Predicted Lifetime Third‐Party Costs of Obesity for Black and White Adolescents with Race‐Specific Age‐Related Weight Gain

Abstract

Original Article EPIDEMIOLOGY/GENETICS Study ImportanceWhat is already known?► Accounting for age-related weight gain causes a huge correction in the lifetime cost of obesity because of the tendency of normal-weight people to face obesity later in life. ► The relative cost of obesity is generally significantly higher for white males and females compared with their black counterparts. ► Age-related weight gain likely occurs fastest among black males and females, although there exist relatively few studies on the subject. What does this study add?► This is the first study to account for differential trends in weight gain throughout adulthood between races, which results in far more realistic estimates of obesity's long-term costs for black males and females. ► This study updates previous estimates on the effect of BMI on life expectancy and medical costs. ► This study demonstrates the powerful divergence in racial health outcomes between even normal-weight black and white males and females. It suggests that obesity in the black community has some of its most profound effects long after adolescence.Objective: There exists enormous variation in estimates of the lifetime cost of adolescent obesity by race. To justify policy measures to reduce obesity rates nationally in this demographic, the costs of obesity in late adolescence must first be discerned. Although several researchers have sought to quantify obesity's true cost, none has accounted for racespecific age-related weight gain, a vital component in producing an accurate estimate.Methods: This paper employs a Markov model of BMI category state changes separately for black and white males and females from age 18 to 75 applied to updated estimates of obesity's costs and effect on mortality to quantify the median lifetime cost of obesity at age 18.Results: This study found lower lifetime costs than previously, largely because of the dramatic gain in weight among normal-weight individuals, particularly black males, that occurs in early adulthood.Conclusions: A substantial portion of obesity's prevalence, and therefore cost, for black males and females comes from age-related weight gain in early adulthood. This speaks to the persistent threat of obesity beyond adolescence for this demographic, and further research should focus on whether policy can modify the behaviors and environment through which and in which this sharp increase in weight occurs.Obesity (2020) 28, 397-403.

Sleep, Health Outcomes and Body Weight (SHOW) study: a measurement burst design study on sleep and risk factors for obesity in black emerging adults in North Carolina, USA

“…Compared with peers in other racial groups, black emerging adults have the highest risk for short sleep duration 3 16–18 and obesity, 19 20 but sleep data are limited to self-report 3 16–18 and actigraphy-based 21 measures. In addition, the CARDIA study reported excessive weight gain (defined as >20 kg) in 15%–22% of black emerging adults (compared with 6%–9% of white emerging adults), 20 and a recent report noted that black emerging adults face the prospect of obesity a full decade before their white counterparts.…”

“…In addition, the CARDIA study reported excessive weight gain (defined as >20 kg) in 15%–22% of black emerging adults (compared with 6%–9% of white emerging adults), 20 and a recent report noted that black emerging adults face the prospect of obesity a full decade before their white counterparts. 19 …”

Effect of migrant parents' bodyweight perception on children's body bodyweight: A longitudinal analysis of population cohort study

“…Childhood overweight and obesity (OVOB) is a global public health problem ( Di Cesare et al, 2019 ) associated with adverse physical and psychological health ( Berardis & Sokal, 2014 ; Quek, Tam, Zhang, & Ho, 2017 ) and lower educational outcomes ( Ma et al, 2020 ). As the condition continues to adulthood ( Ward et al, 2017 ), childhood OVOB is a risk factor for a range of chronic conditions ( Llewellyn, Simmonds, Owen, & Woolacott, 2016 ), leading to higher health costs ( Schell, Just, & Levitsky, 2020 ). While OVOB can affect children of all backgrounds, those born to migrants in developed countries tend to be disproportionately affected ( Hartono, Cochrane, Niyonsenga, & Kinfu, 2021 ; Zulfiqar, Burns, D'Este, & Strazdins, 2019 ).…”

Methodological Challenges in Estimating the Lifetime Medical Care Cost Externality of Obesity

“…This assumption is contrary to fact. Recent work by Fallah-Fini et al (2017) and Schell et al (2020) has found that age-related weight gainthe fact that a person's BMI tends to increase significantly as they age accounts for the majority of costs associated with obesity (Fallah-Fini et al, 2017;Schell et al, 2020). There are numerous other factors that explain the divergence of cost estimates between studies, including the selection of an appropriate cost model and accounting for differential life expectancy, that are essential to producing accurate and consistent estimates.…”

“…Age-related weight gain is a persistent phenomenon found in the USA, where people tend to gain weight with a concomitant rise in adiposity as they age (Williams & Wood, 2006). Despite this fact, relatively few lifetime cost estimates of obesity factor age-related weight gain into their models (Finkelstein et al, 2008;Fallah-Fini et al, 2017;Schell et al, 2020). To understand the sheer complexity of modeling BMI development over time, it is instructive to think about what causes a person to develop obesity in their lifetime.…”