CONCLUSION

The undercoding of obesity in claims may contribute to underestimation of the population with obesity, affecting research, policymaking, resource allocation, and prevention and disease management strategies. In this study, ICD-10-CM codes demonstrated high specificity and PPV, suggesting that patients with an obesity code are likely to have BMI-defined obesity. However, the low sensitivity indicates that reliance on diagnosis codes alone is insufficient to identify the full population with obesity. More complete identification, particularly through approaches combining claims data with complementary information such as EHR-derived BMI, may improve population-level estimates and support more accurate assessments of treatment patterns, healthcare resource use, and obesity-related costs. Future research should continue to evaluate methods for identifying obesity in real-world data beyond ICD-10-CM codes alone.

Disclosure

The authors did not receive payment related to the development of the manuscript. Boehringer Ingelheim was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations. The study was supported and funded by Boehringer Ingelheim. Carelon Research, which is under contract from Boehringer Ingelheim. Carelon Research and Boehringer Ingelheim contributed to the conception of the work, study design, and interpretation of results, and drafting and review of the manuscript for medical and scientific accuracy. Carelon Research was responsible for statistical analysis and had access to patient-level study data; Boehringer Ingelheim did not have access to patient-level study data. All authors approved the final manuscript.

Conflict of Interest

The authors declare no conflicts of interest regarding the publication of this paper.