Estimating the lifetime cost of childhood obesity in Germany: Results of a Markov Model

Sonntag, Diana; Ali, Shehzad; Lehnert, Thomas; Konnopka, Alexander; Riedel-Heller, SG; König, Hans‐Helmut

doi:10.1111/ijpo.278

Cited by 52 publications

(68 citation statements)

References 22 publications

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“…Studies also reported a high risk for tracking obesity and its associated metabolic changes from childhood to adulthood [7] which increases the risk of disease, disability, and premature death. Furthermore, it causes a high economic burden for the national health system [8,9]. …”

Section: Introductionmentioning

confidence: 99%

Changing Characteristics of Obese Children and Adolescents Entering Pediatric Lifestyle Intervention Programs in Germany over the Last 11 Years: An Adiposity Patients Registry Multicenter Analysis of 65,453 Children and Adolescents

Bohn

Wiegand²,

Kieß³

et al. 2017

Obes Facts

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Objective: To examine whether characteristics of children and adolescents who start lifestyle intervention (LI) for obesity in Germany changed over the last decade. Methods: 65,453 subjects (<21 years) from the APV database (Adiposity Patients Registry) with a BMI ≥ 90th percentile were included (years 2005-2015). Logistic regression models (confounders: age, sex, migration background) were created for overweight, obesity, extreme obesity, and obesity-related comorbidities. Comorbidities were further adjusted for weight category. Results were stratified by inpatient or outpatient care. Results: Extreme obesity was found to be more frequent at the onset of LI (2005: 11.6; 2015: 12.7%) with a similar trend in subgroups (p < 0.001). Obesity increased (2005: 50.3%; 2015: 55.1%), and overweight decreased (2005: 34.1%; 2015: 29.0%) in the whole study population. Trends were similar for inpatient or outpatient care (all p < 0.001). Hypertension increased from 45.7% to 49.2% in the whole study population, and similar data were obtained in the subgroup of inpatients (both p < 0.0001). Dyslipidemia increased in all patients (2005: 21.9%; 2015: 28.0%) and in inpatients (2005: 20.2%; 2015: 25.7%; both p < 0.0001). Abnormal carbohydrate metabolism rose in all patients (from 5.2 to 6.4%; p = 0.0002) without significant trends in subgroups. Conclusion: During the last decade, children and adolescents presented with higher BMI SDS at the onset of LI and the proportion with obesity-related comorbidities increased. Particularly the presence of comorbidities differed between outpatients and inpatients.

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Section: Introductionmentioning

confidence: 99%

Changing Characteristics of Obese Children and Adolescents Entering Pediatric Lifestyle Intervention Programs in Germany over the Last 11 Years: An Adiposity Patients Registry Multicenter Analysis of 65,453 Children and Adolescents

Bohn

Wiegand²,

Kieß³

et al. 2017

Obes Facts

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show abstract

“…As a result, long-term healthcare consequences and costs cannot be estimated. Only a few international COI studies [5][6][7] have estimated the lifetime cost of childhood overweight and obesity. Fernandes [6] , for example, calculated lifetime costs among the US elementary school population aged 6-11 in 2008, estimating them to be $31,869 for obese boys and $39,815 for obese girls.…”

Section: The Economic Burden Of Childhood Overweight and Obesitymentioning

confidence: 99%

“…When compared with normal weight adults, lifetime excess costs were more than twice or thrice as high among men or women, respectively, in adults who had been obese during childhood [6] . Only 2 pediatric simulation studies in Germany [5,7] considered the long-run economic impact of childhood overweight and obesity, estimating total lifetime costs of €1.8 billion for the current prevalent population (discounted at 3%, cost year 2010). More specifically, Table 1 shows that costs attributable to overweight and obesity are 3 times higher for men and nearly 5 times higher for women with a history of childhood obesity.…”

Section: The Economic Burden Of Childhood Overweight and Obesitymentioning

confidence: 99%

Why Early Prevention of Childhood Obesity Is More Than a Medical Concern: A Health Economic Approach

Sonntag

2017

Ann Nutr Metab

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Background: Childhood overweight and obesity are a non-deniable health concern with increasing economic attention. Summary: International studies provide robust evidence about substantial lifetime excess costs due to childhood obesity, thereby underscoring the urgent need to implement potent obesity prevention programs in early childhood. Fortunately, this is happening more and more, as evidenced by the increase in well-conducted interventions. Nevertheless, an important piece of the puzzle is often missing, that is, health economic evaluations. There are 3 main reasons for this: an insufficient number of economic approaches which consider the complexity of childhood obesity, a lack of (significant) long-term effect sizes of an intervention, and inadequate planning of health economic evaluations in the design phase of an intervention. Key Messages: It is advisable to involve health economists during the design phase of an intervention. Equally necessary is the development of a tailored toolbox for efficient data acquisition.

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“…Furthermore, when severe obesity is present in childhood, there is a high probability that it tracks into adulthood [21,22], leading to health problems and accompanying healthcare costs also later in life [21,23]. When compared with normal-weight adults, men and women who were overweight/obese during their childhood were estimated to have 19,479 EUR and 14,524 EUR higher healthcare costs during their adulthood, respectively [24].…”

Section: Introductionmentioning

confidence: 99%

Economic Evaluation of Intensive Inpatient Treatments for Severely Obese Children and Adolescents

et al. 2017

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Background: Considering the large economic consequences of severe childhood obesity for the society, we aimed to conduct an economic evaluation comparing two intensive 1-year lifestyle treatments with varying inpatient periods for severely obese children and adolescents with regard to standard deviation score BMI (SDS-BMI) and quality-adjusted life years (QALYs). Methods: An economic evaluation from a societal perspective accompanying a randomized controlled trial with a 24-month follow-up. 80 participants (8-19 years) with severe obesity were included. Participants received an intensive 1-year lifestyle treatment with an inpatient period of 2 months (short-stay group) or 6 months (long-stay group). Data were collected at baseline, 6, 12 ,and 24 months and included SDS-BMI and QALYs. Results: SDS-BMI decreased in the first 6 months of treatment, stabilized in the second 6 months, and increased during the 2nd year in both groups. After 24 months, SDS-BMI was similar in both groups, but remained lower than baseline values (mean difference -0.24, 95% CI -0.42; -0.06). There was no difference in QALYs between the groups after 24 months. For SDS-BMI, the probability of the short-stay treatment being cost-effective in comparison with the long-stay treatment was 1 at a willingness-to-pay of 0 EUR/unit of effect, which slowly decreased to 0.54 for larger willingness-to-pay values. Conclusions: Based on the results of this study, the short-stay treatment is considered to be more cost-effective from the societal perspective in comparison with the long-stay treatment. Future research should provide insight in whether the short-stay treatment is cost-effective in comparison with usual care.

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Estimating the lifetime cost of childhood obesity in Germany: Results of a Markov Model

Abstract: Because childhood obesity determines healthcare costs occurring in adulthood, interventions preventing the persistence of child obesity and obesity-related comorbidities during adulthood could have a substantial impact on reducing the burden of the obesity epidemic.

Cited by 52 publications

References 22 publications

Changing Characteristics of Obese Children and Adolescents Entering Pediatric Lifestyle Intervention Programs in Germany over the Last 11 Years: An Adiposity Patients Registry Multicenter Analysis of 65,453 Children and Adolescents

Changing Characteristics of Obese Children and Adolescents Entering Pediatric Lifestyle Intervention Programs in Germany over the Last 11 Years: An Adiposity Patients Registry Multicenter Analysis of 65,453 Children and Adolescents

Why Early Prevention of Childhood Obesity Is More Than a Medical Concern: A Health Economic Approach

Economic Evaluation of Intensive Inpatient Treatments for Severely Obese Children and Adolescents

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