6)	−$59.8 (−$133.4, $14.1)	$71.1 (−$36.1, $178.3)
Total costs: female	$812.9 ($755.2, $863.3)	$821.4 ($710.1, $944.6)	$849.4 ($781.6, $932.4)	$1121.9 ($1013.4, $1243.5)
Cost difference	Reference group	$8.5 (−$105.1, $140.2)	$36.5 (−$45.0, $128.3)	$309.0 ($185.3, $441.4)
Total costs: Young adults (18–39)	$424.3 ($389.2, $460.0)	$404.1 ($338.8, $480.5)	$436.4 ($394.3, $483.4)	$506.3 ($435.1, $586.6)
Cost difference	Reference group	−$20.2 (−$87.6, $61.6)	$12.1 (−$50.9, $71.4)	$82.0 ($2.0, $176.1)
Total costs: Middle-age adults (40–59)	$673.4 ($613.9, $745.7)	$810.4 ($599.6, $1040.0)	$618.7 ($556.7, $685.5)	$918.3 ($809.3, $1051.2)
Cost difference	Reference group	$137.0 (−$79.1, $382.0)	−$54.7 (−$137.7, $33.6)	$244.9 ($108.9, $393.1)
Total costs: Older adults (60 and +)	$1230.5 ($1123.1, $1348.7)	$1201.9 ($975.8, $1462.3)	$1282.9 ($1162.9, $1399.0)	$1476.1 ($1296.9, $1665.7)
Cost difference	Reference group	−$28.6 (−$268.4, $220.1)	$52.4 (−$95.1, $177.1)	$245.6 ($59.1, $442.3)

a Notes: Total cost = hospitalization costs + day procedure costs + physician costs;

b adjusted for personal income, smoking status, physical activity status, age and gender; all values are Canadian dollars; bold indicates statistical significance (ie, P < 0.05) compared to normal weight.