Medical spending higher for youth with obesity, underweight
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Key takeaways:
- Medical expenditures are higher for severely overweight and underweight young people.
- It is important to evaluate youth for underweight in addition to overweight.
Medical spending is higher for children and young adults who do not have a healthy body mass index, including those who are underweight, according to study findings published in JAMA Pediatrics.
Ashutosh Kumar, PhD, a researcher in the CDC’s Division of Nutrition, Physical Activity and Obesity, and colleagues assessed data from 205,876 privately insured children and adolescents aged 2 to 19 years and found that compared with peers of healthy weight, those with a BMI labeled underweight, overweight, moderate obesity or severe obesity had higher total and out-of-pocket medical expenses.
Differences were most evident for those labeled severely obese — $909 in total and $121 in out-of-pocket excess expenditures — and underweight, which was associated with $671 in total and $117 in out-of-pocket excess spending.
Overweight expenditures were highest among females, whereas underweight spending was highest among males.
In an accompanying editorial, Harvard researchers Andrea Luviano, MD, MPH, Ankur Pandya, PhD, and Davene R. Wright, PhD, outlined three themes they deemed important for understanding the implications of the findings: prediction vs. causal implications for BMI-specific health care spending; equity and social determinants of health; and the future of BMI-associated health care expenditures.
“To date, treatments for unhealthy BMI classes have primarily included behavioral interventions, and thus, the costs captured by studies of BMI class-related expenditures likely relate to BMI class-related comorbidities and behavioral interventions,” they wrote.
“Related to overweight and obesity,” they continued, “the therapeutic arsenal for treating childhood obesity may soon change, with a growing movement to use bariatric surgery and pharmacotherapy in child and adolescent populations, as is now recommended by the American Academy of Pediatrics. These more costly treatments may have maintenance costs over a lifetime horizon, meaning that we might see children at a normal BMI class but with very high expenditures due to the use of pharmacotherapy, and we will no longer be able to rely solely on current BMI class-related expenditures as a marker for the costs attributable unhealthy weight.”
They noted the “many nuances” of studies of BMI-associated medial costs.
“As the behavioral, pharmacologic, and surgical therapeutic arsenal for managing pediatric weight disorders evolves, researchers must be conscious of how these cost estimates can and should be used and what populations may have differential access to treatments that could influence costs,” they wrote.
References:
Kumar A, et al. JAMA Pediatr. 2023;doi:10.1001/jamapediatrics.2023.2012.
Luviano A, et al. JAMA Pediatr. 2023;doi:10.1001/jamapediatrics.2023.2018.
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