Pricing Childhood Obesity While Discounting the Future

JAMA Pediatrics has a pair of new papers today on the cost of childhood obesity. One of them adds up the medical expenses incurred by youth aged 2 to 19. The other editorializes about determining the value of interventions to manage weight. Both of them focus on pricing childhood obesity in the present while discounting the future.

A Fine Estimate of Present Medical Spending

In their paper, Ashutosh Kumar and colleagues do a fine job of estimating how much healthcare spending goes into care for young persons with obesity. They used data from IQVIA for electronic medical records and insurance claims. All of these data are limited to privately insured patients. Medicaid patients are definitively excluded.

This is an analysis that considers nothing but BMI and medical costs. Nothing about any real medical diagnoses comes into play. Kumar et al find that on both ends of the BMI range, medical costs go up. A BMI in the range of severe obesity adds about a thousand dollars to annual medical spending for a young person. The relevance of these findings, say the authors, is that they “may indicate potential economic value of interventions or treatments aimed at reducing BMI-associated health risks.”

Complexity and Nuance

In an editorial that accompanies this research, Andrea Luviano and colleagues get one thing right. They note that understanding the value of providing medical care for obesity will require a great deal more accounting for the complexity and nuance of this condition. At the very end of their editorial, they make a fleeting reference to time horizons, but no other mention of the impact of medical care as these young persons move into adulthood

Discounting the Future

Even a cursory reading of the new American Academy of Pediatrics guideline for obesity care should make one thing clear. Up to now, the standard approach has been to sit back, observe, and offer little care for obesity in young persons. But that does not work out well. Obesity persists into adulthood and complications add up.

Caring for obesity in childhood is all about helping these young persons to enhance their quality of life and prevent future health problems. Simply putting a price on minimal medical care for kids with obesity discounts the value of preventing future health issues. It makes no accounting for the cost to quality of life for these young persons today.

Click here for the study and here for the editorial.

Selling Ice Cold Lemonade, photograph by Adam Pieniazek, licensed under CC BY 2.0

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.

July 4, 2023