Quantifying the Economic Consequences of Childhood Obesity and Potential Benefits of Interventions

Leonardo Trasande

Disclosures

Expert Rev Pharmacoeconomics Outcomes Res. 2011;11(1):47-50. 

In This Article

Expert Commentary & Five-year View

While total costs were not found to be elevated among obese children, the results identified by Wenig are highly consistent with previous studies, and useful for providing comparable data to support policy efforts in the German (and more generally, the EU) context.[12] Further studies can be performed to refine our understanding of the incremental impact of BMI Z-score on healthcare utilization and costs and to expand understanding of this relationship to developing world contexts where obesity is increasingly common.[16]

However, it is important to point out that there are other, perhaps larger, economic consequences of childhood obesity for the reader to consider in interpreting this study. Multiple large cohort studies have found that obese and overweight children more frequently remain obese and overweight in adulthood.[17–20] Obese/overweight adolescents have been consistently documented to suffer cardiovascular disease, colon cancer and arthritis, even when the excess childhood weight is lost later in life.[21,22] Together, these findings suggest that adult comorbidities of obesity/overweight can be attributed, at least in part, to childhood obesity. Indeed, one study has directly related increases in childhood obesity/overweight prevalence to decreases in future life expectancy, which may produce the first such reversal in the USA since the Great Depression.[23] Multiple studies have also documented added expenditures associated with adult obesity.[24–27] These studies suggest that reductions in childhood obesity/overweight prevalence could produce short-term economic benefits through reductions in childhood obesity and longer term benefits of preventing adult obesity-associated comorbidities that would in part offset the cost of interventions. Even larger gains that are likely to occur from reductions in childhood obesity are improvements in quality of adult life due to reduced obesity-associated disease/disability.

Quantifying these potential economic benefits of reductions in childhood obesity and overweight, however defined, is extremely important to inform policy makers when making decisions about interventions to prevent and treat obesity and its comorbidities. A mathematical model that accounts for these short- and long-term health and economic consequences of childhood obesity found that a US$2 billion/year investment would be warranted if it could reduce obesity prevalence among 12-year-old Americans from 16.3 to 15.3%.[28] In contrast to Wenig's cost-of-illness model, which measures costs attributable to a condition such as obesity, this analysis quantifies quality-adjusted life years and cost savings that could be achieved in childhood and adulthood through reductions in obesity/overweight prevalence. This model relied upon elements that are worthy of improved refinement, such as incremental probability of obesity/overweight given childhood BMI category, and assumes interventions that can be proven to prevent and treat childhood obesity (which are wanting with perhaps the exception of bariatric surgery). However, Wenig's data support the notion that large economic benefits could be achieved once a successful childhood obesity intervention is implemented and sustained. Further research should be focused on the identification of effective environmental, dietary, physical activity and/or pharmaceutical interventions to prevent or treat obesity in childhood.

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