Rx and Obesity, Tracking the Silent Comorbidity

| | Evidence Based Medicine, Utilization Review

Medicine Bottle with Hydrocodone Label and Tablets
Multiple factors contribute to rising workers’ comp claim costs. Two major factors are prescription drugs and obesity. But did you know that one can directly affect on the other? This article will discuss the link between prescription drugs and obesity rates.


According to the Centers for Disease Control (2015), obesity rates continue to rise in the U.S. Recently released statistics show Colorado has the lowest obesity rates at 21.3 percent, and Arkansas has the highest at 35.9 percent.

While interesting, more significant are states where obesity rates are continually increasing. Below is a snapshot of just 5 states explored with Texas leading the race at an increase of 21.2% over the past 14 years.


A study by Duke University found that obese workers were twice as likely to file workers’ compensation claims as their non-obese counterparts. In addition to being twice as likely, obese claimants’ average seven times more in medical costs and miss almost two more weeks of work than claimants who are not obese. Also, they sometimes seek benefits for obesity itself as a consequence of their work-related injury.


According to Helios, a pharmacy benefit management company, prescription drugs Abilify and Lyrica have the highest percentage of weight gain in users, at greater than ten percent. Celebrex, Cymbalta and Neurontin are also in the top 25, with up to ten percent weight gain in users. While weight gain is a known side effect of certain medications, for those who are obese or borderline, taking one or more of these drugs could significantly increase their health risks and mortality rates, which increases claim costs.

A study by Berrington (National Cancer Institute) in 2010 found that for every 5-point increase in BMI (for Caucasians in developed countries) risk of death from all causes increases by 31 percent. Obese people with a BMI of 30 to 34.9 have a 44 percent higher risk of death from any cause, severely obese people (BMI over 35) have an 88 percent higher risk and the most obese (BMI over 40) have a 250 percent higher risk. For a claimant who is five feet, ten inches tall, weighs 200 pounds, and taking Lyrica, that ten percent weight gain can increase their risk of death by 31 percent or more. Who is held accountable for these problems? The medication provider should carefully take into consideration pre-existing obesity, and the additional risk factors of worsening obesity with certain medications, and consider alternatives.

Data is available to help point workers’ comp professionals in a better direction. Software like ReviewStat® from UniMed Direct makes tracking, mining and analyzing data much easier than it used to be. It can be an invaluable tool in managing claim costs, identifying risks and getting claimants back to work faster.

Zenia Cortes, MD, Orthopedic Surgeon

Dr. Zenia Cortes brings her combined expertise in sports and orthopaedic medicine to UniMed Direct, along with insights from her experience in peer and utilization review.