An economic perspective on childhood obesity: Recent findings on cost of illness and cost effectiveness of interventions

Abstract

Objective

This review aims to put an economic perspective on childhood and adolescent obesity by providing an overview on the latest literature on obesity-related costs and the cost effectiveness of interventions to prevent or manage the problem.

Methods

The review is based on a comprehensive PubMed/Medline search performed in October 2011.

Results

Findings on the economic burden of childhood obesity are inconclusive. Considering the different cost components and age groups, most but not all studies found excess health care costs for obese compared with normal-weight peers. The main limitations relate to short study periods and the strong focus on health care costs, neglecting other components of the economic burden of childhood obesity. The results of the economic evaluations of childhood and adolescent obesity programs support the expectation that preventive and management interventions with acceptable cost effectiveness do exist. Some interventions may even be cost saving. However, owing to the differences in various methodologic aspects, it is difficult to compare preventive and treatment approaches in their cost effectiveness or to determine the most cost-effective timing of preventive interventions during infancy and adolescence.

Conclusion

To design effective public policies against the obesity epidemic, a better understanding and a more precise assessment of the health care costs and the broader economic burden are necessary but, critically, depend on the collection of additional longitudinal data. The economic evaluation of childhood obesity interventions poses various methodologic challenges, which should be addressed in future research to fully use the potential of economic evaluation as an aid to decision making.

Introduction

The worldwide prevalence of childhood obesity has increased greatly in recent decades [1], [2], although there is evidence to suggest that rates are leveling off in some countries [3], [4], [5], [6]. The epidemic of childhood obesity is deemed one of the most important public health challenges of this century [7], because obese children are likely to stay obese into adulthood and therefore are more likely in later life to have an increased burden of several diseases, most notably cardiovascular diseases, diabetes, and cancers. The increasing prevalence of childhood obesity is also a major economic concern. Not only are there underlying economic causes of obesity, such as technologic developments or changes in the prices of goods and commodities [8], [9], [10], but also there are serious economic consequences, such as lower skill attainment and academic outcomes, worse labor market outcomes, and an increasing economic burden from health care costs and productivity losses [9]. From a policy perspective, the cost burden to the health care system is of particular interest, considering the already existent trend of an ever-escalating medical expenditure and its reinforcement by the aging of populations. This review aims to present an update of a previous review of research into the economic aspects of childhood and adolescent obesity [11] and to offer further research perspectives. It summarizes the latest findings focusing, first, on the economic burden of childhood and adolescent obesity and, second, on the cost effectiveness of interventions to prevent or manage childhood obesity.