Health Status, Emotional/Behavioral Problems, Health Care Use, and Expenditures in Overweight/Obese US Children/Adolescents

  • Christy Boling Turer
    Address correspondence to Christy Boling Turer, MD, MHS, Department of Pediatrics, Division of General Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9063.
    Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Tex

    Children's Medical Center Dallas, Dallas, Tex
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  • Hua Lin
    Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Tex
    Search for articles by this author
  • Glenn Flores
    Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Tex

    Children's Medical Center Dallas, Dallas, Tex
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      To examine the association of overweight/obesity with health, health care utilization, and expenditures in a national sample of 10- to 17-year-old children and adolescents.


      Secondary analysis of 2005 to 2009 Medical Expenditure Panel Survey data (n = 17,224). Outcome measures included suboptimal health, emotional/behavioral problems, health care utilization, and expenditures.


      Overweight and obese children and adolescents had greater risk of suboptimal health (adjusted risk ratio [ARR], 1.4 and 1.7; P < .01), use of prescriptions (ARR, both 1.1; P = .01), and emergency department visits (ARR, 1.2 and 1.1; P = .01); overweight children/adolescents had lower mean out-of-pocket expenditures (∼$100, P < .01); and obese children/adolescents had greater risk of emotional/behavioral problems (ARR, 1.2; P < .01) and specialist visits (ARR, 1.1; P = .01). The most common specialty referral among obese children/adolescents was psychiatry. Overweight and obesity were not associated with office visits or total expenditures. A greater proportions of children and adolescents with suboptimal health and emotional/behavioral problems had health care expenditures, and those with suboptimal health were more likely to have out-of-pocket expenditures.


      Pediatric overweight and obesity affect child and adolescent health status, emotional/behavioral problems, and specific domains of health care utilization, but do not appear to be associated with total health care expenditures. Out-of-pocket expenditures are lower among overweight children and adolescents. These findings highlight the need for early intervention in overweight children/adolescents, when health care expenditures may not be greater, and suggest that it may prove useful to pay special attention to the health status and emotional/behavioral problems of overweight and obese children/adolescents in weight-management interventions.


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