thesis statement child obesity

Childhood Obesity: Causes/Solutions Research Paper

Thesis statement, introduction, statistics about the problem, causes of childhood obesity, steps the government should take to eliminate the problem, works cited, note card i, note card ii.

Childhood obesity is one of the biggest developing health problems associated with the things such as types of foods that children consume, genetic factors, addiction to highly pleasurable foods, and diminished physical activities.

Therefore, failure of the government to take precautionary measures such as controlling the foods served to children, introduction of BMI checking to schoolchildren, and planning of anti-obesity campaigns amongst others will automatically threaten the health of children and that of the population of the nation at large.

Obesity is the development of more weight than the body of an individual is supposed to carry. Ideally, the body of a person should carry weight within a certain range according to the height of the given individual. Much weight for a specific height is deemed overweight and consequently underweight for a much less weight for a specific height.

Therefore, childhood obesity is the development of more weight, which is mostly fats, more than the height can accommodate. It is usually 20% more body fat weight in a child. Childhood obesity is a serious health problem to society due to the frequency of obesity cases that are being reported of late.

The greatest concern brought about by childhood obesity is that it has been identified as a precursor to certain adulthood ailments if not controlled. Thus, controlling it is a way of eliminating some adulthood ailments. As Riley reveals, childhood obesity leads to such ailments as; “hypertension, respiratory ailments, orthopedic problems, depression, type two diabetes, and high cholesterol among others” (395).

According to Green and Riley, childhood obesity has increased threefold since the year 1981. Sixteen per cent percentage of the population of children between the ages of 6 and 19 years suffer from obesity (917).

In the United States, 23% of children coming from poor families are likely to suffer from obesity compared to 14% of those who come from families that are doing well socially and economically (Riley 395). Obesity has led to a rise in the cost of healthcare for the national government with obesity cases consuming up to 71million dollars in terms of treatment between the years 2008-2009.

According to statistics, there has been a 50% increase in obese cases among children of 7-12 years during the years 1991-1998. Eyler finds that the United States of America government has had to come up with policies and legislation that would reverse the trend by the year 2015 (2294). This effort is an indicator to the seriousness of the problem and the concern that the government has towards it. What causes childhood obesity?

The Foods in the Market

One of the biggest causes of childhood obesity is the type of food a child eats. Following the increase in populations and the decrease in the land for agricultural production, scientists have come up with ways of producing high yields of crops on remarkably small pieces of land for feeding the populations. Most of these foods are produced using biotechnology and bioengineering, which lead to high crop yields. Most crops produced using the methods have been cited as sources of obesity upon producing food from them.

High yield crop production involves altering of the genetic makeup of the crops. When consumed by children and or other people, the effects are directly transferred to them. Animals that used as food to human beings are usually fed on foods with high hormones to spur quick growth of the animals. When children feed on products from these animals, the hormones are directly transferred to them thus triggering a faster development of their cells and body tissues hence leading to obesity.

Genetic Factors

Genetic factors can also be attributed to be a cause of childhood obesity that happens when a child grows bigger than the actual size, and then it is cited as a family trend. Some people are naturally grown. This condition sometimes inherited and passes from one generation to the other.

The study further revealed that there is a 75% chance of children being obese if their parents were obese and a 75% chance of children being thin or slim if their parents were thin. This fact is a sure indicator that obesity is a genetic factor that is passed on from parents to their children. The situation can be controlled if the children engage in activities that can enable them burn the extra calories and fats.

Addiction to highly pleasurable foods

According to Pretlow, addiction to highly pleasurable foods can be one of the biggest causes of obesity in children between the age of 5years to 19years (297). Most of these highly pleasurable foods are extraordinarily high in calories thus leading to extremely fast weight gain in children and young adults.

The advent of fast food outlets has exacerbated the problem because most of the foods sold in fast food outlets are highly pleasurable besides containing excess calories. Addiction to these kinds of foods can be equated to some extent to the addiction found in substances like drugs. Addiction to highly pleasurable foods thus leads the child eating more and more of the food. Because they are not in a position to burn the loads of calories gained by their bodies, they tend to begin piling more and more fats in their bodies.

Diminished physical activities

Childhood obesity can be attributed to diminished physical activities among children. Most children nowadays do not engage in physical activities as compared to the past. In the past, most parents would engage their children in physical activities like doing household chores while going out to play at the same time as a way of engaging in fun. That trend has changed dramatically in the recent past with most children engaging in activities that are not energy sapping.

The trend has changed with the introduction of computer games in society. Most children have ended up becoming couch potatoes because they spend almost all of their playing time playing computer games, which are addictive in nature. The increase in television programs has also led to children getting addicted to watching television. Reilly finds that television companies have come up with tailor-made programs for children thus leading to television addiction (395).

Controlling the food served in schools

The government should come up with a policy guideline on what types of food can be served in school kitchens. Nutritionists should recommend the foods because they have the right calorie contents for children at specific ages.

This campaign will see the government prepare a school feeding diet program that is based on healthy eating habits, which are aimed at reducing obesity and hence eliminating it in the end. An observation by Wojcicki and Heyman contends that an awareness program starting from schools is a sure way of controlling obesity (1630).

Introduction of BMI check in schools

The government should introduce a regular body mass index check to all children in schools as a way of checking and regulating the problem. A regular body mass index check will make the children aware of their weight status and the need to keep healthy bodies and lifestyles.

Such checks can also be used for recommending specific physical activity programs to the children as a way of enabling them burn the excess fats that have accumulated in their bodies. Children growing up with the awareness of the right body mass index will be able to control overweight problems when they occur in the future thus ensuring a healthy nation.

Develop a nationwide anti obesity campaign

The government should develop a nationwide campaign that will see the awareness levels of the population increased to such an extent that everyone in society is aware of the problem. Huang observes that a nationwide campaign to eliminate obesity will enable parents bring up their children with awareness of the obesity problem (148).

Most parents are usually unaware of the obesity problem in their children thus ending up not taking the right steps to stop it. The society today is made up of parents who spend a lot of their time chasing their careers than taking care of their children and hence the need to remind them of their responsibility.

Childhood obesity is a complex problem that cannot be easily wished away due to the many different elements that cause to it. It needs a multipronged approach that will control it. The problem with obesity is that it cannot be eliminated. Thus, there is a need for the government to put measures as discussed above to minimize it as much as possible.

Eyler, Army et al. “Patterns and predictions of state childhood obesity legislation in United States: 2006-2009.” American Journal of Public health 102.12 (2012): 2294- 2302. Print.

Green, Gregory, and Riley Clarence. “Physical activity and childhood obesity: Strategies and solutions for schools and parents.” Education 132.4 (2012): 915-920. Print.

Huang, Terry. “Prevention and treatment: Solutions beyond the individual.” Journal of Law, Medicine & Ethics 35 (2007): 148-149. Print.

Pretlow, Robert. Addiction to highly pleasurable food as a cause of the childhood obesity epidemic: A qualitative internet study . Washington D.C: Routledge, 2008. Print.

Riley, John. “Childhood obesity: An overview.” Children & Society 21.5 (2007): 390-396. Print.

Wojcicki, Janet, and Melvin Heyman. “Reducing childhood obesity by eliminating 100% fruit juice.” American Journal of Public Health 102.9 (2012): 1630-1633. Print.

Summary Note Card:

Following the rising impacts that obesity has had on the US citizens, leave alone the children, there has been a call to the government to pass bills that emphasize the need to reduce the danger caused by this fatal disease. Patterns and Predictors of Enactment of State Childhood Obesity Legislation in the United States: 2006-2009 points out the efforts that the US is making to curb the rising trend by 2015. The article reveals how the US has made it a priority to pass bills that address needs of the obese people as a way of ensuring that they are not left to die of the disease when measures can actually be implemented to rescue them and the US at large.

Quotation Note Card:

Eyler et al state, “…the number of bills introduced from 2006 to 2009 with obesity prevention content is encouraging, as is the enactment rate of these bills.”

Eyler, Army et al. “Patterns and predictions of state childhood obesity legislation in United States: 2006-2009.” American Journal of Public health 102.12 (2012): 2298. Print.

Paraphrase Note Card:

According to Eyler et al, the period 2006-2008 has been characterized by tremendous efforts by the US government to publish many bills that specifically touch on the issue of obesity. The findings indicate that the earlier on observed obesity trend in the US will be changing with time with fewer reports of obesity cases.

Despite the many efforts put in place to fight obesity, it is alarming to find out how obesity prevalence is rising in the UK and the US specifically among children and adolescents.

This revelation indicates that the current strategies used to fight the disease do not have a well-crafted message to persuade the children and adolescents to change their eating habits and or engage in strenuous activities to help rid themselves of the many useless calories whose accumulation has led to their obese nature. Hence, there is room for more studies on the best strategies to use to reach the affected children and adolescent if at all eliminating obesity is the goal of both the UK and the US.

“Successful prevention of obesity in future will require good examples or models of interventions which have achieved objectively measured and sustained behavior change”

Riley, John. “Childhood obesity: An overview.” Children & Society 21.5 (2007): 395. Print.

Due to the observed failure of the current strategies to help the obese children and adolescents, there has been a call for future research to incorporate interventions that will have the capacity to alter the observed high rates of obesity among the US and the UK children and adolescents.

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Extent of Weight Stigma in Multiple Settings

Weight stigma in youth, weight stigma and parents and educators, weight stigma and the media, weight stigma in health care, psychological, social, and physical health consequences of weight stigma, emotional and psychological effects, social isolation and academic outcomes, unhealthy eating behaviors, decreased exercise and physical activity, worsening obesity, recommendations, improving clinical practice, advocating against weight stigma, conclusions, appendix 1: resources for practitioners and community members to address weight stigma, lead authors, contributing authors, section on obesity executive committee, 2016–2017, the obesity society executive committee, 2016–2017, the obesity society pediatric obesity section, 2016–2017, stigma experienced by children and adolescents with obesity.

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

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Stephen J. Pont , Rebecca Puhl , Stephen R. Cook , Wendelin Slusser , SECTION ON OBESITY , THE OBESITY SOCIETY; Stigma Experienced by Children and Adolescents With Obesity. Pediatrics December 2017; 140 (6): e20173034. 10.1542/peds.2017-3034

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The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting.

More children in the United States suffer from obesity than from any other chronic condition, with one-third of US children and youth having overweight or obesity and 17% of children 2 to 19 years of age having obesity. 1 In some pediatric populations, such as children living in economically challenged communities, as many as two-thirds of children have overweight or obesity. 2 Although some promising signs suggest the prevalence of obesity may be stabilizing, rates remain unacceptably high, and some studies suggest that the rate of children with severe obesity (BMI ≥120% of the 95th percentile) continues to increase. 1 , 2  

Although numerous efforts are underway to help children and adults reach and maintain a healthy weight, many such efforts do not address the social consequences of obesity, specifically weight stigmatization and discrimination. 3 Weight stigma refers to the societal devaluation of a person because he or she has overweight or obesity and often includes stereotypes that individuals with obesity are lazy, unmotivated, or lacking in willpower and discipline. These stereotypes manifest in different ways, leading to prejudice, social rejection, and overt unfair treatment and discrimination. For children and adolescents with overweight or obesity, weight stigma is primarily expressed as weight-based victimization, teasing, and bullying.

Weight stigmatization is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. 4 However, rather than motivate positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain over time, which worsen obesity and create barriers to healthy behavior change. 5 Experiences of weight stigma also dramatically impair quality of life, especially for youth. A landmark study by Schwimmer et al 6 revealed that children and adolescents with severe obesity had quality-of-life scores that were worse than age-matched children who had cancer. Furthermore, the manifestation of weight stigma is not isolated to older adolescents with severe levels of obesity, because negative weight-based stereotypes toward children with overweight emerge as young as 3 years old. 7 Importantly, peers are not the only sources of weight stigma. Research documents weight stigma by parents and other family members, teachers, health care professionals, and society at large, including the popular media. 3 , 8 , 9 Thus, children are vulnerable to stigma and its negative consequences in school, at home, and in clinical settings.

Pediatricians and pediatric health care professionals strive to improve the health of patients through direct clinical care and through advocating for systemic and environmental change to support the health and success of patients in homes, schools, and communities. Weight stigma is prevalent through numerous settings and negatively affects the health and success of patients across several domains, including personal and social development, education, and the workplace. Many examples throughout the history of public health demonstrate that disease stigma is a legitimate barrier to prevention, intervention, and treatment. Conditions such as HIV/AIDS, various forms of cancer, alcoholism, and drug use were initially stigmatized and required considerable efforts by the medical field to reduce stigma-induced barriers that impaired effective treatment. 10 Weight stigma is no exception but unfortunately remains an ongoing omission in approaches to address obesity. To best support patients’ healthy changes, it is important to recognize, address, and advocate against weight stigma in all settings.

Weight stigma among youth is most often experienced as victimization, teasing, and bullying. In the school setting, weight-based bullying is among the most frequent forms of peer harassment reported by students. As early as preschool, young children attribute negative characteristics and stereotypes to peers with larger body sizes. 11 , 12 By elementary school, negative weight-based stereotypes are common. Students are less likely to offer help to peers with overweight or obesity, and those with overweight or obesity are more likely to be bullied than are students of a healthier weight. 12 , – 14 The likelihood of being targeted by verbal, relational, and physical victimization from peers increases with a student’s BMI percentile. Longitudinal evidence demonstrates that weight status significantly predicts future victimization, with youth of the highest weight being the most vulnerable to bullying. 15 Recent evidence demonstrates that adolescents report the primary reason their peers are teased or bullied at school is because of their weight. 16 Self-reported experiences of bullying, even among racially diverse samples of adolescents, indicate weight-based harassment is the most prevalent form of harassment reported by girls and the second-most common form of harassment among boys. 17 A study of adolescents seeking weight loss treatment found that 71% reported being bullied about their weight in the past year, and more than one-third indicated that the bullying had persisted for >5 years. 9  

Perspectives of parents and educators have similarly identified weight-based bullying as a prevalent and problematic issue. A 2011 national study by the National Education Association examined perspectives of bullying among >5000 educators and found that weight-based bullying was viewed by teachers as the most problematic form of bullying in the classroom, more so than bullying because of a student’s sex, sexual orientation, or disability. 18 In a national study of parents, having overweight was perceived by parents to be the most common reason youth are bullied, and these perspectives remained consistent regardless of their children’s weight status. 19 Furthermore, a recent multinational study (including the United States, Canada, Australia, and Iceland) showed that adults across these countries consistently viewed having overweight as the most common reason youth are bullied. 20 Thus, reports by students, educators, and parents all point to weight-based bullying as a significant problem in the school setting.

Unfortunately, weight-based victimization of youth extends beyond peer relationships. Increasing evidence indicates educators can be sources of weight stigma. Experimental research shows that teachers have lower expectations of students with obesity than they have of students without obesity, including expectations of inferior physical, social, and academic abilities. 21 Data from 5 waves of the Early Childhood Longitudinal Study, Kindergarten found that weight status in students was more negatively related to teachers’ assessments of their academic performance than to their test scores, indicating that teachers rate academic performance of students with obesity as worse than their test performance suggests. 22 Self-report studies have additionally demonstrated negative weight-related stereotypes and beliefs among educators in the school setting. 23 , – 26  

Of concern, parents have also been identified as a source of weight-based victimization toward youth with obesity. In a survey study of adolescents attending weight-loss camps, 37% reported they had been teased or bullied about their weight by a parent. 9 Survey researchers assessing experiences of weight stigma among women with obesity found that family members were reported to be the most prevalent interpersonal source of weight-stigma incidents, with 53% reporting weight stigma from their mothers and 44% reporting it from their fathers. 27 Weight stigma expressed by parents can have a lasting effect on children, who continue to report emotional consequences from these experiences through adulthood. 28  

Beyond the school and home settings, youth are additionally vulnerable to weight stigma through the media. Content analyses of popular children’s television shows and movies reinforce weight stigma through stereotypical portrayals of characters who appear to have larger body sizes. Characters who are visually slim in children’s media are often portrayed as being kind, popular, and attractive, but characters with larger body sizes are depicted as aggressive, unpopular, evil, unhealthy, and the target of humor or ridicule. 29 , – 31 A content analysis of recent children’s movies found 70% included weight-related stigmatizing content, of which 90% targeted characters with obesity. 32 Similarly, research examining popular adolescent television shows identified a significantly higher proportion of weight-stigmatizing content in youth-targeted shows (50%) compared with shows targeting a general audience (38.3%). 33 Given that youth spend multiple hours per day watching television and other media, there is a considerable likelihood they are exposed to negative weight-based stereotypes and stigma. 34 Furthermore, research has documented associations between greater media exposure among youth and increased expressions by those youth of weight stigma toward peers with overweight and obesity. 35 Taken together, this evidence highlights youth-targeted media as sources of weight-based stereotypes that may reinforce and add to stigmatizing messages communicated to children at school and home.

Research shows that health care professionals express weight stigma toward patients with obesity, and patients with obesity frequently feel stigmatized in health care settings. 36 Some research has found that more than two-thirds of women with overweight or obesity report being stigmatized about their weight by doctors. 27 Health care professionals, including physicians, nurses, dietitians, psychologists, and medical trainees, self-report bias and prejudice toward patients with obesity. 8 , 37 Research shows that physicians associate obesity with noncompliance and decreased medication adherence, hostility, dishonesty, and poor hygiene. They often view patients with obesity as being lazy, lacking self-control, and being less intelligent. 8 , 38 Furthermore, this prejudice negatively affects quality of care and can result in patients with obesity being less likely to seek preventive care and delaying or canceling appointments. 39 , – 41 Physicians spend less time and engage in less discussion in office visits with patients with obesity than they do with patients with a lower BMI and are more reluctant to perform preventive health screenings, such as pelvic examinations, cancer screenings, and mammograms, for patients with obesity. Psychologists have been shown to ascribe more pathology, more negative and severe symptoms, and worse prognosis to patients with obesity than to those at a healthier weight but with otherwise similar behavioral health histories. 8 , 36 , 41 Anecdotal reports in the news suggest that patients have been denied care because they have obesity, which suggests a need for future studies exploring this discriminatory practice. 42 Additionally, patients with obesity have reported not being provided with appropriate-sized medical equipment, such as blood pressure cuffs and patient gowns, which results in a less welcoming clinical environment and affects the quality of the health care that is provided. 8 , 38 , 43  

When it comes to youth, even nuances in the language doctors use to discuss body weight with patients can lead to stigma and health care avoidance. Parental perceptions of words commonly used to describe excess body weight were examined in a national study of parents of children 2 to 18 years of age. 44 Parents were asked to evaluate 10 common words regarding the extent to which each word was desirable, stigmatizing, blaming, or motivating for weight loss. The terms “fat,” “obese,” and “extremely obese” were rated as the most undesirable, stigmatizing, blaming, and least motivating. In contrast, more neutral words like “weight” or “unhealthy weight” were rated as the most desirable and motivating for weight loss. 44 , – 46 When parents were asked how they would react if a doctor referred to their children’s weight in a stigmatizing way, 34% responded that they would switch doctors, and 24% stated that they would avoid future medical appointments for their children. 44 Limited literature has evaluated how health care professionals might most effectively and sensitively discuss weight with their patients and families and also with whom pediatric patients prefer to talk with about their weight. 47 , 48 These findings merit further study and underscore the importance of how health care professionals communicate with patients about obesity and weight-related health.

Traditionally, medical school and residency education have provided limited training regarding successful approaches to encouraging health behavior change (eg, motivational interviewing) and addressing obesity in patients and their families, leading health care professionals to report that they do not feel competent or comfortable discussing weight with their patients. 49 , – 51 More training is needed for trainees and practicing health care professionals regarding effective approaches to empowering children and families to make healthy changes. There are different approaches to educating medical students and health care professionals about weight stigma, such as educational strategies that emphasize the complex causes of obesity (eg, biological, genetic, and environmental contributors beyond personal control), communication skills training, interacting with virtual standardized patients, and using brief educational films, role play, and dramatic readings in addition to traditional lecture-style learning. 3 , 52 , – 57 These approaches have been tested in different formats and can be incorporated into health care professional training programs.

Weight stigma poses numerous consequences for the psychological and physical health of children and adolescents, including adverse outcomes that may reinforce unhealthy behaviors that promote obesity and weight gain. Experiences of weight-based teasing and bullying increase the risk for a range of emotional and psychological consequences for youth. Evidence has documented increased vulnerability to depression, anxiety, substance use, low self-esteem, and poor body image among youth who are teased or bullied about their weight. 58 , – 62 These findings persist after accounting for factors such as age, sex, BMI, and age of obesity onset, which suggests stigmatizing experiences rather than just body weight are contributing to these negative outcomes. Of concern, self-harm behaviors and suicidality are also higher among youth who have been teased or bullied about their weight compared with same-weight peers who have not been teased. In addition to higher suicidal attempts reported among adolescents with obesity, research has found that the odds of thinking about and attempting suicide are approximately 2 times higher among girls and boys who are teased about their weight compared with those who are not teased about their weight. 63 , 64  

Weight-based teasing and bullying also contribute to social isolation and adverse academic outcomes for youth. Evidence from the National Longitudinal Study of Adolescent Health demonstrated that compared with students without overweight, adolescents with overweight or obesity are significantly more likely to experience social isolation and are less likely to be nominated as friends by peers. 65 , 66 Youth are keenly aware at an early age that their weight status may affect their social relationships; 1 study found that more than two-thirds of 9- to 11-year-old children who perceived themselves as having excess weight believed they would have more friends if they could lose weight. 37 Teasing that impairs social bonds may have an additional negative effect on academic performance. Weight-based teasing has been found to mediate the relationship between students’ higher BMI and poorer school performance 67 and may lead students to disengage from their school environment. In a recent study, adolescents who reported experiencing weight-based bullying during the previous year indicated that their grades were harmed by these experiences, and they avoided going to school to escape weight-based teasing and bullying. 68 The likelihood of students reporting these reactions increased by 5% per teasing incident even after accounting for sex, race, age, grades, and weight status.

Weight-based victimization may reinforce unhealthy eating behaviors that contribute to increased body weight. Among boys and girls enrolled in weight-loss camps, those who reported weight-based teasing were more likely to engage in unhealthy eating behaviors and binge eating than were peers who were not teased. 69 , 70 Prospective research has demonstrated longitudinal associations between early experiences of weight-based teasing and later disordered eating behaviors. 71 Other work has found links between weight-based teasing and disordered eating for both adolescent boys and girls across weight strata. 65 Among Hispanic and African American girls, weight-based teasing from peers and parents was associated with more emotional eating and binge eating. 72 Retrospective research with young adult women has additionally demonstrated that those who experienced weight-based teasing in childhood are more likely to engage in unhealthy eating behaviors than peers who were not teased, and as the variety of weight-based teasing insults increased in childhood, so did the disordered eating patterns and current body weight status in adulthood. 67  

Experiences of weight-based teasing and bullying have negative implications for exercise motivation and physical activity. Youth who experience more frequent weight-based teasing have decreased levels of physical activity. 73 , 74 Middle school students who report being teased about their weight have less self-confidence in being physically active and lower levels of physical fitness compared with peers who are not teased even after controlling for sociodemographic characteristics. 75 Furthermore, adolescents who report more emotional distress in response to experiences of weight-based teasing are more likely to cope with teasing by avoiding school activities, including physical activities and going to physical education class. 70 These findings raise additional concerns in light of recent research showing that as many as 85% of high school students report witnessing weight-based teasing toward their peers during gym class at school. 19  

Emerging research has demonstrated associations between weight-based teasing and increased body weight status in youth. One study found that compared with girls who did not experience weight stigmatization, girls reporting previous experiences of weight stigmatization had a 64% to 66% increased risk of developing and/or worsening overweight or obesity. 76 , 77 During adolescence, teasing and hurtful weight labels from family members may be especially harmful; evidence from a diverse sample of girls found greater odds of obesity as a result of stigmatization from family members than from friends and teachers. 78 Recent longitudinal evidence additionally shows that weight-based teasing experienced by girls and boys in adolescence predicts higher BMI and obesity for both women and men 15 years later. 79 In addition, several recent longitudinal studies of adults have found that perceived weight stigma and discrimination increase the risk of developing and continuing to have obesity over time even after controlling for baseline BMI, sex, race, and socioeconomic factors. 80 , 81 Furthermore, emerging research reports that perceived pressure to be thin in adolescence is associated with a greater elevation of fasting insulin and poorer insulin sensitivity. The negative effect of emotional pressure on hyperinsulinemia was sustained even after controlling for fat mass and adiposity. 82 Taken together, these findings raise significant concerns about the effects of weight stigma on health behaviors and outcomes of vulnerable youth.

The American Academy of Pediatrics recommends that pediatricians engage in efforts to mitigate weight stigmatization at the practice level and beyond. The following recommendations offer practice-level strategies for pediatricians.

Role Modeling. It is important for pediatricians and pediatric health care professionals to demonstrate and model professional behavior with colleagues, staff, and trainees that is supportive and nonbiased toward children and families with obesity. These efforts should include the recognition and acknowledgment of the complex etiology of obesity, including genetic and socioeconomic factors, environmental contributors, community assets, family and cultural traditions, and individual choices. This recognition can help dispel common assumptions and stereotypes that place blame and judgment solely on individuals for having excess weight or difficulties achieving weight loss.

Language and Word Choice. It is important for pediatricians and pediatric health care professionals to use appropriate, sensitive, and nonstigmatizing language in communication about weight with youth, families, and other members of the pediatric health care team. Words can heal or harm, intentionally and unintentionally. Recent evidence shows that neutral words like “weight” and “body mass index” are preferred by adolescents with overweight and obesity, whereas terms like “obese,” “extremely obese,” “fat,” or “weight problem” induce feelings of sadness, embarrassment, and shame if parents use these words to describe their children’s body weight. 83 , 84 Furthermore, using people-first language is one step to help reduce the use of potentially stigmatizing language, and it is now emerging as the preferred standard with obesity as well as other diseases and disabilities. People-first language places the individual first before the medical condition or disability and involves using phrases such as “a child with obesity” rather than an “obese child.”

Clinical Documentation. Obesity is a medical diagnosis with real health consequences, so it is important for children and families to understand the current and future health risks associated with the degree to which a patient weighs more than what is healthy. However, this should be addressed with a balanced and empathetic approach so that the information is conveyed and understood in a sensitive and supportive manner. Using more neutral terms, such as “unhealthy weight and “very unhealthy weight,” both in clinical notes and when speaking to patients and family members can assist in these efforts. Electronic health records and medical coding nomenclature could consider using the terms “unhealthy weight” and “very unhealthy weight” instead of “obesity” and “morbid obesity” in problem lists to further support the use of patient-sensitive language during clinical encounters.

Behavior Change Counseling. Beyond specific word choice, it is recommended that patient-centered, empathetic behavior change approaches, such as motivational interviewing, be used as a framework to support patients and families in making healthy changes. 85 , – 87 Through motivational interviewing, health care professionals collaboratively engage the patient and/or parents in determining their goals and addressing barriers to how they will achieve sustained health behavior change.

Clinical Environment. Pediatricians should create a safe, welcoming, and nonstigmatizing clinic space for youth with obesity and their families. This requires creating a supportive practice setting that accommodates patients of diverse body sizes, from the clinic entrance to the examination room (see Appendix 1).

Behavioral Health Screening. Addressing weight stigma in clinical practice also necessitates that pediatricians assess patients not only for physical but also emotional comorbidities and negative exposures associated with obesity, including bullying, low self-esteem, poor school performance, depression, and anxiety. 88 , – 90 These are often overlooked but can be signs a child is experiencing weight-based bullying.

Creating a healthy environment in which patients live is critical to effectively address and prevent obesity. As part of these efforts, it is important to promote an environment that supports and empowers youth and families to be healthy rather than reinforcing societal shame or stigma directed toward those with obesity. Thus, pediatricians can be important advocates to reduce weight stigma in multiple settings.

Schools. Pediatricians can work with schools to ensure antibullying policies include protections for students who are bullied about their weight. Given that weight-based bullying is often absent in school policies, advocacy efforts by health care professionals could play an important role in reducing such bullying.

Youth-Targeted Media. It is important that pediatricians and pediatric health care professionals advocate for a responsible and respectful portrayal of individuals with obesity in the media. By speaking out (eg, opinions and commentaries, letters to editors, professional presentations, or commenting on social media) against stigmatizing depictions in the media, pediatric health care professionals can help increase the awareness of weight stigma that can be particularly damaging to children and can reinforce broader societal stigma.

Provider Training. It is important for pediatricians and professional entities to continue to advocate for the inclusion of training to address weight stigma in medical school and residency curricula and through ongoing continuing medical education programs for practicing physicians; and

Parents. It is important for pediatricians and pediatric health care professionals to work to empower families and patients to manage and address weight stigma in schools, communities, and their homes. Pediatricians can encourage parents of patients to actively inquire with their children’s teachers and school administrative staff to ensure that plans are in place to address weight-based victimization in their institutions. Parents should also be asked to consider potential weight stigma at home, of which friends and family members can be sources. Finally, because the rates of obesity are higher in communities that are socioeconomically challenged and in communities of color, additional stigma attributable to race, socioeconomics, and sex could further compound the weight stigma experienced by some individuals, families, and communities. 91  

Obesity is a challenging disease to treat. Many factors are at play, and many of these factors are difficult to effectively address during a short office encounter. The challenges health care professionals may face regarding obesity can affect interactions with patients and unintentionally communicate stigma, blame, or judgment when attempting to increase patient motivation for change. Unfortunately, evidence shows these approaches likely impair rather than improve health behaviors and weight outcomes. In addition, the emotional distress experienced by patients who feel stigmatized can reduce the likelihood of returning for future health care visits.

Supportive health care, community, and educational environments can be sources of strength for patients; however, at present, many of these environments contribute to rather than correct and address damaging weight stigma. Thus, pediatric health care professionals can play an important role in efforts to address the stigmatization of people with obesity and increase the awareness that stigmatizing obesity does not reduce obesity or improve healthful behaviors. By examining their own weight biases, modeling sensitive communication and behavior to children and families with obesity, and taking steps to address weight stigma with their staff, in their clinic environments, and in the broader communities, pediatric health care professionals can make important shifts in the culture of care for children with obesity. With these concerted efforts to reduce weight stigma, interventions can more effectively help and empower patients to improve their weight-related health.

A first step in addressing weight stigma is to become aware of one’s own potential attitudes and assumptions about body weight. The University of Connecticut's Rudd Center for Food Policy and Obesity has several evidence-based resources on weight stigma to help health care professionals raise self-awareness of personal attitudes about obesity, learn how weight stigma can affect patient care, and take actionable steps for personal, clinical, and community change. Resources include educational videos and a free, online continuing medical education course ( http://ruddcentercme.org ).

The American Academy of Pediatrics Institute for Healthy Childhood Weight developed the free “ChangeTalk: Childhood Obesity” online resource ( https://go.kognito.com/changetalk ) for providers to learn and practice motivational interviewing skills with interactive avatars and clinical encounters with a patient and parent challenged by obesity.

When assessing for a sensitive clinical environment, ask the following types of questions to help identify potential aspects of the clinical office environment in which steps can be taken to address weight stigma. Are the chairs in the waiting room able to support the weight of a patient or parent of high body weight? Do the chairs have arm rests that might prevent a larger parent or patient from being able to comfortably sit down? Are available reading materials for patients supportive of healthy lifestyle changes, or do they inadvertently promote unhealthy body images and fad diets? When a patient is brought back to the clinic room, is the scale in a private area, and can it accurately weigh a larger patient? Are there blood pressure cuffs that will accommodate and provide an accurate reading on a larger arm? Are there gowns that will allow larger patients to feel comfortable and not overly exposed when they change?

The Obesity Action Coalition, The Obesity Society, and the Rudd Center for Food Policy and Obesity published guidelines for the portrayal of individuals with obesity in the media ( http://www.obesityaction.org/wp-content/uploads/Guidelines-for-Media-Portrayals-of-Individuals-Affected-by-Obesity-2016.pdf ). 92 These guidelines include the following sections: (1) Respect Diversity and Avoid Stereotypes; (2) Appropriate Language and Terminology; (3) Balanced and Accurate Coverage of Obesity; and (4) Appropriate Pictures and Images of Individuals Affected by Obesity. Following guidelines like these in health communication about obesity can help ensure that messages about obesity are respectful and supportive of people with obesity rather than contributing to societal stigma.

For useful resources to support parents regarding weight-based bullying at school, visit the University of Connecticut's Rudd Center for Food Policy and Obesity’s resources on weight-based bullying ( http://www.ruddrootsparents.org/weight-bias-and-bullying ).

Dr Pont conceptualized the report; Drs Pont and Puhl led the writing of the manuscript; Drs Cook and Slusser served as contributing authors; and all authors contributed to drafts and revisions and approved the final manuscript.

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

Policy statements from the American Academy of Pediatrics benefit from expertise and resources of liaisons and internal (AAP) and external reviewers. However, policy statements from the American Academy of Pediatrics may not reflect the views of the liaisons or the organizations or government agencies that they represent.

The guidance in this statement does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

FUNDING: No external funding.

Stephen J. Pont, MD, MPH, FAAP

Rebecca Puhl, PhD, FTOS

Stephen R. Cook, MD, MPH, FAAP, FTOS

Wendelin Slusser, MD, MS, FAAP

Christopher F. Bolling, MD, FAAP, Chairperson

Sarah Armstrong, MD, FAAP

Natalie Digate Muth, MD, MPH, RD, FAAP

John Rausch, MD, MPH, FAAP

Victoria Rogers, MD, FAAP

Robert P. Schwartz, MD, FAAP

Alyson B. Goodman, MD, MPH – Centers for Disease Control and Prevention

Marc Michalsky, MD, FACS, FAAP

Stephanie Walsh, MD, FAAP

Mala Thapar, MPH

Penny Gordon-Larsen, PhD, FTOS, President

Allen S. Levine, PhD, FTOS, President-Elect

Caroline Apovian, MD, FTOS, Vice President

Martin Binks, PhD, FTOS, Secretary and Treasurer

Nikhil V. Dhurandhar, PhD, FTOS, Immediate-Past President

Stephen R. Cook, MD, MPH, FAAP, FTOS, Chair

Youfa Wang, MD, PhD, MS, FTOS, Chair-Elect

Aaron S. Kelly, PhD, FTOS, Secretary and Treasurer

Simone French, PhD, FTOS, Past Chair

Competing Interests

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How To Write A Strong Obesity Research Paper?

Table of Contents

Obesity is such a disease when the percent of body fat has negative effects on a person’s health. The topic is very serious as obesity poisons the lives of many teens, adults and even children around the whole world.

Can you imagine that according to WHO (World Health Organization) there were 650 million obese adults and 13% of all 18-year-olds were also obese in 2016? And scientists claim that the number of them is continually growing.

There are many reasons behind the problem, but no matter what they are, lots of people suffer from the wide spectrum of consequences of obesity.

Basic guidelines on obesity research paper

Writing any research paper requires sticking to an open-and-shut structure. It has three basic parts: Introduction, Main Body, and Conclusion.

According to the general rules, you start with the introduction where you provide your reader with some background information and give brief definitions of terms used in the text. Next goes the thesis of your paper.

The thesis is the main idea of all the research you’ve done written in a precise and simple manner, usually in one sentence.

The main body is where you present the statements and ideas which disclose the topic of your research.

In conclusion, you sum up all the text and make a derivation.

How to write an obesity thesis statement?

As I’ve already noted, the thesis is the main idea of your work. What is your position? What do you think about the issue? What is that you want to prove in your essay?

Answer one of those questions briefly and precisely.

Here are some examples of how to write a thesis statement for an obesity research paper:

• The main cause of obesity is determined to be surfeit and unhealthy diet.
• Obesity can be prevented no matter what genetic penchants are.
• Except for being a problem itself, obesity may result in diabetes, cancers, cardiovascular diseases, and many others.
• Obesity is a result of fast-growing civilization development.
• Not only do obese people have health issues but also they have troubles when it comes to socialization.

20 top-notch obesity research paper topics

Since the problem of obesity is very multifaceted and has a lot of aspects to discover, you have to define a topic you want to cover in your essay.

How about writing a fast food and obesity research paper or composing a topic in a sphere of fast food? Those issues gain more and more popularity nowadays.

A couple of other decent ideas at your service.

• The consequences of obesity.
• Obesity as a mental problem.
• Obesity and social standards: the problem of proper self-fulfilment.
• Overweight vs obesity: the use of BMI (Body Mass Index).
• The problem of obesity in your country.
• Methods of prevention the obesity.
• Is lack of self-control a principal factor of becoming obese?
• The least obvious reasons for obesity.
• Obesity: the history of the disease.
• The effect of mass media in augmentation of the obesity level.
• The connection between depression and obesity.
• The societal stigma of obese people.
• The role of legislation in reducing the level of obesity.
• Obesity and cultural aspect.
• Who has the biggest part of the responsibility for obesity: persons themselves, local authorities, government, mass media or somebody else?
• Why are obesity rates constantly growing?
• Who is more prone to obesity, men or women? Why?
• Correlation between obesity and life expectancy.
• The problem of discrimination of the obese people at the workplace.
• Could it be claimed that such movements as body-positive and feminism encourage obesity to a certain extent?

Best sample of obesity research paper outline

An outline is a table of contents which is made at the very beginning of your writing. It helps structurize your thoughts and create a plan for the whole piece in advance.

…Need a sample?

Here is one! It fits the paper on obesity in the U.S.

Introduction

• Hook sentence.
• Thesis statement.
• Transition to Main Body.
• America’s modern plague: obesity.
• Statistics and obesity rates in America.
• Main reasons of obesity in America.
• Social, cultural and other aspects involved in the problem of obesity.
• Methods of preventing and treating obesity in America.
• Transition to Conclusion.
• Unexpected twist or a final argument.
• Food for thought.

Specifics of childhood obesity research paper

A separate question in the problem of obesity is overweight children.

It is singled out since there are quite a lot of differences in clinical pictures, reasons and ways of treatment of an obese adult and an obese child.

Writing a child obesity research paper requires a more attentive approach to the analysis of its causes and examination of family issues. There’s a need to consider issues like eating habits, daily routine, predispositions and other.

Top 20 childhood obesity research paper topics

We’ve gathered the best ideas for your paper on childhood obesity. Take one of those to complete your best research!

• What are the main causes of childhood obesity in your country?
• Does obesity in childhood increase the chance of obesity in adulthood?
• Examine whether a child’s obesity affects academic performance.
• Are parents always guilty if their child is obese?
• What methods of preventing childhood obesity are used in your school?
• What measures the government can take to prevent children’s obesity?
• Examine how childhood obesity can result in premature development of chronic diseases.
• Are obese or overweight parents more prone to have an obese child?
• Why childhood obesity rates are constantly growing around the whole world?
• How to encourage children to lead a healthy style of life?
• Are there more junk and fast food options for children nowadays? How is that related to childhood obesity rates?
• What is medical treatment for obese children?
• Should fast food chains have age limits for their visitors?
• How should parents bring up their child in order to prevent obesity?
• The problem of socializing in obese children.
• Examine the importance of a proper healthy menu in schools’ cafeterias.
• Should the compulsory treatment of obese children be started up?
• Excess of care as the reason for childhood obesity.
• How can parents understand that their child is obese?
• How can the level of wealth impact the chance of a child’s obesity?

Childhood obesity outline example

As the question of childhood obesity is a specific one, it would differ from the outline on obesity we presented previously.

Here is a sample you might need. The topic covers general research on child obesity.

• The problem of childhood obesity.
• World’s childhood obesity rates.
• How to diagnose the disease.
• Predisposition and other causes of child obesity.
• Methods of treatment for obese children.
• Preventive measures to avoid a child’s obesity.

On balance…

The topic of obesity is a long-standing one. It has numerous aspects to discuss, sides to examine, and data to analyze.

Any topic you choose might result in brilliant work.

How can you achieve that?

Follow the basic requirements, plan the content beforehand, and be genuinely interested in the topic.

Option 2. Choose free time over struggle on the paper. We’ve got dozens of professional writers ready to help you out. Order your best paper within several seconds and enjoy your free time. We’ll cover you up!

How To Write The Best Paper On Police Brutality?

Why is a ‘how to write assignment’ request too common among learners.

55 Rare Topics For Persuasive Essays

CHILDHOOD OBESITY AND FAMILY INFLUENCE ON CHILDREN’S NUTRITION INTAKE, PHYSICAL ACTIVITY PATTERNS, AND BMI Z-SCORES IN OMAN

Add to collection, downloadable content.

• March 22, 2019
• Affiliation: School of Nursing
• Childhood Obesity is a public health problem. It poses a significant health risk, which has been demonstrated to track into adulthood and decreases children’s physical and psychosocial well-being. The purpose of this study was to examine the relationship between weight status, nutrition intake, and physical activity patterns of Omani middle age children and explore the familial factors that influence them. The sample of the study consisted of 204 Omani mother-child dyads. The mean age of children was 7.74 years (SD ± 1.161). Among examined children, 17.4% were either overweight or obese and more than 72% of mothers were found to be overweight or obese. Weak associations between children’s nutrition and physical activity pattern and obesity were found. Main familial factors that showed influence on children’s nutrition intake were parental education level, family income, and family nutrition and physical activity pattern. Children’s physical activity pattern as reflected by moderate to vigorous physical activity (MVPA), screen time, and sleep time found to be influenced by maternal BMI, parental education level and working status, as well as family nutrition and physical activity pattern. Interestingly, the results of the study indicated that child’s BMI z-score was strongly associated with maternal BMI and parental education level, particularly mothers’.
• physical activity
• https://doi.org/10.17615/ttc7-n970
• Dissertation
• Leeman, Jennifer
• Thompson, Amanda
• Crandell, Jamie
• Berry, Diane
• Brooks, Jada
• Doctor of Philosophy
• University of North Carolina at Chapel Hill Graduate School

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Talking About Childhood Obesity: We Can Do Better

Jennie Day-Burget

Senior Communications Officer, Robert Wood Johnson Foundation

October 23rd, 2023

Since 2005, RWJF has committed more than $1 billion to preventing childhood obesity and helping kids grow up healthy. During that time, we’ve learned important lessons from our grantees, partners, and advocates who are working to create opportunities for kids and families to live healthier lives. And in recent years, we’ve begun to learn more about the inadvertent impact of the language we and others have used to describe the causes and effects of obesity, as well as strategies for preventing it.   

We acknowledge that prevailing narratives on childhood obesity—including those we at RWJF have used—have unintentionally contributed to anti-fat bias in children. We know that kids link feelings of shame, sadness, and embarrassment with terms like “obesity,” “fat,” and “weight problem.” We understand the   limits of using body mass index (a simple ratio of height and weight) to assess individual health and how our overreliance on this measure has caused harm to the children and adults we’re trying to help. We also know that the “epidemic/disease” language often used in the clinic, in the media, and across society has played an important role in raising the profile of the health impacts of obesity—but that these words have also inadvertently created harmful societal connections between larger bodies and diseased bodies.   

We can do better. We’re working to better understand how obesity and weight stigma are being discussed across our culture. We’re investing in message research to build a new, evidence-based narrative that puts people first, focuses on shared values, and communicates a positive vision that empowers us to talk about childhood obesity through the lens of public health, in a way that does not perpetuate stigma and harm.  

We know the use of the word “obesity” in our report title will put some people off. For now, we’re keeping it to ensure we communicate clearly about this work. But we’re changing other things—the stories we tell, the grants we make, and the data we focus on—as we work towards painting a broader perspective about supporting children’s health. We are moving forward with humility and are committed to providing meaningful support in ways that will promote healing and inclusion. 

Explore the full 2023 annual report.

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Early care and education state indicator report 2023.

Strengthening WIC’s Impact During and After the COVID-19 Pandemic

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Economic burden of childhood overweight and obesity: A systematic review and meta‐analysis

Jiying ling.

1 Michigan State University College of Nursing, East Lansing Michigan, USA

2 Georgia Southwestern State University School of Health Sciences, Americus Georgia, USA

Nagwan R. Zahry

3 Department of Communication, University of Tennessee at Chattanooga, Chattanooga Tennessee, USA

Tsui‐Sui Annie Kao

Associated data.

To update existing literature and fill the gap in meta‐analyses, this meta‐analysis quantitatively evaluated the worldwide economic burden (in 2022 US $) of childhood overweight and obesity in comparison with healthy weight. The literature search in eight databases produced 7756 records. After literature screening, 48 articles met the eligibility criteria. The increased annual total medical costs were $237.55 per capita attributable to childhood overweight and obesity. Overweight and obesity caused a per capita increase of $56.52, $14.27, $46.38, and $1975.06 for costs in nonhospital healthcare, outpatient visits, medication, and hospitalization, respectively. Length of hospital stays increased by 0.28 days. Annual direct and indirect costs were projected to be $13.62 billion and $49.02 billion by 2050. Childhood obesity ascribed to much higher increased healthcare costs than overweight. During childhood, the direct medical expenditures were higher for males than for females, but, once reaching adulthood, the expenditures were higher for females. Overall, the lifetime costs attributable to childhood overweight and obesity were higher in males than in females, and childhood overweight and obesity resulted in much higher indirect costs than direct healthcare costs. Given the increased economic burden, additional efforts and resources should be allocated to support sustainable and scalable childhood obesity programs.

1. INTRODUCTION

Childhood obesity is one of the world's most threatening and alarming health problems. Global childhood obesity has skyrocketed with an increase of more than eightfold over 40 years. 1 In 2020, an estimated 39 million children under the age of 5 years and 150 million children aged 5–19 years were overweight or obese. 2 These numbers are estimated to reach 40 and 254 million in 2030. 2 The current global coronavirus disease 2019 (COVID‐19) pandemic has exacerbated this childhood obesity epidemic. A study with 432,302 United States children found that the pandemic doubled the increase rate of body mass index (BMI), with preschoolers and school‐age children experiencing the largest increase. 3 Being overweight in childhood and adolescence was found to be a strong predictor of adult obesity, which imposes serious short‐ and long‐term physical and psychological threats including type 2 diabetes, cardiovascular diseases, increased mortality, premature death, disability, 2 and decreased mental health. 4 Moreover, obesity can adversely affect children and adolescents' school performance and educational attainment because of its negative effects on cognitive functioning. 5

Childhood obesity imposes personal, societal, and economic challenges for children and their parents, communities, and countries. The direct economic consequences of childhood obesity can include medical costs (e.g., prescription drug, emergency room, and outpatient and inpatient costs), whereas the indirect economic consequences can involve labor market costs such as job absenteeism and lower productivity of caregivers because of caring for sick children. 6 Further, childhood overweight and obesity may persist through adulthood resulting in higher lifetime costs including obesity‐related comorbidities and treatments. 7 Studies conducted in the United States found that the incremental lifetime direct medical costs for a 10‐year‐old child with obesity versus the one with a healthy weight ranged from $16,310 to $19,350. 8 Additionally, the added lifetime medical costs related to obesity among US fifth graders were estimated to be $17 billion higher than those who maintained a healthy weight during childhood but gained weight during adulthood, or $25 billion higher than those who maintained a healthy weight during both childhood and adulthood. 9 By the same token, a study conducted in Germany found that individuals with overweight or obesity during childhood increased lifetime costs by 3.7 times in men and five times in women compared with children with a healthy weight. 10 The estimated excess lifetime costs due to obesity were €10,666 ($8458) for males and €15,963 ($12,659) for females. 10

Relative to overweight and obesity in adulthood, there is a scarcity of research in general and systematic reviews in particular related to the economic burden associated with childhood overweight and obesity. To the best of our knowledge, only a few systematic reviews on the economic burden of childhood overweight and obesity were published during 2012–2018. 6 , 8 , 11 For example, one systematic review of 10 studies published up to July 2010 found that six studies estimated inpatient costs and four estimated outpatient and primary care costs. 6 However, this review was not able to quantitatively synthesize the different healthcare costs because of different healthcare models. 6 Another systematic review with six US‐based studies published before May 2013 estimated increased lifetime medical costs of $19,000 for a child with obesity compared with a child with a healthy weight. 8 A more recent systematic review of 13 studies published between January 2000 and February 2016 reported average total lifetime costs of €149,206 ($112,203) for a boy and €148,196 ($111,443) for a girl with obesity compared with a child with a healthy weight. 11 The two later systematic reviews only focused on the lifetime costs of childhood obesity, and no meta‐analysis was conducted yet. Moreover, all three systemic reviews included a small number of studies ( n  = 6–13) published before February 2016. Given the increasing rates of childhood overweight and obesity and the annual growth in healthcare spending, an updated review is merited.

Therefore, to update the existing literature and expand the research on healthcare cost categories (e.g., overall healthcare costs, inpatient costs, outpatient costs, medication costs, and total length of hospital stays), this systematic review and meta‐analysis was conducted to quantitatively estimate the total medical costs (including all medical direct costs of inpatient care, outpatient care, and prescriptions), nonhospital healthcare costs (including costs of outpatient care and prescriptions), outpatient visit costs, prescribed medication costs, hospitalization costs, length of hospital stays, and total population or lifetime costs (i.e., annual direct medical and indirect costs and lifetime direct medical and indirect costs) due to childhood overweight and obesity.

A systematic review and meta‐analysis was conducted. We followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) 12 and the Meta‐analysis Of Observational Studies in Epidemiology (MOOSE) checklist 13 for this report.

2.1. Data sources and search strategy

Our health science librarian conducted a literature search for journal articles, conference abstracts, theses and dissertations, and research reports in the following eight databases: CINAHL, Cochrane, EconLit, Embase, Food Sciences and Technology Abstracts, PsycINFO, PubMed, and Scopus in February 2022. The search focused on three main areas: costs, children or pediatrics, and obesity. Search terms for the costs included healthcare costs, direct costs, indirect costs, economic burden, cost savings, and associated keywords and subject headings. For child, the keywords applied were child, pediatric, adolescents, youth, infants, and associated keywords and subject headings. Lastly, obesity included obesity, overweight, BMI, pediatric obesity, body mass index, and associated keywords and subject headings. The search was modified for each database to include controlled vocabulary but remained largely similar across databases. The search was not date limited. Controlled vocabulary (Medical Subject Headings [MeSH], CINAHL Subject Headings, and EMTREE) as well as keywords were used. The bibliographies of relevant review articles and included eligible articles were also reviewed for potential records.

2.2. Eligibility criteria and study screening

The following inclusion criteria were used for selecting eligible primary articles for this review: (1) mainly included children aged 0–18 years with overweight or obesity and the mean age was under 18 years, (2) the comparison group was children with a healthy weight, (3) calculated increased costs per capita with overweight or obesity compared with subjects with a healthy weight, and (4) written in English. Studies focusing on intervention costs were excluded. Moreover, conference abstracts, theses, dissertations, summary reports, editorials, and expert opinions were not selected. Following the PRISMA flow diagram, two‐step screening was conducted by two independent reviewers: (1) two trained independent reviewers screened each record's title and abstract, and the results were compared and evaluated by the first author, and (2) the first author and a second reviewer carefully screened the full text of each selected article from Step 1 and discussed any discrepancies until reaching an agreement.

2.3. Data extraction

We developed a data extraction form based on previously published reviews. 6 , 11 The form included author, publication year, country, data used for analyses and time frame, child demographic characteristics (e.g., sample size, age, sex, and race), child groups, cost included items, and results on costs (e.g., costs, currency, and year). One trained research assistant extracted relevant data from each selected eligible article following this form, and the first author conducted a thorough review to verify each entry.

We estimated the economic burden of childhood overweight and obesity in US 2022 dollars. Using the purchasing power parities (PPP), 14 we converted different currencies into US dollars for the relevant years. Then we inflated the costs to US dollars ($) in February 2022 using the Consumer Price Index Inflation calculator developed by the US Bureau of Labor Statistics. 15

2.4. Quality appraisal

We adapted the Risk of Bias in Non‐randomized Studies–of Interventions (ROBINS‐I) tool to assess each eligible study's risk of bias. 16 Our adapted evaluation tool included five domains: (1) bias due to confounding, (2) bias in the selection of participants into the study, (3) bias due to missing data, (4) bias in measurements of outcomes, and (5) bias in the selection of the reported results. Following these five domains, two independent evaluators (SC and TK) rated the risk of bias as either low, moderate, serious, or critical for each domain. Results from the two independent evaluators were compared, and inconsistencies were discussed with the first author until reaching a consensus. Studies with low or moderate risk of bias on all five domains were rated to have an overall low risk of bias, and those with any serious or critical risk of bias on any five domains were considered to have an overall high risk of bias. 16 We retained all eligible studies in this review regardless of their risk of biases, but sensitivity analyses were performed to examine the influence of risk of biases (low vs. high) on the economic costs of childhood obesity.

2.5. Data synthesis and analyses

All data analyses were conducted using the Comprehensive Meta‐Analysis Version 3 program ( www.meta-analysis.com ). Difference in means was calculated as the effect size using random‐effects models to compare the healthcare costs or length of hospital stays between children with a healthy weight and those with overweight or obesity, and the number of comparisons or effect sizes was the sample size in meta‐analysis. A positive effect size indicated that children with overweight or obesity had a higher healthcare cost or a longer length of hospital stays than those with a healthy weight. When mean and standard deviation ( SD ) were not reported, median ( m ) and interquartile range ( IQR , q 1, q 3) were used to calculate mean and SD by x ¯ = q 1 + m + q 3 3 and s = q 3 − q 1 1.35 . 17 Influential outliers were identified with standardized residual >2.58 and I 2 being decreased by >10% after removing a potential outlier. 18 Heterogeneity among the included studies was assessed by the Q test and I 2 statistics. Q is the weighted sum of squared differences between individual study effects and pooled effects, and it follows a chi‐square distribution. I 2 statistics of 25%, 50%, and 75% indicated low, moderate, and high levels of heterogeneity. Publication bias was evaluated using the Begg and Mazumdar rank correlation test, Egger's regression asymmetry test, and funnel plot. When both tests' results were significant and funnel plot was asymmetric, there was evidence of publication bias. If publication bias was present, Duval and Tweedie's trim and fill method was used to adjust the effect size. Additionally, sensitivity analyses were performed to examine whether the results were robust according to studies' risk of biases, country, and age.

3.1. Study selection

Figure  1 illustrates the PRISMA flow diagram. The literature search produced 7756 records (CINAHL, 921; Cochrane, 9; EconLit, 21; Embase, 1676; Food Science and Technology Abstracts, 31; PsycINFO, 367; PubMed, 2505; Scopus, 2226), and hand searching through article bibliographies resulted in additional 239 records. After removing duplicates, we screened the titles and abstracts of 4679 records. A total of 141 articles were obtained from the first screening. Further screening the full texts of the 141 articles resulted in 48 eligible articles (see Table  S1 ). Ninety‐three articles were excluded because of being reviews/reports/commentaries/editorials ( n  = 39), abstracts only ( n  = 23), not assessed healthcare costs ( n  = 18), not on childhood obesity ( n  = 9), not in English ( n  = 3), or a dissertation/thesis ( n  = 1). Three studies were excluded from the meta‐analysis because of lack of effect size data reported in published articles and unsuccessful contact with corresponding authors. 19 , 20 , 21

PRISMA flow diagram

3.2. Quality appraisal

Of the 48 studies maintained in this review, 16 (33.3%) were evaluated to have a high risk of bias, and the remaining with a low risk of bias (see Table  1 ). For the 16 studies rated having a high risk of bias, 10 were due to applying self‐ or parent‐reported height and weight for assessing children's weight status, three had missing data >50%, and three did not consider confounding factors during analysis. Regarding the missing data, 10 studies did not report any missing data information, and eight described a missing data proportion ranging between 20% and 50%. One study even did not report the data analysis approach used in the published article. 22

Risk of bias assessment of included studies ( n  = 48)

Notes : 1 = low, 2 = moderate, 3 = serious risk of bias.

3.3. Study characteristics

Among the included 48 studies, 29 were conducted in the United States, seven in Europe (including five in Germany, one in Ireland, and one in the Netherlands), five in Australia, four in Canada, and three in Japan. Publication years ranged from 2002 to 2021: one in 2002, 17 in 2005–2009, 13 in 2010–2014, 12 in 2015–2019, and five in 2020–2021. The average sample size was 412,000, with a range from 200 to 8 million. Among the 48 studies, 16 included all age categories of children (0–18 years), nine included school‐age children and adolescents (6–17 years), three included preschoolers and school‐age children (3–8 years), and 20 included only one age category including three with young children (0–5 years), seven with school‐age children (6–11 years), and 10 with adolescents (12–18 years). About 52.9% were male (range: 41%–86.9%).

Twenty‐one studies (43.8%) examined the total medical costs including inpatient care, outpatient visits, emergency visits, and medication. Three studies (6.3%) focused on the nonhospital healthcare costs, and three other studies (6.3%) assessed only the outpatient visit costs. Eight studies (16.7%) estimated the prescribed medication costs. Fifteen (31.3%) studies focused on hospitalization‐related medical care costs and lengths of hospital stays. Four studies (8.3%) focused on annual population or lifetime direct medical or indirect costs in relation to childhood overweight and obesity.

3.4. Direct healthcare costs

3.4.1. total medical costs.

Thirty‐five comparisons, with a high level of heterogeneity ( Q  = 239,663.71, p  < 0.001; I 2  = 99.99%), evaluated the annual total medical costs between healthy weight and overweight/obesity, and no influential outlier was identified. Overall, being overweight or obese resulted in a per capita increase of $237.55 (95%CI: 165.54, 309.56; p  < 0.001; see Figure  2 ) total medical costs annually during childhood. Specifically, obesity increased the annual total medical costs by $307.72 per capita ( k  = 15; 95%CI: 241.39, 374.04; p  < 0.001), whereas overweight increased the annual total medical costs by $190.51 per capita ( k  = 19; 95%CI: 130.14, 250.88; p  < 0.001), and the differences were statistically significant ( Q  = 6.56, p  = 0.010).

Effect size of total medical costs

3.4.2. Nonhospital healthcare costs

Seven comparisons, without any identified influential outliers, assessed the annual nonhospital healthcare costs and had a high level of heterogeneity ( Q  = 45.12, p  < 0.001; I 2  = 86.70%). The average annual increased costs were $56.52 per capita (95%CI: 27.94, 85.09; p  < 0.001) during childhood attributable to childhood overweight and obesity. Obesity increased the costs by $68.22 per capita annually ( k  = 3; 95%CI: 12.73, 123.70; p  = 0.016), and overweight resulted in an increase of $52.28 per capita ( k  = 4; 95%CI: 13.55, 91.01; p  = 0.008), and the increases were not significantly different ( Q  = 0.21, p  = 0.644).

3.4.3. Outpatient visit costs

One study evaluated the mean outpatient visit costs per year but found no difference between healthy weight and overweight/obesity. 23 Four comparisons, having a high level of heterogeneity ( Q  = 190.70, p  < 0.001; I 2  = 98.43%), evaluated the outpatient visit costs per capita per visit, with an average increase of $14.27 (95%CI: 3.76, 24.78; p  = 0.008) during childhood among children with overweight or obesity. Moreover, obesity resulted in a significantly larger per capita increase of $20.86 per visit ( k  = 2; 95%CI: 12.28, 29.44; p  < 0.001), compared with increased costs of $6.95 ( k  = 2; 95%CI: −0.02, 13.91; p  = 0.050) for being overweight ( Q  = 6.09, p  = 0.014).

3.4.4. Prescribed medication costs

Thirteen comparisons, with no influential outlier but a high level of heterogeneity ( Q  = 19,271.33, p  < 0.001; I 2  = 99.94%), assessed the annual prescribed medication costs during childhood. Being overweight or obese increased the annual prescribed medication costs by $46.38 per capita (95%CI: −5.03, 97.78; p  = 0.077; see Figure  3 ). The increased annual prescribed medication costs per capita were $64.69 ( k  = 5; 95%CI: 13.68, 115.71; p  = 0.013) for being obese and $33.23 ( k  = 8; 95%CI: −8.98, 75.44; p  = 0.123) for being overweight, but the differences were not statistically significant ( Q  = 0.87, p  = 0.352).

Effect size of prescribed medication costs

3.4.5. Hospitalization costs

The primary diagnoses for hospitalization varied across studies including asthma ( k  = 7), pneumonia ( k  = 6), adenotonsillectomy ( k  = 2), appendicitis ( k  = 2), affective disorder ( k  = 2), acute pancreatitis ( k  = 1), urinary tract infection ( k  = 1), and obesity ( k  = 1); resulting in a very high level of heterogeneity ( Q  = 56,051,897.3, p  < 0.001; I 2  = 100%). The average increased per capita hospitalization costs for being overweight or obese were $1975.06 per hospitalization (95%CI: 1816.85, 2133.27; p  < 0.001; see Figure  4 ) during childhood. The increased hospitalization costs were much higher ( Q  = 40.70, p  < 0.001) for being obese ($2439.14, k  = 19; 95%CI: 2135.93, 2742.36; p  < 0.001) than for being overweight ($142.27, k  = 4; 95%CI: −494.92, 779.47; p  = 0.662). When obesity was the primary diagnosis, the increased hospitalization costs were $6997.29 per capita per hospitalization (95%CI: 6864.40, 7130.18; p  < 0.001). Additionally, when the primary diagnosis was appendicitis, urinary tract infection, affective disorder, acute pancreatitis, asthma, pneumonia, or adenotonsillectomy, the increased hospitalization costs were $5503.95 (95%CI: 5370.67, 5637.22; p  < 0.001), $2128.58 (95%CI: 1365.46, 2891.70; p  < 0.001), $1936.45 (95%CI: 1807.25, 2065.66; p  < 0.001), $1846.20 (95%CI: 1707.20, 1985.20; p  < 0.001), $1825.38 (95%CI: 1759.10, 1891.66; p  < 0.001), $1318.37 (95%CI: 1258.90, 1377.84; p  < 0.001), or $902.64 (95%CI: 497.19, 1308.08; p  < 0.001), respectively.

Effect size of hospitalization costs

3.4.6. Length of hospital stays

Twenty‐three comparisons, with no influential outliers but a very high level of heterogeneity ( Q  = 358,237,293, p  < 0.001; I 2  = 100%), evaluated the length of hospital stays during childhood attributed to being overweight or obese. The average length of hospital stays increased by 0.28 days (95%CI: −0.44, 0.99; p  = 0.446; see Figure  5 ) for being overweight or obese, with 0.36 days ( k  = 18; 95%CI: −0.47, 1.18; p  = 0.398) for being obese and 0.002 ( k  = 4; 95%CI: −1.74, 1.75; p  = 0.998) for being overweight, and the differences were not significant ( Q  = 0.13, p  = 0.720).

Effect size of length of hospital stays

3.5. Total population or lifetime costs

Five studies (four in the United States and one in Germany) assessed the total population or lifetime costs due to being overweight or obese. The annual hospital costs associated with childhood obesity were estimated to be $55.59 million in 1979–1981 and $203.13 million in 1997–1999. 24 The average adolescent overweight rate in 1971–2000 would result in excess annual direct medical costs of $177.02 million in 2020 and $13.62 billion in 2050 and annual indirect costs of lost productivity of $1.28 billion in 2020 and $49.02 billion in 2050. 25 The direct medical expenditures in childhood were $1.02 billion in males and $973.39 in females for being overweight in 2003–2006, whereas $1.05 billion in males and $997.46 million in females for being obese in 2003–2006. 26 The direct medical expenditures in adulthood were projected to be $401.29 million in males and $509.81 million in females because of being overweight during childhood and $1.82 billion in males and $2.33 billion in females attributed to childhood obesity. 26 The lifetime medical costs saved due to a 1% reduction in adolescent overweight and obesity in 2000 were $798.37 million ($99.41/capita). 27 One study in Germany found that the excess indirect lifetime costs due to childhood overweight and obesity were $4130.93 per male and $2399.65 per female. 28

3.6. Publication bias

Overall, no strong evidence of publication bias was identified based on the results from the Begg and Mazumdar rank correlation test and Egger's regression asymmetry test and the relative symmetry of funnel plots. For the total medical costs, the Begg and Mazumdar rank correlation test's results were significant ( Tau  = 0.33, z  = 2.83, p  = 0.005), but the Egger's regression asymmetry test's results were not significant ( b  = 15.44, t  = 0.87, p  = 0.392). For medication costs ( Tau  = 0.38, z  = 1.83, p  = 0.067; b  = −10.36, t  = 0.62, p  = 0.548) and hospitalization length of stays ( Tau  = 0.25, z  = 1.66, p  = 0.096; b  = −92.23, t  = 0.39, p  = 0.698), results from both tests were nonsignificant. For the hospitalization costs, results from the Begg and Mazumdar rank correlation test were not significant ( Tau  = 0.23, z  = 1.59, p  = 0.112), but the results from the Egger's regression asymmetry test were significant ( b  = −183.60, t  = 2.15, p  = 0.043).

3.7. Sensitivity analyses

The increased total medical costs (146.52 vs. 292.53, Q  = 3.68, p  = 0.055) and length of hospital stays (0.24 vs. 0.45, Q  = 0.05, p  = 0.827) due to being overweight or obese did not vary significantly between studies with a low risk of bias and those with a high risk of bias. Increased prescribed medication costs were greater among studies with a high risk of bias than those with a low risk of bias (113.38 vs. 22.34, Q  = 7.75, p  = 0.005). However, the increased hospitalization costs were higher in studies with a low risk of bias than those with a high risk of bias (2047.34 vs. 1309.53, Q  = 7.38, p  = 0.007). Studies assessing nonhospital healthcare costs and outpatient visit costs all had a low risk of bias.

As demonstrated in Table  2 , increased total medical and prescribed medication costs due to being overweight or obesity were significantly higher in adolescents aged 12–18 years than among young children, but nonhospital healthcare costs were significantly higher in young children aged 0–5 years than among school‐age children. Overall, direct healthcare costs (i.e., total medical costs, prescribed medication costs, and hospitalization costs) attributable to childhood overweight and obesity were higher in the United States than in other countries.

Direct healthcare costs by country and age categories

4. DISCUSSION

This is the first systematic review and meta‐analysis in the international literature of studies that comprehensively evaluated the average increased total medical costs, nonhospital healthcare costs, outpatient visit costs, prescribed medication costs, hospitalization costs, and length of hospital stays attributable to childhood overweight and obesity. The total population or lifetime costs of childhood overweight and obesity were also synthesized. Overall, being overweight or obese during childhood significantly increased the total medical costs, nonhospital healthcare costs, outpatient visit costs, and hospitalization costs. It is clear that childhood obesity resulted in higher increased total medical costs, outpatient visit costs, and hospitalization costs than childhood overweight. Thus, reducing childhood obesity prevalence could save many preventable healthcare costs.

The increased annual total medical costs attributable to childhood overweight and obesity were $237.55 per capita ($307.72 due to obesity and $190.51 due to overweight) in comparison with a child with a healthy weight. Among the 189 million children who were overweight or obese in 2020 worldwide, 2 the increased total medical costs are approximately $45 billion per year. With the current estimated childhood obesity prevalence of 22% in the United States, 3 the increased total medical costs are about $5 billion per year, accounting for over 1% healthcare spending in the United States. 29 This 1% estimation is within the range of 0.7% and 2.8% of a country's total healthcare expenditures on account of obesity. 30 By 2050, United States' adolescent overweight is projected to cause $13.62 billion in annual direct medical costs and $49.02 billion in annual indirect costs. 25 This study also found that the increased total medical costs attributable to overweight or obesity were highest in older adolescents aged 12–18 years. This may be due to the increased health risks of being obese on developing chronic comorbidities such as type 2 diabetes and cardiovascular diseases in adolescence. 31 , 32 These results indicate the urgent need of preventing childhood overweight and obesity early on.

Nonhospital healthcare and outpatient visit costs also increased because of childhood overweight and obesity. Unfortunately, no previous review was identified to quantitatively synthesize these outpatient care costs among children. Literature in adults found average annual physician visit costs of about $500 per capita ascribable to overweight and obesity. 33 The increased physician visit costs in adults are much higher than the increased costs (annual $40 per capita) in children. 34 The increased nonhospital healthcare costs due to childhood overweight and obesity lead to extra expenditures of approximately 11 billion per year globally and over 1 billion in the United States. 2 , 3 For the increased outpatient visit costs, childhood obesity ascribed to an increase of $20.86 per capita per visit, which is equivalent to about 1 billion annual increased costs in the United States. 34 , 35 Given the increased outpatient care costs attributable to childhood overweight and obesity, healthcare providers at the outpatient settings play the key role of focusing on childhood obesity prevention and treatment through assessing and monitoring weight status, providing healthy lifestyle promotion consultations, and referring to community‐based obesity prevention resources. 36 , 37

Childhood obesity resulted in a significant annual increase of $64.69 per capita in prescribed medication costs. This result is supported by previous literature indicating that children with obesity were more likely to use prescribed medications, especially medications for respiratory conditions, than those with a healthy weight. 38 During the current global COVID‐19 pandemic, obesity is recognized as a strong risk factor of hospitalization and death because of its suppressed effects on the immune system. 39 With the global obesity epidemic colliding with the COVID‐19 pandemic, 40 public and healthcare service actions (i.e., virtual obesity consultation, healthy food accessibility, and active lifestyle promotion) are needed to increase adequate access of effective obesity prevention or treatment resources.

Obesity significantly increased the hospitalization costs by $2439.14 per hospitalization but not the length of hospital stays. The increased hospitalization costs were much higher than the estimation of $1200 in 2000 and $1900 in 2009. 41 The average increased length of hospital stays of 0.36 days attributable to childhood obesity is much lower than the 1.5–1.8 days reported in one United States' study. 41 These mixed results may be due to the widely diverse healthcare systems with different coverages around the world: universal coverage with single‐payer system, universal coverage with multi‐payer system, multi‐payer system with no universal coverage, and no national healthcare infrastructure. 42 Surprisingly, the increased hospitalization costs were much higher when the primary diagnosis was childhood obesity ($6997.29) compared with other diseases ($902.64–5503.95) such as asthma, pneumonia, or appendicitis. This disturbing result highlights the urgent need to control the increasing childhood obesity prevalence.

In comparison with overweight, childhood obesity resulted in higher total medical, outpatient visit, and hospitalization costs but not in the nonhospital healthcare or prescribed medication costs. These results suggest that the excessive increased healthcare costs due to childhood obesity are more related to inpatient care instead of outpatient care or prescriptions. Similarly, one US study also found that the total population direct medical expenditures in both childhood and adulthood were higher in both females and males for being obese than overweight during childhood. 26 Another US study showed that with one‐unit BMI increase among an adult with obesity, the total medical expenditures would increase by $253 per capita. 43 Likewise, studies conducted in Australia and Canada also supported the higher direct healthcare costs due to childhood obesity compared with being overweight. 44 , 45 To prevent children from progressing to severe obesity and, consequently, reduce overall healthcare costs, especially in relation to inpatient care, “the big five” behaviors should be targeted early on: sweetened beverages, fast foods, family meals, media time, and habitual physical activity. 46 Moreover, compared with obesity treatments such as adolescent bariatric surgery that results in negligible effects on reducing childhood obesity prevalence, primary preventions focusing on population behavioral changes are more cost effective. 47 , 48

Interestingly, sex differences are observed in total population and lifetime costs ascribable to childhood overweight and obesity. Direct medical expenditures are higher in males than in females during childhood, but during adulthood, the costs are higher in females than in males. 26 The higher direct healthcare costs in adult women than in men may attribute to the increased functional limitation and disability and longer life expectancy in women. 49 However, the indirect lifetime costs are higher in men than in women. One study in Germany found that the estimated indirect lifetime costs due to childhood overweight and obesity were almost two times higher in males than in females. 28 Consistently, one review also concluded that the total lifetime direct and indirect costs of childhood overweight and obesity were higher in males than in females. 11 The plausible explanation for these sex differences in indirect and total lifetime costs is that women usually have lower employment and wage rates than men because of increased household responsibilities. 50 , 51 As a result, the indirect lifetime costs related to work absenteeism and low productivity due to being obesity may be lower in women than in men. Moreover, childhood overweight and obesity result in much higher indirect lifetime costs than direct healthcare costs. 25 This result is consistent with a previous review with 13 studies showing that indirect costs due to productivity losses were about seven times higher than the direct healthcare costs of childhood overweight and obesity. 11 Therefore, both direct healthcare costs and indirect costs associated with psychosocial problems, mobbing, school absences, and productivity losses should be considered when estimating the economic burden of childhood overweight and obesity.

5. LIMITATIONS

This review has a few limitations, mainly because of the high levels of heterogeneity among studies. First, the included 48 studies were conducted in different countries with different age categories of children, and our results showed cost variations by country and age. Because of the worldwide diverse healthcare systems along with different insurance coverages 42 as well as the increasing rates of obesity‐related comorbidities and decreasing quality of life from childhood to adolescence, 31 , 52 interpretation of the results needs caution. Moreover, the included studies were published from 2002 to 2021. In the past 20 years, the overall healthcare expenditures rose because of new technologies, new medications, more service provided per patient, defensive medicine, insurance system, and free rider programs. 53 , 54 Therefore, the validity of the study's results may be reduced because of the increasing healthcare expenditures and changes in costs associated with new medications and surgery in the past two decades.

6. CONCLUSIONS

Although the included 48 studies varied widely in study data, country, child characteristics such as age, risk of biases, cost included items, and currency used, this review's results consistently demonstrate the increased economic burden attributable to childhood overweight and obesity. Obesity ascribed to much higher increased healthcare costs in comparison with overweight. During childhood, the direct medical expenditures due to obesity are higher among males than among females, but the expenditures become higher in females than in males during adulthood. Overall, the total lifetime costs of childhood overweight and obesity are higher in males than in females, and childhood obesity results in much higher indirect costs than direct healthcare costs. Therefore, given the growing prevalence of childhood overweight and obesity and its increasing economic burden especially the astounding huge indirect lifetime costs, additional efforts and resources should be allocated to support sustainable and scalable obesity prevention and intervention programs. To prevent and mitigate childhood obesity‐related long‐term economic burden in healthcare and productivity losses, early prevention is the most promising tool than later treatment or care. 55 , 56

CONFLICT OF INTEREST

No conflict of interest statement.

Supporting information

Table S1 Summary Table (N = 48)

ACKNOWLEDGMENTS

We would like to thank Michigan State University undergraduate students Nandini Koneru and Madison Penetrante for their assistance in literature screening and data extraction. Also, we want to acknowledge our College of Nursing master‐prepared health science librarian Jessica Sender for her comprehensive literature search for this systematic review.

Ling J, Chen S, Zahry NR, Kao T‐SA. Economic burden of childhood overweight and obesity: A systematic review and meta‐analysis . Obesity Reviews . 2023; 24 ( 2 ):e13535. doi: 10.1111/obr.13535 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]