The proportion of children who are overweight or obese* is rising rapidly across the world, having increased from 4% in 1975 to over 18% in 2016, or around 340 million children (World Health Organization). This presents an urgent need to understand the short- and long-term consequences of excess weight in children, besides the broader societal costs.
The review analysed studies published in the last ten years which have investigated the economic impacts of excess weight in children and adolescents (up to 18 years old). These included both direct costs used to treat or manage childhood overweight/obesity (such as use of health services), and indirect costs due to impacts on time and productivity of families of children with excess weight. Certain studies also estimated the cost-effectiveness of interventions to prevent or treat childhood excess weight, or policies to restrict the availability of unhealthy foods.
In total, the review assessed 110 individual studies published between 2010 and 2021, including 44 recent studies that had not been included in earlier reviews.
- Childhood overweight and obesity led to significant direct and indirect costs, both in the short- and long-term. However, these cost estimates varied significantly between different studies with gender, ethnicity and geographical location all appearing to have an influence.
- Four studies estimated the average annual direct cost of overweight or obesity in children. This ranged from £89 to £1,829 per person per year (2020 prices).
- Three studies estimated the lifetime costs directly associated with childhood excess weight. The mean cost estimates ranged from £1,494 to £27,644 per person (2020 prices).
- Only one study (based in Germany) investigated the lifetime indirect costs associated with childhood excess weight at an individual level. These were estimated to be £2,586 and £4,451 per girl and boy, respectively. This difference between girls and boys was thought to be due to lower rates of full-time employment and lower lifetime earnings among women during adulthood.
- From the studies which investigated the cost-effectiveness of interventions, around 86% of interventions focused on prevention and 79% of interventions focused on treatment were estimated to be cost-effective.
- The review also found evidence that interventions may show greater health benefits and cost-savings for those living in socioeconomically disadvantaged areas, compared with those living in the least disadvantaged areas.
- The studies found evidence that food-pricing policies to limit consumption of unhealthy foods can be effective. In particular, taxes on sugar-sweetened beverages introduced in various countries had cut purchases of these.
Lead author Olu Onyimadu, (a NIHR ARC OxTV DPhil student in the Nuffield Department of Primary Care Health Sciences, said: ‘Our review demonstrates how the estimated direct and indirect costs of childhood excess weight vary significantly across different regions and demographic groups. It provides important evidence for healthcare professionals, policy makers and individuals affected by obesity, besides highlighting key knowledge gaps where future economic research should be targeted.’
Mara Violato, an Associate Professor at HERC and one of Olu’s supervisors, added: ‘In particular, there remains a paucity of evidence on the economic costs of childhood overweight and obesity in low- and middle-income countries, where the rates of these are increasing rapidly. The studies identified in our analysis mostly covered high-income countries, hence there is an urgent need for more original research to be undertaken in a broader range of populations.’
* Overweight and obesity in children and adolescents are defined according to the World Health Organization’s growth reference for school-aged children and adolescents (overweight = 1 standard deviation body mass index for age and sex, and obese = 2 standard deviations body mass index for age and sex).
Health Economic Aspects of Childhood Excess Weight: A Structured Review,
Olu Onyimadu, Mara Violato, Nerys M. Astbury, Susan A. Jebb, and Stavros Petrou. Children 2022, 9(4), 461; https://doi.org/10.3390/children9040461