An estimate of the lifetime medical costs of an obese child provides a benchmark of the potential per capita savings that could accrue from successful childhood obesity prevention efforts. We reviewed the literature to identify the best current estimate of the incremental lifetime per capita medical cost of an obese child in the United States today relative to a normal weight child.
We searched PubMed and Web of Science for US-based studies published within the 15 years preceding May 2013 from which lifetime medical cost estimates can be extracted or imputed. Two reviewers independently screened search results and extracted data from eligible articles. All estimates were inflated to 2012 dollars and discounted to reflect costs from the perspective of a 10-year-old child today.
We identified 6 studies. The incremental lifetime direct medical cost from the perspective of a 10-year-old obese child relative to a 10-year-old normal weight child ranges from $12 660 to $19 630 when weight gain through adulthood among normal weight children is accounted for and from $16 310 to $39 080 when this adjustment is not made.
We recommend use of an estimate of $19 000 as the incremental lifetime medical cost of an obese child relative to a normal weight child who maintains normal weight throughout adulthood. The alternative estimate, which considers the reality of eventual weight gain among normal weight youth, is $12 660. Additional research is needed to include estimates of indirect costs of childhood obesity.
I was pleased to see this article, which could potentially be used to build a case for much needed childhood obesity treatment services. However I was surprised to see the statement that 'most obese children will remain obese in adulthood'. I have recently searched the literature for evidence on this and was excited to see two citations supposedly supporting that assertion. Unfortunately neither of them provided the necessary evidence, since one did not actually extend beyond adolescence and the other addressed risk factors for adult obesity, not the persistence of childhood obesity. Actually very few studies have followed obese children into adulthood, but the two fairly substantial studies I found (1-2) both showed that, while most did remain overweight as adults, only 50-70% of obese children and adolescents went on to become obese adults. It may seem overcritical of me to point this out, but if we believe that obesity in childhood and adolescence inevitably leads to obesity in adulthood - where is the hope for intervention?
References
1/ Power, C., Lake, J.K., & Cole, T.J. 1997. Body mass index and height from childhood to adulthood in the 1958 British birth cohort 1-3. American Journal of Clinical Nutrition, 66, 1094-1101 2/ Venn, A.J., Thomson, R.J., Schmidt, M.D., Cleland, V.J., Curry, B.A., Gennat, H.C., & Dwyer, T. 2007. Overweight and obesity from childhood to adulthood: a follow-up of participants in the 1985 Australian Schools Health and Fitness Survey. Med.J Aust., 186, (9) 458-460 available from: PM:17484707
Conflict of Interest:
None declared